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Gonzales A, Lin JH, Cha JS. A year-long case study of multicomponent interventions to promote physical activity in office workers: A randomized control trial. APPLIED ERGONOMICS 2024; 120:104333. [PMID: 38876003 DOI: 10.1016/j.apergo.2024.104333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 06/01/2024] [Accepted: 06/06/2024] [Indexed: 06/16/2024]
Abstract
The purpose of this study was to identify if workplace interventions, (i.e., mindfulness classes and monetary incentives for gym attendance), influenced workers' physical activity. Office-based participants were randomized into one of four intervention assignments: 1) CONTROL (no interventions) (n = 40), 2) MINDFULNESS (n = 33), 3) GYM INCENTIVE (n = 41), or 4) BOTH mindfulness and gym incentive (n = 31). Activity-tracker and self-reported metabolic expenditure and step counts were gathered between January 2020 and December 2020 whereas the eight-week long interventions were provided between January and March 2020, when the impact of COVID-19 pandemic started. While physical activity decreased during the follow-up months, percent changes of physical activity at 1-, 2-, and 9-month follow-ups compared to baseline show no significant differences between or across the four intervention assignments (p > 0.05). These results suggest that the intervention assignments had no effect on physical activity from baseline. The lack of effectiveness of these interventions on participant physical activity could be attributed to the influence of the COVID-19 pandemic, and any effects of the interventions could not outweigh the effects of the pandemic.
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Affiliation(s)
- Alec Gonzales
- Department of Industrial Engineering, Clemson University, USA
| | - Jia-Hua Lin
- SHARP, Washington State Department of Labor & Industries, USA
| | - Jackie S Cha
- Department of Industrial Engineering, Clemson University, USA.
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Al-Ozairi E, Irshad M, Al-Ozairi A, Al-Kandari J, Taghadom E, Varghese A, Megahed A, Abdullah A, Murad S, Gray SR. Seasonal differences in physical activity, sedentary behaviour, and sleep patterns in people with type 1 diabetes in Kuwait. Diabetes Metab Syndr 2024; 18:103046. [PMID: 38830288 DOI: 10.1016/j.dsx.2024.103046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024]
Abstract
AIMS The main aim of the current study was to measure physical activity, sedentary behaviors and sleep levels across the different seasons in people with type 1 diabetes in Kuwait. METHODS A prospective cross-sectional study was conducted from August 2021 to September 2022. Physical activity and sleep metrics were measured over a 7-day period with a wrist-worn accelerometer (GENEActiv). Overall physical activity was measured as a Euclidean Norm Minus One in milli gravitational units (mg). Accelerometer metrics were compared across the seasons and between the sex. RESULTS A total of 784 people with type 1 diabetes participated. Mean daily physical activity was 25.2 mg (SD = 7.3). Seasonal differences were seen in overall physical activity (p = 0.05), inactivity (p = 0.04), light activity (p = 0.001), the intensity gradient (p = 0.001) and sleep efficiency (p = 0.02). Poorer metrics were generally seen in Spring and Summer. Overall physical activity, moderate and vigorous physical activity, and inactivity were significantly higher in males compared to females (p ≤ 0.02). Females had a longer sleeping duration (p = 0.02), and higher sleep efficiency (p = 0.04) and light physical activity (p = 0.01). Overall physical activity and the intensity gradient were negatively associated with HbA1c (both p = 0.01). CONCLUSIONS Physical activity levels were generally low and sleep poor in people with type 1 diabetes in Kuwait and these varied by sex and season. The current data are useful to target and develop interventions to improve physical activity and glycemic control.
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Affiliation(s)
| | | | - Abdullah Al-Ozairi
- Dasman Diabetes Institute, Kuwait City, Kuwait; Department of Psychological Medicine, Faculty of Medicine, Kuwait University, Kuwait
| | - Jumana Al-Kandari
- Dasman Diabetes Institute, Kuwait City, Kuwait; Ministry of Health, Kuwait City, Kuwait
| | - Etab Taghadom
- Dasman Diabetes Institute, Kuwait City, Kuwait; Ministry of Health, Kuwait City, Kuwait
| | | | | | | | - Sahar Murad
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Stuart R Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, UK.
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3
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Júdice PB, Silva H, Teno SC, Hetherington-Rauth M. The effectiveness of a 6-month intervention with sit-stand workstation in office workers: Results from the SUFHA cluster randomized controlled trial. Work 2024:WOR230624. [PMID: 38669507 DOI: 10.3233/wor-230624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Prolonged periods of sitting have been linked to negative health outcomes. Implementation of sit-stand desks in the workplace has been one strategy to reduce prolonged sitting. OBJECTIVE To assess the effectiveness of sit-stand workstations on reducing sitting time and improving other health outcomes of office-based workers. METHODS 39 Portuguese office workers were randomized into a 6-month parallel-group cluster RCT consisting by the implementation of sit-stand desks in the workplace. The primary outcome of sitting time was assessed using ActivPAL. Secondary outcomes included biometric, psychological, and diet-related variables. All outcomes were assessed at baseline and 6 months for the whole sample and at 3 months for a sub-sample of the intervention group (n = 11). RESULTS No significant time*group interaction was found for the primary or secondary outcomes, apart from waist circumference favoring the control group (Δ-1.81 cm, pinteraction = 0.04). There were significant changes within the intervention group for sitting time (-44.0 min/day), prolonged sitting (>30 min) (-45.3 min/day) and standing time (51.7 min/day) at 3 months in the sub-sample and in prolonged sitting (>30 min) (-26 min/day) in the full intervention group (p < 0.05). Changes were also observed within the intervention group for percent body fat (Δ-3.7%) and ratings of quality of life (Δ2.2), musculoskeletal discomfort (Δ-4.9), overall fatigue (Δ-2.2), and the need for recovery after work (Δ-1.7) at 6-month follow-up (p < 0.05). CONCLUSION Although not being effective for reducing sitting time, the implementation of sit-stand desks in the Portuguese workspace was shown to be feasible over the long term, received well by users, and may offer other health benefits. TRIAL REGISTRATION OSF Registration, OSF.IO/JHGPW. Registered 15 November 2022. https://doi.org/10.17605/OSF.IO/JHGPW.
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Affiliation(s)
- Pedro B Júdice
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Portugal
- Centro de Investigação Formação Inovação e Intervenção em Desporto (CIFI2D), Universidade do Porto, Portugal
| | - Hélio Silva
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Portugal
| | - Sabrina C Teno
- Centro de Investigação Em Educação Física, Desporto, Saúde e Exercício (CIDEFES), Universidade Lusófona, Portugal
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Kringle EA, Kersey J, Lewis MA, Gibbs BB, Skidmore ER. Similarities and differences in factors associated with high and low sedentary behavior after stroke: a mixed methods study. Disabil Rehabil 2024:1-9. [PMID: 38632899 DOI: 10.1080/09638288.2024.2341867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 04/08/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To identify similarities and differences in factors affecting activity engagement between adults with stroke who are more and less sedentary. MATERIALS AND METHODS Data were pooled from two studies of adults with stroke (N = 36). Sedentary time was measured activPAL micro3. Participants completed activPAL interviews, which were analyzed using framework analysis. Participants were stratified into more and less sedentary groups based on activPAL data. Between-group similarities and differences were identified. RESULTS Adults with stroke (mean [SD] age = 65.8 [13.6] years, stroke chronicity = 40.5 [SD = 38.3] months, 36.1% female) were more sedentary (785.5 [64.7] sedentary minutes/day) and less sedentary (583.6 [87.4] sedentary minutes/day). Those who were more sedentary: engaged in basic activities of daily living, avoided activities, received assistance from other people, and did not use strategies to overcome barriers. Those who were less sedentary: engaged in instrumental and community activities, embraced new strategies, did activities with other people, and used strategies to overcome environmental barriers. CONCLUSIONS Factors affecting activity engagement differed between people who are more and less sedentary. Interventions that aim to reduce post-stroke sedentary behavior should consider the: (1) types of activities, (2) role of other people, and (2) application of strategies to overcome activity and environment-related barriers.
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Affiliation(s)
- Emily A Kringle
- School of Kinesiology, University of MN, Minneapolis, MN, USA
| | - Jessica Kersey
- Program in Occupational Therapy, School of Medicine, WA University, St. Louis, MO, USA
| | | | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West VA University, Morgantown, WV, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
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Vecellio DJ, Lagoa CM, Conroy DE. Physical Activity Dependence on Relative Temperature and Humidity Characteristics in a Young, Insufficiently Active Population: A Weather Typing Analysis. J Phys Act Health 2024; 21:357-364. [PMID: 38290496 DOI: 10.1123/jpah.2023-0438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Physical activity (PA) is an important contributor to one's physical and mental health both acutely and across the lifespan. Much research has done on the ambient environment's impact on PA; however, these studies have used absolute values of atmospheric measures such as temperature and humidity, which vary spatiotemporally and make comparisons between studies which differ in location or time of year difficult to square with one another. METHODS Here, we employ the Global Weather Type Classification, Version 2, to determine the combined impact of temperature and humidity on PA in a sample of insufficiently active young adults. We conducted secondary analyses of data from a single-group behavioral intervention trial that varied the number of digital messages sent daily. Young adults (n = 81) wore Fitbit Versa smartwatches for a 6-month period sometime between April 2019 and July 2020, and location was tracked using a custom smartphone application. RESULTS Mixed linear models indicated that, across 8179 person-days, PA was significantly lower on days with humid conditions and significantly higher on warm dry days, though the latter relationship was no longer significant when controlling for timing in relation to the COVID-19 pandemic declaration. Demographic factors did not affect the relationship between weather and PA. CONCLUSIONS Results are a first step in providing additional guidance for encouraging PA in insufficiently active individuals given forecasted daily weather conditions. Future work should examine seasonal variability in the weather type-PA relationship without the influence of a world-altering event influencing results.
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Affiliation(s)
- Daniel J Vecellio
- Center for Healthy Aging, Pennsylvania State University, University Park, PA, USA
| | - Constantino M Lagoa
- School of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Center for Healthy Aging, Pennsylvania State University, University Park, PA, USA
- Department of Kinesiology, Pennsylvania State University, University Park, PA, USA
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Woldamanuel Y, Bergman P, von Rosen P, Johansson UB, Hagströmer M, Rossen J. Association between Weather and Self-Monitored Steps in Individuals with Prediabetes and Type 2 Diabetes in Sweden over Two Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:379. [PMID: 38673292 PMCID: PMC11050403 DOI: 10.3390/ijerph21040379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Many studies have identified key factors affecting the rates of engagement in physical activity in older adults with chronic disease. Environmental conditions, such as weather variations, can present challenges for individuals with chronic diseases, such as type 2 diabetes when engaging in physical activity. However, few studies have investigated the influence of weather on daily steps in people with chronic diseases, especially those with prediabetes and type 2 diabetes. OBJECTIVE This study investigated the association between weather variations and daily self-monitored step counts over two years among individuals with prediabetes and type 2 diabetes in Sweden. METHODS The study is a secondary analysis using data from the Sophia Step Study, aimed at promoting physical activity among people with prediabetes and type 2 diabetes, which recruited participants from two urban primary care centers in Stockholm and one rural primary care center in southern Sweden over eight rounds. This study measured physical activity using step counters (Yamax Digiwalker SW200) and collected self-reported daily steps. Environmental factors such as daily average temperature, precipitation, and hours of sunshine were obtained from the Swedish Meteorological and Hydrological Institute. A robust linear mixed-effects model was applied as the analysis method. RESULTS There was no association found between weather variations and the number of steps taken on a daily basis. The analysis indicated that only 10% of the variation in daily steps could be explained by the average temperature, precipitation, and sunshine hours after controlling for age, gender, and BMI. Conversely, individual factors explained approximately 38% of the variation in the observations. CONCLUSION This study revealed that there was no association between weather conditions and the number of daily steps reported by individuals with prediabetes and type 2 diabetes taking part in a physical activity intervention over two years. Despite the weather conditions, women and younger people reported more steps than their male and older counterparts.
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Affiliation(s)
- Yohannes Woldamanuel
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
| | - Patrick Bergman
- Department of Medicine and Optometry, eHealth Institute, Linnaeus University, 391 82 Kalmar, Sweden;
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden;
| | - Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
| | - Maria Hagströmer
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Academic Primary Care Center, Region Stockholm, 113 65 Stockholm, Sweden
| | - Jenny Rossen
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
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Ferguson T, Curtis R, Fraysse F, Olds T, Dumuid D, Brown W, Esterman A, Maher C. The Annual Rhythms in Sleep, Sedentary Behavior, and Physical Activity of Australian Adults: A Prospective Cohort Study. Ann Behav Med 2024; 58:286-295. [PMID: 38394346 DOI: 10.1093/abm/kaae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Sleep, sedentary behavior, and physical activity have fundamental impacts on health and well-being. Little is known about how these behaviors vary across the year. PURPOSE To investigate how movement-related behaviors change across days of the week and seasons, and describe movement patterns across a full year and around specific temporal events. METHODS This cohort study included 368 adults (mean age = 40.2 years [SD = 5.9]) who wore Fitbit activity trackers for 12 months to collect minute-by-minute data on sleep, sedentary behavior, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Data were analyzed descriptively, as well as through multilevel mixed-effects linear regression to explore associations with specific temporal cycles (day-of-the-week, season) and events. RESULTS Movement patterns varied significantly by day-of-the-week and season, as well as during annual events like Christmas-New Year and daylight saving time (DST) transitions. For example, sleep was longer on weekends (+32 min/day), during autumn and winter relative to summer (+4 and +11 min/day), and over Christmas-New Year (+24 min/day). Sedentary behavior was longer on weekdays, during winter, after Christmas-New Year, and after DST ended (+45, +7, +12, and +8 min/day, respectively). LPA was shorter in autumn, winter, and during and after Christmas-New Year (-6, -15, -17, and -31 min/day, respectively). Finally, there was less MVPA on weekdays and during winter (-5 min/day and -2 min/day, respectively). CONCLUSIONS Across the year, there were notable variations in movement behaviors. Identifying high-risk periods for unfavorable behavior changes may inform time-targeted interventions and health messaging.
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Affiliation(s)
- Ty Ferguson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Rachel Curtis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Wendy Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland 4072, Australia
| | - Adrian Esterman
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, City East Campus, Frome Road, GPO Box 2471, Adelaide, SA, 5001, Australia
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Benavente-Marín JC, Barón-López FJ, Gil Barcenilla B, Longo Abril G, Rumbao Aguirre JM, Pérez-Farinós N, Wärnberg J. Accelerometry-assessed daily physical activity and compliance with recommendations in Spanish children: importance of physical education classes and vigorous intensity. PeerJ 2024; 12:e16990. [PMID: 38468640 PMCID: PMC10926909 DOI: 10.7717/peerj.16990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/30/2024] [Indexed: 03/13/2024] Open
Abstract
Background Physical activity (PA) is associated with numerous health benefits. Vigorous PA (VPA) may have a greater impact on public health than lower-intensity PA. The incorporation of a specific recommendation on VPA could complement and improve existing recommendations for average daily moderate-vigorous PA (MVPA). Physical education classes could have a positive impact on children's adherence to average daily physical activity recommendations. The aim was to investigate the association between MVPA and VPA in children, as well as adherence to recommendations, and obesity and the presence of physical education classes. Methods A cross-sectional study of physical activity was conducted in a sample of 8 and 9-year-old children in Andalusia (Spain). GENEActiv accelerometers were used, placed on the non-dominant wrist for at least eight consecutive days (24-h protocol). School days with and without physical education class, and weekend days were defined. ROC curves were used to calculate the threshold associated with obesity for average daily MVPA and VPA for recommendations. Results A total of 360 schoolchildren were included in the analyses (184 girls). An average of 7.7 (SD 1.4) valid days per participant were evaluated, with 19.9 (SD 10.5) and 11.4 (SD 5.1) minutes of VPA performed by boys and girls respectively. 25.8% of the participants were classified with central obesity. The optimal threshold determined with ROC analysis was 12.5 and 9.5 minutes of average daily VPA for boys and girls, respectively (RecVPA), and 75 minutes of average daily MVPA for both sexes (RecMVPA). The RecVPA showed stronger association with obesity. On school days with physical education class, compared to days without this class, children showed increased VPA and MVPA engagement and better compliance with recommendations, with smaller differences in adherence according to sex or obesity. Conclusions On days with physical education class, more physical activity was accumulated at all intensities and greater adherence to the recommendations than on days without this class. VPA had a stronger correlation with the absence of obesity than lower-intensity activity. It was also observed that boys were physically more active and had higher adherence to the recommendations than girls.
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Affiliation(s)
- Juan Carlos Benavente-Marín
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Francisco Javier Barón-López
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Begoña Gil Barcenilla
- Plan Integral de Obesidad Infantil de Andalucía (PIOBIN), Consejería de Salud y Consumo. Junta de Andalucía, Sevilla, Spain
| | - Guadalupe Longo Abril
- Plan Integral de Obesidad Infantil de Andalucía (PIOBIN), Consejería de Salud y Consumo. Junta de Andalucía, Sevilla, Spain
| | - José M. Rumbao Aguirre
- Plan Integral de Obesidad Infantil de Andalucía (PIOBIN), Consejería de Salud y Consumo. Junta de Andalucía, Sevilla, Spain
| | - Napoleón Pérez-Farinós
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Julia Wärnberg
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
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Yang H, Gould CA, Jones R, St Juliana A, Sarofim M, Rissing M, Hahn MB. By-degree Health and Economic Impacts of Lyme Disease, Eastern and Midwestern United States. ECOHEALTH 2024; 21:56-70. [PMID: 38478199 PMCID: PMC11127817 DOI: 10.1007/s10393-024-01676-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/20/2024] [Indexed: 05/26/2024]
Abstract
Lyme disease (LD) is the most common vector-borne disease in the United States (U.S.). This paper assesses how climate change may influence LD incidence in the eastern and upper Midwestern U.S. and the associated economic burden. We estimated future Ixodes scapularis habitat suitability and LD incidence with a by-degree approach using variables from an ensemble of multiple climate models. We then applied estimates for present-day and projected habitat suitability for I. scapularis, present-day presence of Borrelia burgdorferi, and projected climatological variables to model reported LD incidence at the county level among adults, children, and the total population. Finally, we applied an estimate of healthcare expenses to project economic impacts. We show an overall increase in LD cases with regional variation. We estimate an increase in incidence in New England and the upper Midwestern U.S. and a concurrent decrease in incidence in Virginia and North Carolina. At 3°C of national warming from the 1986-2015 baseline climate, we project approximately 55,000 LD cases, a 38-percent increase from present-day estimates. At 6°C of warming, our most extreme scenario, we project approximately 92,000 LD cases in the region, an increase of 145 percent relative to current levels. Annual LD-related healthcare expenses at 3°C of warming are estimated to be $236 million (2021 dollars), approximately 38 percent greater than present-day. These results may inform decision-makers tasked with addressing climate risks, the public, and healthcare professionals preparing for treatment and prevention of LD.
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Affiliation(s)
- Haisheng Yang
- Abt Associates, 6130 Executive Boulevard, Rockville, MD, 2085, USA
| | - Caitlin A Gould
- Climate Change Division, Climate Science and Imapcts Branch, U.S. Environmental Protection Agency, 1200 Pennsylvania Ave NW, 4226-G South, Washington, DC, 20460, USA.
| | - Russ Jones
- Abt Associates, 6130 Executive Boulevard, Rockville, MD, 2085, USA
| | | | - Marcus Sarofim
- Climate Change Division, Climate Science and Imapcts Branch, U.S. Environmental Protection Agency, 1200 Pennsylvania Ave NW, 4226-G South, Washington, DC, 20460, USA
| | - Matt Rissing
- Abt Associates, 6130 Executive Boulevard, Rockville, MD, 2085, USA
| | - Micah B Hahn
- Institute for Circumpolar Health Studies, University of Alaska-Anchorage, 3211 Providence Drive, Anchorage, AK, 99508, USA
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Benavente-Marín JC, Barón-López FJ, Gil Barcenilla B, Longo Abril G, Rumbao Aguirre JM, Pérez-Farinós N, Wärnberg J. Adherence to the WHO recommendation of three weekly days of vigorous intensity activities in children: an accelerometry study of vigorous physical activity bouts. PeerJ 2024; 12:e16815. [PMID: 38406285 PMCID: PMC10893867 DOI: 10.7717/peerj.16815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024] Open
Abstract
Background The World Health Organization (WHO) recommends that children and adolescents incorporate vigorous intensity activities (VIAs) at least three days a week. This recommendation has not been sufficiently studied using objective methods, such as accelerometry. Physical education classes and extracurricular sports activities are optimal opportunities for compliance with this recommendation. Objective To identify VIAs through bouts of vigorous physical activity (VPA-Bouts) evaluated with accelerometry and, with this, to know the compliance with the recommendation on VIAs. Methods A cross-sectional study of the habitual physical activity of 353 children (8-9 years old) was carried out using accelerometry and participation in organized extracurricular sports activities was asked through a questionnaire. School days with and without physical education class, weekends, and the average weekly day were identified, as well as school time and out-of-school time. A VPA-Bout was defined as an interval of at least 60 minutes with a proportion of VPA of at least 16.7% in boys and 12.5% in girls (10.0 and 7.5 minutes/hour of VPA, respectively). Results The average daily time in organized extracurricular sports activities declared by questionnaire and the average daily duration of the VPA-Bouts evaluated with accelerometers in the extracurricular period was 21.3 (SD 19.8) and 23.9 (SD 31.2) minutes, respectively, in boys, whereas, in girls it was 20.2 (SD 17.4) and 11.0 (SD 16.9) minutes, respectively. In school time including a physical education class, there was a higher proportion of VPA-Bouts than without these classes (with: 28.6%, without: 2.1%, p < 0.001). Children who reported at least three weekly hours of organized extracurricular sports activities accumulated a higher proportion of school afternoons with VPA-Bouts than those with fewer weekly hours of this type of activities (≥3 hours/week: 27.5%, <3 hours/week: 9.3%, p < 0.001). On the weekend, boys who reported at least three weekly hours of organized extracurricular sports activities performed more VPA-Bouts than those participating in less weekly hours, while in girls no significant differences were observed (weekend; boys, ≥3 hours/week: 26.0%, <3 hours/week: 9.0%, p < 0.001; girls: 8.3%, 8.0%, p = 0.917). Compliance with the recommendation to incorporate VIAs at least three days a week was 23.8%. Children who reported at least three weekly hours of extracurricular sports activities achieved higher compliance than those who reported fewer extracurricular activities (≥3 hours/week: 35.1%, <3 hours/week: 12.7%, p < 0.001). Additionally, boys showed higher compliance rates than girls (boys: 32.9%, girls: 15.3%, p < 0.001). Conclusion One in every four children met the WHO recommendation to incorporate VIAs at least three days a week, as evaluated by accelerometry. Physical education classes and extracurricular organized sports activities contributed to compliance with this recommendation.
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Affiliation(s)
- Juan Carlos Benavente-Marín
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Francisco Javier Barón-López
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Begoña Gil Barcenilla
- Plan Integral de Obesidad Infantil de Andalucía (PIOBIN), Consejería de Salud y Consumo. Junta de Andalucía, Sevilla, Spain
| | - Guadalupe Longo Abril
- Plan Integral de Obesidad Infantil de Andalucía (PIOBIN), Consejería de Salud y Consumo. Junta de Andalucía, Sevilla, Spain
| | - José M. Rumbao Aguirre
- Plan Integral de Obesidad Infantil de Andalucía (PIOBIN), Consejería de Salud y Consumo. Junta de Andalucía, Sevilla, Spain
| | - Napoleón Pérez-Farinós
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Julia Wärnberg
- EpiPHAAN Research Group, Universidad de Málaga—Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Wu J, Brunke-Reese D, Lagoa CM, Conroy DE. Assessing the impact of message relevance and frequency on physical activity change: A secondary data analysis from the random AIM trial. Digit Health 2024; 10:20552076241255656. [PMID: 38784050 PMCID: PMC11113026 DOI: 10.1177/20552076241255656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Text messages are widely used to deliver intervention content; however, sending more intensive messages may not always improve behavioral outcomes. This study investigated whether message frequency was associated with daily physical activity, either by itself or in interaction with message content relevance. Healthy but insufficiently active young adults (aged 18-29 years) wore Fitbit activity trackers and received text messages for 180 days. Message frequencies varied daily at random, and messages were sent from three content libraries (40% Move More, 40% Sit Less, 20% Inspirational Quotes). Contrary to expectations, the results revealed a null association between total daily text message frequency and physical activity, both for daily step counts and moderate-to-vigorous physical activity (MVPA) duration. Additional analyses revealed that the daily frequency of messages with relevant content (i.e. Move More, Sit Less) was not associated with physical activity, but the daily frequency of messages with irrelevant content (i.e. Inspirational Quotes) was negatively associated with physical activity. We concluded that the effectiveness of text messages in promoting physical activity is impacted by the combination of content relevance and frequency, with frequent irrelevant messages potentially decreasing activity levels. This study suggests that irrelevant message frequency can negatively impact physical activity, highlighting the risks of delivering irrelevant content in digital health interventions.
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Affiliation(s)
- Jingchuan Wu
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Deborah Brunke-Reese
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Constantino M Lagoa
- School of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
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12
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Wennman H, Partonen T. Impacts of temperature and solar radiation changes in northern Europe on key population health behaviors: a scoping review of reviews. Scand J Public Health 2023:14034948231216909. [PMID: 38142291 DOI: 10.1177/14034948231216909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2023]
Abstract
AIM Climate change threatens health directly as well as indirectly through impacts on health-related behaviors. Physical activity, nutrition and sleep are key health-related behaviors for population health. We aimed at elucidating the impacts of climate change which emerge gradually on these three key health-related behaviors, particularly focusing on scenarios and projections relevant to people living in the northern Europe. METHODS We conducted a systematic literature search in three different databases in January 2023 to identify English language review articles summarizing the effects of climate change on either physical activity, nutrition, sleep, or their combination. RESULTS We identified 15 review articles on the topic. Data on climate change impacts on nutrition and sleep were sparse, and those on physical activity were heterogeneous. The climate in northern Europe will become warmer and sunnier in summer as well as warmer and darker in winter, which will probably increase the level of physical activity, but decrease the consumption of fruits and vegetables, as well as increase the occurrence of sleep disturbances in a population. CONCLUSIONS The anticipated changes in physical activity, nutrition and sleep driven by climate change influence population health and call for grass-roots action plans for adaptation.
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Affiliation(s)
- Heini Wennman
- Equality Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
| | - Timo Partonen
- Equality Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Finland
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13
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Burahmah E, Shanmugam S, Stansfield B. Full-Day Physical Activity and Sedentary Behaviour Levels of Typically Developing Children and Adolescents in the Middle East: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6940. [PMID: 37887678 PMCID: PMC10606092 DOI: 10.3390/ijerph20206940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/29/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Physical activity (PA) and sedentary behaviour (SB) are important components of physical behaviour associated with long-term health outcomes. Environmental and cultural factors may influence physical behaviour. To explore full day PA and SB in children and adolescents (2-18 years old) in the Middle East, a systematic literature review was performed including 183 journal articles. A wide range of PA and SB outcomes were reported, in some cases making synthesis of results difficult. As a consequence, results were generally reported narratively (MVPA time, total PA, SB time). Meta-regression of daily step count revealed females took 4600 fewer steps than males, with 3000 fewer steps on weekdays than weekends, and overweight individuals taking 2800 fewer steps/day. Steps decreased with age. Meta-regression for TV viewing time demonstrated an increase by 0.04 h per year of age. Even though environmental and cultural conditions may be different, PA and SB of children and adolescents in the Middle East were largely comparable to those of Europeans and North Americans. The wide range of data collection instruments used (both self-report questionnaire and body-worn devices) and heterogeneity of data made synthesis of reported data across studies very difficult, suggesting a need for greater standardisation of data collection methods.
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Affiliation(s)
| | | | - Ben Stansfield
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK; (E.B.); (S.S.)
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14
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Rech CR, Godtsfriedt CES, Arins GCB, de Zorzi VN, Pazin J, Hino AAF, Lopes AADS. How do the year's seasons and specific weather indices affect physical activity and the patterns of use of public open spaces in the Brazilian context? Int J Behav Nutr Phys Act 2023; 20:124. [PMID: 37828506 PMCID: PMC10571415 DOI: 10.1186/s12966-023-01521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Public open spaces (POS) can offer various resources to promote visitation and engagement in moderate-to-vigorous physical activity (MVPA). However, the influence of seasonal variations and specific meteorological conditions on this relationship remains unclear. Thus, this study aims to investigate the effect of seasonal variations and specific meteorological elements on different days of the week and times of day on POS use and POS-based MVPA in the Brazilian context. METHODS In 2018, repeated measurements carried out in Southern Brazil used a systematic observation to identify the presence of users in the POS and their engagement in MVPA. The meteorological elements (temperature, thermal sensation, and relative humidity), as well as seasonality (summer, autumn, winter, and spring), were aggregated into the observations. RESULTS A total of 19,712 systematic observations were conducted across nine POS. During these observations, a total of 59,354 users were identified. Out of theses, 39,153 (66.0%) were engaged in POS-based MVPA. The presence of users was found to be more frequent during the spring season (38.7%) and on weekends (ranging from 37.6 to 50.1% across seasons). Additionally, user presence was higher in the late afternoon (ranging from 36.4 to 58.2% across seasons) and at higher temperatures with lower relative humidity (p-value < 0.001). Regarding POS-based MVPA, it was more frequent during the winter season (36.4%) and on weekdays (ranging from 73.2 to 79.9% across seasons). Similarly, MVPA was higher in the late afternoon (ranging from 58.3 to 67.5% across seasons) and at lower temperatures and thermal sensations (p-value < 0.005). CONCLUSIONS Higher presence of users in POS, as well as their visiting, to practice POS-based MVPA, depending on the seasons and specific meteorological elements. By creating infrastructure and conducive conditions, cities can encourage individuals to adopt more active and healthy behaviors. These findings emphasize the importance of designing urban spaces that promote physical activity and contribute to overall well-being.
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Affiliation(s)
- Cassiano Ricardo Rech
- School of Sports, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, 88040-900 SC Brazil
| | - Carla Elane Silva Godtsfriedt
- School of Sports, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, 88040-900 SC Brazil
| | - Gabriel Claudino Budal Arins
- School of Sports, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, 88040-900 SC Brazil
| | - Viviane Nogueira de Zorzi
- School of Sports, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, 88040-900 SC Brazil
| | - Joris Pazin
- State University of Santa Catarina. R. Pascoal Simone, 358 - Coqueiros, Florianópolis, 88080-350 SC Brazil
| | - Adriano Akira Ferreira Hino
- Medical and Life Science School, Pontifical Catholic University of Parana, Curitiba. R. Imac. Conceição, 1155 - Prado Velho, Curitiba, 80215-901 PR Brazil
| | - Adalberto Aparecido dos Santos Lopes
- School of Sports, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, 88040-900 SC Brazil
- Observatory for Urban Health, Federal University of Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, 31270-901 MG Brazil
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15
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Hailey V, Bloomberg M, Hamer M, Fisher A. Association between neighbourhood cohesion and physical activity trajectories during the COVID-19 pandemic using data from Understanding Society: The UK Household Longitudinal Study & COVID-19 sub-study. Prev Med Rep 2023; 35:102392. [PMID: 37680857 PMCID: PMC10480663 DOI: 10.1016/j.pmedr.2023.102392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023] Open
Abstract
Neighbourhood cohesion is increasingly recognised as a key determinant of health and health-related behaviours. Positive association between social support and physical activity have been demonstrated on an interpersonal level, there is less evidence at group-level. This study aimed to examine the association between neighbourhood cohesion and physical activity trajectories during the COVID-19 pandemic. Hypothesizing that higher neighbourhood cohesion was a protective factor against reduced physical activity during the pandemic. Data from Understand Society (wave 9, Jan 2017-Dec 2019), and the COVID-19 sub-study (waves 1, 5, 7) was used. Participants (N = 14,475) had baseline data and at least one Covid physical activity measure. We used linear mixed models with a random intercept and slope at the individual level and an unstructured correlation matrix to examine the association between neighbourhood cohesion and physical activity during the follow-up period. We found a significant reduction in physical activity (-441 MET-min/wk, (CI 374.51 - 507.65, p < 0.001) through the COVID-19 pandemic, and that higher neighbourhood cohesion was related to higher physical activity after control for covariates. There was a significant difference between neighbourhood cohesion categories and change seen in PA during the 39-month follow-up period (difference in change between lowest and highest neighbourhood cohesion categories = 373 MET-min/wk, p = 0.036), higher neighbourhood cohesion had a protective effect. Strong relationships between public health and urban planning sectors are needed to build communities with structures in place to support a sense of community, social interaction and attraction to the neighbourhood. This will help long-term neighbourhood cohesion and support increased physical activity.
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Affiliation(s)
- Verity Hailey
- Department of Behavioural Science and Health, University College London, London, UK
| | - Mikaela Bloomberg
- Department of Behavioural Science and Health, University College London, London, UK
| | - Mark Hamer
- Institute Sport Exercise & Health, Division Surgery & Interventional Science, University College London, London, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
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16
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Timm I, Reichert M, Ebner-Priemer UW, Giurgiu M. Momentary within-subject associations of affective states and physical behavior are moderated by weather conditions in real life: an ambulatory assessment study. Int J Behav Nutr Phys Act 2023; 20:117. [PMID: 37777773 PMCID: PMC10541720 DOI: 10.1186/s12966-023-01507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/28/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Physical behavior (PB) is a key lifestyle factor in regulating and preventing diseases across the lifespan. Researchers identified affective, cognitive, and contextual factors like weather conditions, as significant contributors in determining if individuals are physically active. However, there is scarce empirical evidence about potential associations between PB and affective states influenced by weather conditions in daily life. Therefore, we explored if weather conditions moderated the within-subject association between momentary affective states and subsequent PB. METHODS Utilizing ambulatory assessment, 79 participants completed electronic diaries about their affective states (i.e., valence, energetic arousal, and calmness) up to six times a day over five days, and their PB (i.e., physical activity and sedentariness) was simultaneously recorded via accelerometers. Weather conditions (i.e., temperature and precipitation) recorded near participants' locations served as moderators in the multilevel analyses. RESULTS We confirmed earlier findings associating affective states with PB. Increased valence and energetic arousal were positively associated with physical activity (β = 0.007; p < .001), whereas calmness predicted lower levels of physical activity (β = -0.006; p < .001). Higher levels of calmness showed a positive association with sedentary behavior (β = 0.054; p = .003). In addition, we revealed a significant positive association between temperature, as a momentary weather condition, and physical activity (β = 0.025; p = .015). Furthermore, we showed that the association of affective states and physical activity was moderated by temperature. Higher temperatures enhanced the positive effects of valence on physical activity (β = .001, p = .023) and attenuated the negative effects of calmness on physical activity (β = .001, p = .021). Moreover, higher temperatures enhanced the positive effects of valence on reduced sedentary behavior (β = -0.011, p = .043). CONCLUSIONS Temperature alterations appeared to have an impact on subsequent physical activity. Furthermore, temperature alterations moderated the influence of affective states on conducted physical activity. This might offer the opportunity for just-in-time adaptive interventions to intervene in individually appropriate environmental conditions for promoting physical activity.
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Affiliation(s)
- Irina Timm
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany.
| | - Markus Reichert
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany
- Department of eHealth and Sports Analytics, Faculty of Sport Science, Ruhr University Bochum, Gesundheitscampus-Nord 10, Bochum, 44801, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Ulrich W Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Marco Giurgiu
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Hertzstr. 16, Karlsruhe, 76187, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
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17
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Fujihira K, Takahashi M, Wang C, Hayashi N. Factors explaining seasonal variation in energy intake: a review. Front Nutr 2023; 10:1192223. [PMID: 37545581 PMCID: PMC10400769 DOI: 10.3389/fnut.2023.1192223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Maintaining a balance between energy intake and expenditure is crucial for overall health. There are seasonal variations in energy intake, with an increase during spring and winter as well as a decrease during summer. These variations are related to a combination of environmental factors, including changes in temperature and daylight hours; social factors, including events and holidays; and physiological factors, including changes in physical activity and emotions. Accordingly, this review aimed to summarize the environmental, social, and physiological factors that contribute to seasonal variations in energy intake. A review of the current literature revealed that changes in temperature and daylight hours may affect eating behavior by altering homeostatic responses and appetite-related hormones. Additionally, increased participation in events and frequency of eating out, especially during winter vacations, may contribute to increased energy intake. Notably, these findings may not be generalisable to all populations since environmental and social factors can vary significantly depending on the local climatic zones and cultural backgrounds. The findings of the present review indicate that seasonal climate, events, and associated hormonal changes should be taken into account in order to maintain adequate energy intake throughout the year.
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Affiliation(s)
- Kyoko Fujihira
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Masaki Takahashi
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
- Department of Social and Human Sciences, Tokyo Institute of Technology, Tokyo, Japan
| | - Chunyi Wang
- Department of Social and Human Sciences, Tokyo Institute of Technology, Tokyo, Japan
| | - Naoyuki Hayashi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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18
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Maher C, Ferguson T, Curtis R, Brown W, Dumuid D, Fraysse F, Hendrie GA, Singh B, Esterman A, Olds T. Weekly, Seasonal, and Festive Period Weight Gain Among Australian Adults. JAMA Netw Open 2023; 6:e2326038. [PMID: 37498598 PMCID: PMC10375309 DOI: 10.1001/jamanetworkopen.2023.26038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Importance Obesity is a major global health concern. A better understanding of temporal patterns of weight gain will enable the design and implementation of interventions with potential to alter obesity trajectories. Objective To describe changes in daily weight across 12 months among Australian adults. Design, Setting, and Participants This cohort study conducted between December 1, 2019, and December 31, 2021 in Adelaide, South Australia, involved 375 community-dwelling adults aged 18 to 65 years. Participants wore a fitness tracker and were encouraged to weigh themselves, preferably daily but at least weekly, using a body weight scale. Data were remotely gathered using custom-developed software. Exposure Time assessed weekly, seasonally, and at Christmas/New Year and Easter. Main Outcomes and Measures Data were visually inspected to assess the overall yearly pattern in weight change. Data were detrended (to remove systematic bias from intraindividual gradual increases or decreases in weight) by calculating a line of best fit for each individual's annual weight change relative to baseline and subtracting this from each participant's weight data. Multilevel mixed-effects linear regression analysis was used to compare weight across days of the week and seasons and at Christmas/New Year and Easter. Results Of 375 participants recruited, 368 (mean [SD] age, 40.2 [5.9] years; 209 [56.8%] female; mean [SD] baseline weight, 84.0 [20.5] kg) provided at least 7 days of weight data for inclusion in analyses. Across the 12-month period, participants gained a median of 0.26% body weight (218 g) (range, -29.4% to 24.0%). Weight fluctuated by approximately 0.3% (252 g) each week, with Mondays and Tuesdays being the heaviest days of the week. Relative to Monday, participants' weight gradually decreased from Tuesday, although not significantly so (mean [SE] weight change, 0.01% [0.03%]; P = .83), to Friday (mean [SE] weight change, -0.18% [0.03%]; P < .001) and increased across the weekend to Monday (mean [SE] weight change for Saturday, -0.16% [0.03%]; P < .001; mean [SE] weight change for Sunday, -0.10% [0.03%]; P < .001). Participants' weight increased sharply at Christmas/New Year (mean [SE] increase, 0.65% [0.03%]; z score, 25.30; P < .001) and Easter (mean [SE] weight change, 0.29% [0.02%], z score, 11.51; P < .001). Overall, participants were heaviest in summer (significantly heavier than in all other seasons), were lightest in autumn (mean [SE] weight change relative to summer, -0.47% [0.07%]; P < .001), regained some weight in winter (mean [SE] weight change relative to summer, -0.23% [0.07%]; P = .001), and became lighter in spring (mean [SE] weight change relative to summer, -0.27% [0.07%]; P < .001). Conclusions and Relevance In this cohort study of Australian adults with weekly and yearly patterns in weight gain observed across 12 months, high-risk times for weight gain were Christmas/New Year, weekends, and winter, suggesting that temporally targeted weight gain prevention interventions may be warranted.
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Affiliation(s)
- Carol Maher
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Ty Ferguson
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Rachel Curtis
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Wendy Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Brisbane, Australia
| | - Dorothea Dumuid
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Francois Fraysse
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Gilly A Hendrie
- Health and Biosecurity, Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia, Australia
| | - Ben Singh
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Adrian Esterman
- UniSA Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Timothy Olds
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
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19
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Nguyen HT, Christian H, Le HT, Connelly L, Zubrick SR, Mitrou F. The impact of weather on time allocation to physical activity and sleep of child-parent dyads. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163249. [PMID: 37023819 DOI: 10.1016/j.scitotenv.2023.163249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/19/2023] [Accepted: 03/30/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE Previous studies showed that unfavourable weather conditions discourage physical activity. However, it remains unclear whether unfavourable weather conditions have a differential impact on physical activity in children compared with adults. We aim to explore the differential impact of weather on time allocation to physical activity and sleep by children and their parents. METHOD We use nationally representative data with time use indicators objectively measured on multiple occasions for >1100 Australian pairs of 12-13-year-old children and their middle-aged parents, coupled with daily meteorological data. We employ an individual fixed effects regression model to estimate the causal impact of weather. RESULTS We find that unfavourable weather conditions, as measured by cold or hot temperatures or rain, cause children to reduce moderate- and vigorous-intensity physical activity time and increase sedentary time. However, such weather conditions have little impact on children's sleep time or the time allocation of their parents. We also find substantial differential weather impact, especially on children's time allocation, by weekdays/weekends and parental employment status, suggesting that these factors may contribute to explaining the differential weather impact that we observed. Our results additionally provide evidence of adaptation, as temperature appears to have a more pronounced impact on time allocation in colder months and colder regions. CONCLUSION Our finding of a negative impact of unfavourable weather conditions on the time allocated to physical activity by children indicates a need to design policies to encourage them to be more physically active on days with unfavourable weather conditions and hence improve child health and wellbeing. Evidence of a more pronounced and negative impact on the time allocated to physical activity by children than their parents suggests that extreme weather conditions, including those associated with climate change, could make children vulnerable to reduced physical activity.
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Affiliation(s)
- Ha Trong Nguyen
- Telethon Kids Institute & The University of Western Australia, Australia.
| | - Hayley Christian
- Telethon Kids Institute & The University of Western Australia, Australia
| | - Huong Thu Le
- Telethon Kids Institute & The University of Western Australia, Australia
| | - Luke Connelly
- The University of Queensland, Australia & The University of Bologna, Italy
| | - Stephen R Zubrick
- Telethon Kids Institute & The University of Western Australia, Australia
| | - Francis Mitrou
- Telethon Kids Institute & The University of Western Australia, Australia
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20
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Gao P, Wu Y, He L, Wang L, Fu Y, Chen J, Zhang F, Krafft T, Martens P. Adverse short-term effects of ozone on cardiovascular mortalities modified by season and temperature: a time-series study. Front Public Health 2023; 11:1182337. [PMID: 37361179 PMCID: PMC10288843 DOI: 10.3389/fpubh.2023.1182337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Ambient ozone pollution becomes critical in China. Conclusions on the short-term effects of ozone on cardiovascular mortality have been controversial and limited on cause-specific cardiovascular mortalities and their interactions with season and temperature. This research aimed to investigate the short-term effects of ozone and the modifications of season and temperature on cardiovascular mortality. Methods Cardiovascular death records, air pollutants, and meteorological factors in Shenzhen from 2013 to 2019 were analyzed. Daily 1-h maximum of ozone and daily maximum 8-h moving average of ozone were studied. Generalized additive models (GAMs) were applied to evaluate their associations with cardiovascular mortalities in sex and age groups. Effect modifications were assessed by stratifying season and temperature. Results Distributed lag impacts of ozone on total cardiovascular deaths and cumulative effects on mortality due to ischemic heart disease (IHD) were most significant. Population under 65 years old was most susceptible. Majority of significant effects were found in warm season, at high temperature, and at extreme heat. Ozone-associated risks in total deaths caused by hypertensive diseases reduced in warm season, while risks in IHD in males increased at high temperature. Extreme heat enhanced ozone effects on deaths caused by CVDs and IHD in the population under 65 years old. Discussion The revealed cardiovascular impacts of ozone below current national standard of air quality suggested improved standards and interventions in China. Higher temperature, particularly extreme heat, rather than warm season, could significantly enhance the adverse effects of ozone on cardiovascular mortality in population under 65 years old.
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Affiliation(s)
- Panjun Gao
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Yongsheng Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lihuan He
- China National Environmental Monitoring Centre, Beijing, China
| | - Li Wang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jinrong Chen
- China National Environmental Monitoring Centre, Beijing, China
| | - Fengying Zhang
- China National Environmental Monitoring Centre, Beijing, China
| | - Thomas Krafft
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Pim Martens
- University College Venlo, Maastricht University, Venlo, Netherlands
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Baillot A, Bernard P, Eddine JN, Thomas JG, Schumacher LM, Papasavas PK, Vithiananthan S, Jones D, Bond DS. Associations of weather and air pollution with objective physical activity and sedentary time before and after bariatric surgery: a secondary analysis of a prospective cohort study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.22.23287589. [PMID: 36993516 PMCID: PMC10055583 DOI: 10.1101/2023.03.22.23287589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Background-- Most metabolic and bariatric surgery (MBS) patients perform too little moderate-to-vigorous intensity physical activity (MVPA) and too much sedentary time (ST). Identifying factors that influence MVPA and ST in MBS patients is necessary to inform the development of interventions to target these behaviors. Research has focused on individual-level factors and neglected those related to the physical environment (e.g., weather and pollution). These factors may be especially important considering rapid climate change and emerging data that suggest adverse effects of weather and pollution on physical activity are more severe in people with obesity. Objectives-- To examine the associations of weather (maximal, average and Wet Bulb Globe Temperatures), and air pollution indices (air quality index [AQI]) with daily physical activity (PA) of both light (LPA) and MVPA and ST before and after MBS. Methods-- Participants (n=77) wore an accelerometer at pre- and 3, 6, and 12-months post-MBS to assess LPA/MVPA/ST (min/d). These data were combined with participants' local (Boston, MA or Providence, RI, USA) daily weather and AQI data (extracted from federal weather and environmental websites). Results-- Multilevel generalized additive models showed inverted U-shaped associations between weather indices and MVPA (R2≥.63, p<.001), with a marked reduction in MVPA for daily maximal temperatures ≥20°C. Sensitivity analysis showed a less marked decrease of MVPA (min/d) during higher temperatures after versus before MBS. Both MVPA before and after MBS (R2=0.64, p<.001) and ST before MBS (R2=0.395; p≤.05) were negatively impacted by higher AQI levels. Discussion-- This study is the first to show that weather and air pollution indices are related to variability in activity behaviors, particularly MVPA, during pre- and post-MBS. Weather/environmental conditions should be considered in MVPA prescription/strategies for MBS patients, especially in the context of climate change.
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Affiliation(s)
- Aurélie Baillot
- Nursing Department, Université du Québec en Outaouais, Gatineau, Québec, Canada
- Institut du savoir de l’hôpital Montfort-recherche, Ottawa, Ontario, Canada
- Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services Sociaux de l’Outaouais, Gatineau, Québec, Canada
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada
- Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Jmii Nejm Eddine
- Department of Natural Sciences, Université du Québec en Outaouais, Gatineau, Québec, Canada
| | - J. Graham Thomas
- Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, The Miriam Hospital/Brown Alpert Medical School, Providence, Rhode Island
| | - Leah M. Schumacher
- Department of Kinesiology/Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Pavlos K. Papasavas
- Department of Surgery, Hartford Hospital/Hartford Healthcare, Hartford CT, USA
| | | | - Daniel Jones
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Dale S. Bond
- Department of Surgery, Hartford Hospital/Hartford Healthcare, Hartford CT, USA
- Department of Research, Hartford Hospital/Hartford Healthcare, Hartford CT, USA
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22
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Matthiessen J, Biltoft-Jensen A, Stockmarr A, Fagt S, Christensen T. Changes in Diet and Physical Activity among 18-65-Year-Olds after the First National COVID-19 Lockdown in Denmark. Nutrients 2023; 15:nu15061480. [PMID: 36986210 PMCID: PMC10054679 DOI: 10.3390/nu15061480] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
COVID-19 lockdowns affected everyday life significantly and made it challenging to achieve or maintain a healthy lifestyle. The aim of the present study was to examine longitudinal changes in Danish adults' eating habits and physical activity (PA) assessed during and after the first national lockdown in 2020. Furthermore, changes in body weight were examined during the first lockdown period. The whole diet (semi-quantitative Food Frequency Questionnaire), sociodemographic factors, moderate-to-vigorous intensity PA (MVPA), leisure screen time, anthropometrics, change in body weight, and stress level were assessed with a self-administered web-based questionnaire among 839 18-65-year-old Danes during and 5-6 months after the lockdown. Both favorable (decreased intake of saturated fat) and unfavorable (decreased intake of whole grain and fish, and increased intake of red meat) changes were found in the diet after the lockdown, while favorable changes in MVPA (increase in couples) and leisure screen time (decrease with a combined effect of family status and education) were found for PA. More Danish adults reported to gain weight (mean 3.0 kg) than to lose weight (mean 3.5 kg) during the first lockdown period (27% vs. 15%). The study showed favorable changes in PA and mixed results regarding diet among Danish adults after the lockdown. Furthermore, the first lockdown period unfavorably impacted the body weight of many Danes.
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Affiliation(s)
- Jeppe Matthiessen
- National Food Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Anja Biltoft-Jensen
- National Food Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Anders Stockmarr
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Sisse Fagt
- National Food Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Tue Christensen
- National Food Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
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23
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Weather associations with physical activity, sedentary behaviour and sleep patterns of Australian adults: a longitudinal study with implications for climate change. Int J Behav Nutr Phys Act 2023; 20:30. [PMID: 36918954 PMCID: PMC10012316 DOI: 10.1186/s12966-023-01414-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/19/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Weather is a potentially important influence on how time is allocated to sleep, sedentary behaviour and physical activity across the 24-h day. Extremes of weather (very hot, cold, windy or wet) can create undesirable, unsafe outdoor environments for exercise or active transport, impact the comfort of sleeping environments, and increase time indoors. This 13-month prospective cohort study explored associations between weather and 24-h movement behaviour patterns. METHODS Three hundred sixty-eight adults (mean age 40.2 years, SD 5.9, 56.8% female) from Adelaide, Australia, wore Fitbit Charge 3 activity trackers 24 h a day for 13 months with minute-by-minute data on sleep, sedentary behaviour, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) collected remotely. Daily weather data included temperature, rainfall, wind, cloud and sunshine. Multi-level mixed-effects linear regression analyses (one model per outcome) were used. RESULTS Ninety thousand eight hundred one days of data were analysed. Sleep was negatively associated with minimum temperature (-12 min/day change across minimum temperature range of 31.2 °C, p = 0.001). Sedentary behaviour was positively associated with minimum temperature (+ 12 min/day, range = 31.2 oC, p = 0.006) and wind speed (+ 10 min/day, range = 36.7 km/h, p< 0.001), and negatively associated with sunshine (-17 min/day, range = 13.9 h, p < 0.001). LPA was positively associated with minimum temperature (+ 11 min/day, range = 31.2 °C, p = 0.002), cloud cover (+ 4 min/day, range = 8 eighths, p = 0.008) and sunshine (+ 17 min/day, range = 13.9 h, p < 0.001), and negatively associated with wind speed (-8 min/day, range = 36.7 km/h, p < 0.001). MVPA was positively associated with sunshine (+ 3 min/day, range = 13.9 h, p < 0.001) and negatively associated with minimum temperature (-13 min/day, range = 31.2 oC, p < 0.001), rainfall (-3 min/day, range = 33.2 mm, p = 0.006) and wind speed (-4 min/day, range = 36.7 km/h, p < 0.001). For maximum temperature, a significant (p < 0.05) curvilinear association was observed with sleep (half-U) and physical activity (inverted-U), where the decrease in sleep duration appeared to slow around 23 °C, LPA peaked at 31 oC and MVPA at 27 °C. CONCLUSIONS Generally, adults tended to be less active and more sedentary during extremes of weather and sleep less as temperatures rise. These findings have the potential to inform the timing and content of positive movement behaviour messaging and interventions. TRIAL REGISTRATION The study was prospectively registered on the Australian New Zealand Clinical Trial Registry (Trial ID: ACTRN12619001430123).
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Yu H, Song Y, Wang Y, Wang X, Li H, Feng X, Yu M. The Impact of Temperature on 24-Hour Movement Behaviors among Chinese Freshmen Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4970. [PMID: 36981878 PMCID: PMC10049201 DOI: 10.3390/ijerph20064970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Human populations worldwide have experienced substantial climate change issues. Gaps in scientific literature remain regarding the relationship between temperature and 24-hour movement behavior among people. The purpose of this study is to examine the impact of temperature on 24-hour movement behavior including physical activity (PA), sedentary behavior (SB) and sleep duration among university students living in Beijing, China. METHODS We conducted follow-up health surveys on 44,693 freshmen students enrolled at Tsinghua University from 2012 to 2018. PA and SB were measured by using the short version of the International Physical Activity Questionnaire (IPAQ-s); sleep duration was estimated by using The Pittsburgh Sleep Quality Index (CPSQI). Corresponding temperature data measured by the Beijing Meteorological Service were collected to include average daily temperature from the nearest weather station to Tsinghua university. The data were analyzed using linear individual fixed-effect regressions. RESULTS An increase in temperature (temperature range 2.29-28.73 °C) by 1 °C was associated with an increase in 0.66 weekly minutes of vigorous physical activity (VPA) (95% confidence interval [CI] = 0.49, 0.82), an increase in 0.56 weekly minutes of moderate physical activity (MPA)(95% CI = 0.32, 0.79), an increase in 1.21 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 0.90, 1.53), an increase in 0.55 weekly minutes of walking (95% CI = 0.31, 0.78), an increase in 1.76 weekly minutes of total PA (95% CI = 1.35, 2.17), and a reduction in 1.60 weekly minutes of sleeping (95% CI = -2.09, -1.11). There was no significant correlation between temperature and sedentary behavior among participants. CONCLUSIONS Temperature was significantly positively correlated with physical activity levels in the Chinese freshmen students, and significantly negatively correlated with sleep duration. Replication of this study is warranted among various populations within China. The evidence of this novel study focused on understanding the relationship between climate change and 24-hour movement behaviors among people for developing effective adaptation strategies to climate change to improve people's health behavior. This study has important implications for future study, as knowledge of the impact of temperature on movement behavior may help in the interpretation of their results and translate into improving people's health behavior.
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Affiliation(s)
- Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Yiling Song
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Yangyang Wang
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Xiaoxin Wang
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Haoxuan Li
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Xiaolu Feng
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China
| | - Miao Yu
- Renmin University of China Libraries, Beijing 100872, China
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25
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Voigt L, Ullrich A, Groß S, Guertler D, Jaeschke L, Dörr M, van den Berg N, John U, Ulbricht S. Associations of accelerometer-based sedentary bouts with adiposity markers among German adults - results from a cross-sectional study. BMC Public Health 2023; 23:469. [PMID: 36899317 PMCID: PMC10007749 DOI: 10.1186/s12889-023-15304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Long periods of uninterrupted sitting, i.e., sedentary bouts, and their relationship with adverse health outcomes have moved into focus of public health recommendations. However, evidence on associations between sedentary bouts and adiposity markers is limited. Our aim was to investigate associations of the daily number of sedentary bouts with waist circumference (WC) and body mass index (BMI) in a sample of middle-aged to older adults. METHODS In this cross-sectional study, data were collected from three different studies that took place in the area of Greifswald, Northern Germany, between 2012 and 2018. In total, 460 adults from the general population aged 40 to 75 years and without known cardiovascular disease wore tri-axial accelerometers (ActiGraph Model GT3X+, Pensacola, FL) on the hip for seven consecutive days. A wear time of ≥ 10 h on ≥ 4 days was required for analyses. WC (cm) and BMI (kg m- 2) were measured in a standardized way. Separate multilevel mixed-effects linear regression analyses were used to investigate associations of sedentary bouts (1 to 10 min, >10 to 30 min, and >30 min) with WC and BMI. Models were adjusted for potential confounders including sex, age, school education, employment, current smoking, season of data collection, and composition of accelerometer-based time use. RESULTS Participants (66% females) were on average 57.1 (standard deviation, SD 8.5) years old and 36% had a school education >10 years. The mean number of sedentary bouts per day was 95.1 (SD 25.0) for 1-to-10-minute bouts, 13.3 (SD 3.4) for >10-to-30-minute bouts and 3.5 (SD 1.9) for >30-minute bouts. Mean WC was 91.1 cm (SD 12.3) and mean BMI was 26.9 kg m- 2 (SD 3.8). The daily number of 1-to-10-minute bouts was inversely associated with BMI (b = -0.027; p = 0.047) and the daily number of >30-minute bouts was positively associated with WC (b = 0.330; p = 0.001). All other associations were not statistically significant. CONCLUSION The findings provide some evidence on favourable associations of short sedentary bouts as well as unfavourable associations of long sedentary bouts with adiposity markers. Our results may contribute to a growing body of literature that can help to define public health recommendations for interrupting prolonged sedentary periods. TRIAL REGISTRATION Study 1: German Clinical Trials Register (DRKS00010996); study 2: ClinicalTrials.gov (NCT02990039); study 3: ClinicalTrials.gov (NCT03539237).
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Affiliation(s)
- Lisa Voigt
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, Greifswald, D-17475, Germany.
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany.
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
| | - Antje Ullrich
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, Greifswald, D-17475, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Stefan Groß
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Diana Guertler
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, Greifswald, D-17475, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Lina Jaeschke
- Molecular Epidemiology Research Group, Max-Delbrück-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
- Section Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Ulrich John
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, Greifswald, D-17475, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | - Sabina Ulbricht
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Str. 48, Greifswald, D-17475, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
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Issa R, Sarsour A, Cullip T, Toma S, Ruyssen I, Scheerens C. Gaps and opportunities in the climate change, migration and health nexus: insights from a questionnaire based study of practitioners and researchers. J Migr Health 2023; 7:100171. [PMID: 37034242 PMCID: PMC10074186 DOI: 10.1016/j.jmh.2023.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 01/10/2023] [Accepted: 03/08/2023] [Indexed: 03/29/2023] Open
Abstract
Background : While climate change and migration are separately recognised as public health challenges, the combination of the two - climate change-induced migration which is predicted to increase through this century - requires further research to ensure population health needs are met. As such, this paper aims to identify initial gaps and opportunities in the nexus of climate change, migration and health research. Methods : We conducted a questionnaire based study of academics and practitioners working in the fields of climate change, migration and health. Open-ended responses were thematically analysed. Results : Responses from 72 practitioners collected in October 2021 were categorised into a thematic framework encompassing i) gaps and opportunities: across health care and outcomes, impact pathways between climate change and migration, most at risk groups (specific actors) and regions, and longitudinal perspectives on migrant journeys; alongside ii) methodological challenges; iii) ethical challenges, and iv) advancing research with better funding and collaboration. Broadly, findings suggested that research must clarify the interlinkages and drivers between climate change, migration, health (systems), and intersecting factors including the broader determinants of health. Study of the dynamics of migration needs to extend beyond the current focus of rural-urban migration and international migration into high income countries, to include internal displacement and immobile/ trapped populations. Research could better include considerations of vulnerable groups currently underrepresented, people with specific health needs, and focus more on most at-risk regions. Research methodology could be strengthened through better data and definitions, clear ethical guidelines, and increased funding and collaboration. Conclusion : This study describes gaps, challenges and needs within research on the nexus of climate change, migration and health, in acknowledgement of the complexity of studying across multiple intersecting factors. Working with complexity can be supported by using the framework and findings to support researchers grappling with these intersecting themes.
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Affiliation(s)
- Rita Issa
- Institute for Global Health, University College London, London, United Kingdom
- School of International Development, University of East Anglia, Norwich, United Kingdom
- Corresponding author.
| | - Amal Sarsour
- The United Nations University Institute on Comparative Regional Integration Studies (UNU-CRIS), Bruges, Belgium
| | - Teresa Cullip
- Institute for Global Health, University College London, London, United Kingdom
| | - Sorana Toma
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Ilse Ruyssen
- The United Nations University Institute on Comparative Regional Integration Studies (UNU-CRIS), Bruges, Belgium
- Department of Economics, Ghent University, Ghent, Belgium
| | - Charlotte Scheerens
- The United Nations University Institute on Comparative Regional Integration Studies (UNU-CRIS), Bruges, Belgium
- Department of Economics, Ghent University, Ghent, Belgium
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27
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Ang G, Edney SM, Tan CS, Lim N, Tan J, Müller-Riemenschneider F, Chen C. Physical Activity Trends Among Adults in a National Mobile Health Program: A Population-Based Cohort Study of 411,528 Adults. Am J Epidemiol 2023; 192:397-407. [PMID: 36345089 PMCID: PMC9985108 DOI: 10.1093/aje/kwac193] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/13/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022] Open
Abstract
Physical inactivity is a global public health challenge, and effective, large-scale interventions are needed. We examined the effectiveness of a population-wide mobile health (mHealth) intervention in Singapore, National Steps Challenge Season 3 (NSC3) and 2 booster challenges (Personal Pledge and Corporate Challenge). The study includes 411,528 participants. We used regression discontinuity design and difference-in-difference with fixed-effects regression to examine the association of NSC3 and the additional booster challenges on daily step counts. Participants tended to be female (58.5%), with an average age of 41.5 years (standard deviation, 13.9) and body mass index (weight (kg)/height (m)2) of 23.8 (standard deviation, 4.5). We observed that NSC3 was associated with a mean increase of 1,437 steps (95% confidence interval (CI): 1,408, 1,467) per day. Enrollments in Personal Pledge and Corporate Challenge were associated with additional mean increases of 1,172 (95% CI: 1,123, 1,222) and 896 (95% CI: 862, 930) steps per day, respectively. For NSC3, the associated mean increase in the step counts across different sex and age groups varied, with greater increases for female participants and those in the oldest age group. We provide real-world evidence suggesting that NSC3 was associated with improvements in participants' step counts. Results suggest NSC3 is an effective and appealing population-wide mHealth physical activity intervention.
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Affiliation(s)
- Gregory Ang
- Department of Statistics and Data Science, National University of Singapore, Singapore
| | - Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nicole Lim
- Health Promotion Board, Ministry of Health, Singapore
| | - Jeremy Tan
- Health Promotion Board, Ministry of Health, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Berlin Institute of Health, Charité University Medical Centre, Berlin, Germany
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.,Schaeffer Center for Health Policy and Economics, University of Southern California, USA.,Department of Non-Communicable Disease Epidemiology, The London School of Hygiene & Tropical Medicine, UK
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28
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Ho JY, Lam HYC, Huang Z, Liu S, Goggins WB, Mo PKH, Chan EYY. Factors affecting outdoor physical activity in extreme temperatures in a sub-tropical Chinese urban population: an exploratory telephone survey. BMC Public Health 2023; 23:101. [PMID: 36641429 PMCID: PMC9840260 DOI: 10.1186/s12889-022-14788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 09/29/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Physical activity (PA) can be affected by extreme temperatures, however fewer studies have identified factors impacting this relationship. This study sought to identify factors associated with changes of outdoor PA during extreme cold/heat events in a sub-tropical Chinese urban population, including factors of sociodemographic, health conditions, temperature-related awareness and attitude, and protective behaviours. METHODS Two telephone surveys were conducted a week after extreme cold/heat events in 2016 and 2017 among a cohort of Hong Kong residents over age 15. Data was collected on self-reported changes in outdoor PA level during the periods of extreme temperatures, health status, comorbidities, sociodemographic, and temperature-related awareness, and behavioural variables. We conducted multivariable logistic regression analyses to assess predictors of change in outdoor PA over the two extreme temperature events. RESULTS AND CONCLUSION Among 435 participants (42.8% response rate), over a third of the participants reported decreased outdoor PA level in extreme temperature events, while 10% reported an increase in extreme heat. Self-reported cardiovascular diseases were associated with decreased PA level in extreme cold, while hypertension was associated with unchanged/increased PA level in extreme heat. These results suggest physical activity to be an important consideration in the understanding of climate change-and-health pathways and meriting further research.
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Affiliation(s)
- Janice Y. Ho
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Holly Y. C. Lam
- grid.7445.20000 0001 2113 8111Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Zhe Huang
- grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China
| | | | - William B. Goggins
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Phoenix K. H. Mo
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Emily Y. Y. Chan
- grid.10784.3a0000 0004 1937 0482Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China ,grid.10784.3a0000 0004 1937 0482Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), Hong Kong, China ,GX Foundation, Hong Kong, China ,grid.4991.50000 0004 1936 8948Nuffield Department of Medicine, University of Oxford, Oxford, UK
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29
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Liang K, Chen S, Chi X. Differential Associations Between Meeting 24-Hour Movement Guidelines With Mental Wellbeing and Mental Illness Among Chinese Adolescents. J Adolesc Health 2023; 72:658-666. [PMID: 36599758 DOI: 10.1016/j.jadohealth.2022.11.231] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Contemporary mental health models simultaneously consider psychological distress and wellness. Researchers have proposed that adhering to the 24-hour movement guidelines (24-HMG) contributes to mental health. 24-HMG integrates recommendations of time distribution among sleep, screen use, and moderate to vigorous physical activity (MVPA). Yet, there are few studies on the relationship between meeting 24-HMG and mental health, especially mental wellbeing. This study aimed to examine the associations between adherence to 24-HMG with mental wellbeing and mental illness among Chinese adolescents. METHODS Cross-sectional data of 67,281 Chinese adolescents aged 10-17 years (mean age = 13.0 years, 51.9% males) were collected by sending online questionnaires to local primary and middle schools in Shenzhen in 2021. We used multilevel generalized linear models to analyze associations between meeting 24-HMG with mental wellbeing (subjective wellbeing, resilience, and positive youth development) and mental illness (depression and anxiety). RESULTS Only 1.7% of participants met recommendations for all three behaviors (sleep, screen use, and MVPA). Compared with meeting none of the recommendations, participants who met one or more recommendations reported significantly better performance in mental wellbeing (all p < .001); on the contrary, meeting one or more recommendations (except for only meeting the MVPA recommendation) were significantly related to lower severity of mental illness (all p < .001). The relationship between the number of recommendations met with mental well-being and mental illness indicators presented a dose-response pattern (all p < .001). DISCUSSION Meeting 24-HMG was associated with superior mental health, including a higher propensity for mental wellbeing and a lower risk of mental illness. The importance of limiting screen time and getting enough sleep should be highlighted in promoting mental health in adolescents.
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Affiliation(s)
- Kaixin Liang
- School of Psychology, Shenzhen University, Shenzhen, China; Center for Mental Health, Shenzhen University, Shenzhen, China
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Xinli Chi
- School of Psychology, Shenzhen University, Shenzhen, China; Center for Mental Health, Shenzhen University, Shenzhen, China.
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Coussens M, Lapauw B, Verroken C, Goemaere S, De Wandele I, Malfait F, Banica T, Calders P. Bone Mass, Density, Geometry, and Stress-Strain Index in Adults With Osteogenesis Imperfecta Type I and Their Associations With Physical Activity and Muscle Function Parameters. J Bone Miner Res 2022; 37:2456-2465. [PMID: 36239015 DOI: 10.1002/jbmr.4722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 11/09/2022]
Abstract
Osteogenesis imperfecta (OI) is a clinically and genetically heterogeneous heritable connective tissue disorder mainly characterized by bone fragility and increased fracture risk. This study investigated bone parameters in adults with OI type I and their relationship with physical activity and muscle function parameters in comparison with controls. A total of 27 (15 women, 12 men) adults with OI type I and 27 healthy age- and sex-matched controls, with mean age 45 years (range 18-72 years), were included. Peripheral quantitative computed tomography was performed at the lower leg and forearm to assess muscle density, muscle and fat cross-sectional area (CSA) (66% site), and trabecular (4% site) and cortical bone parameters (66% site) at radius and tibia. Physical activity (step count and moderate-to-vigorous physical activity [MVPA]) was assessed by accelerometry, muscle function parameters by Leonardo mechanography (single two-legged jump - peak power), and hand grip dynamometry (maximal hand grip strength). Overall, the OI type I group had significantly lower muscle CSA at the lower leg and forearm, lower trabecular and cortical bone mineral content, lower polar stress-strain index (SSIp), and smaller cortices but higher cortical bone mineral density and lower step count and MVPA in comparison with controls. Maximal hand grip strength was positively associated with SSIp at radius (p = 0.012) in the control group but not in the OI type I group (p = 0.338) (difference in associations: p = 0.012). No other significantly different associations between bone and muscle function parameters or physical activity (step count or MVPA) were found in the OI type I versus control group. We conclude that adults with OI type I have smaller bones, lower trabecular bone mass, lower estimates of bone strength, and higher cortical density in comparison with controls and that there are some indications of a disturbed biomechanical muscle-bone relationship in adults with OI type I. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Marie Coussens
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium
| | - Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium
| | - Inge De Wandele
- Centre for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Fransiska Malfait
- Reference Centre for Rare Bone, Calcium and Phosphate Disorders, Ghent University Hospital, Ghent, Belgium.,Centre for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Thiberiu Banica
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium
| | - Patrick Calders
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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Hunter S, Spence JC, Leatherdale ST, Carson V. Associations Between Parent's Perceived Neighborhood Environment and Objectively Measured Walkability With Their Children's Physical Activity. J Phys Act Health 2022; 19:811-819. [PMID: 36370701 DOI: 10.1123/jpah.2022-0310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/01/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Neighborhoods are one setting to promote children's physical activity. This study examined associations between neighborhood features and children's physical activity and whether season or socioeconomic status modified these associations. METHODS Parents (n = 641) of children aged 6-10 years completed the Neighborhood Environment Walkability Scale-Abbreviated. Walkability was objectively measured at 400, 800, and 1200 m around the centroid of participants' postal codes. Children's physical activity was measured via StepsCount pedometers and parental report. Regression analyses were performed with interaction terms for season and socioeconomic status. Multiple imputation was used primarily to triangulate the results for children with missing steps data (n = 192). RESULTS Higher perceived residential density and traffic hazards were significantly associated with lower squareroot transformed parental-reported physical activity and steps per day, respectively. Higher perceived aesthetics was associated with higher squareroot transformed parental-reported physical activity. Socioeconomic status modified 2 associations though they were not significant upon stratification. During winter months, better perceived infrastructure and safety for walking was associated with higher squareroot transformed parental-reported physical activity. No other significant associations emerged. CONCLUSION Residential density, traffic hazards, and aesthetics are important for children's physical activity. Few associations were modified by socioeconomic status or season. The need for objective and subjective measures of the neighborhood environment and children's physical activity is apparent.
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Affiliation(s)
- Stephen Hunter
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB,Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB,Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
| | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB,Canada
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32
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Hailey V, Burton A, Hamer M, Fancourt D, Fisher A. Physical Activity during the COVID-19 Pandemic in the UK: A Qualitative Analysis of Free-Text Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14784. [PMID: 36429501 PMCID: PMC9690793 DOI: 10.3390/ijerph192214784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Several quantitative studies have found a decline in physical activity in response to COVID-19 pandemic restrictions. The aim of the present study was to use large-scale free text survey data to qualitatively gain a more in-depth understanding of the impact of the COVID-19 pandemic on physical activity, then map barriers and facilitators to the Capability, Opportunity, Motivation, and Behaviour (COM-B) Model of Behaviour to aid future intervention development. METHODS 17,082 participants provided a response to the free text module, and data from those who mentioned a physical activity related word in any context were included. Data were analysed using thematic analysis and key themes identified. RESULTS 5396 participants provided 7490 quotes related to physical activity. The sample were predominately female (84%), white (British/Irish/Other) (97%) and aged <60 years (57%). Seven key themes were identified: the importance of outdoor space, changes in daily routine, COVID-19 restrictions prevented participation, perceived risks or threats to participation, the importance of physical health, the importance of physical activity for mental health and the use of technology. CONCLUSION Future physical activity interventions could encourage people to walk outdoors, which is low cost, flexible, and accessible to many. Developing online resources to promote and support physical activity provides a flexible way to deliver quality content to a large audience.
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Affiliation(s)
- Verity Hailey
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - Alexandra Burton
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - Mark Hamer
- Institute Sport Exercise & Health, Division Surgery & Interventional Science, University College London, London W1T 7HA, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - Abigail Fisher
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
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Hojjatinia S, Lee AM, Hojjatinia S, Lagoa CM, Brunke-Reese D, Conroy DE. Physical Activity Dynamics During a Digital Messaging Intervention Changed After the Pandemic Declaration. Ann Behav Med 2022; 56:1188-1198. [PMID: 35972330 PMCID: PMC9384787 DOI: 10.1093/abm/kaac051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic adversely impacted physical activity, but little is known about how contextual changes following the pandemic declaration impacted either the dynamics of people's physical activity or their responses to micro-interventions for promoting physical activity. PURPOSE This paper explored the effect of the COVID-19 pandemic on the dynamics of physical activity responses to digital message interventions. METHODS Insufficiently-active young adults (18-29 years; N = 22) were recruited from November 2019 to January 2020 and wore a Fitbit smartwatch for 6 months. They received 0-6 messages/day via smartphone app notifications, timed and selected at random from three content libraries (Move More, Sit Less, and Inspirational Quotes). System identification techniques from control systems engineering were used to identify person-specific dynamical models of physical activity in response to messages before and after the pandemic declaration on March 13, 2020. RESULTS Daily step counts decreased significantly following the pandemic declaration on weekdays (Cohen's d = -1.40) but not on weekends (d = -0.26). The mean overall speed of the response describing physical activity (dominant pole magnitude) did not change significantly on either weekdays (d = -0.18) or weekends (d = -0.21). In contrast, there was limited rank-order consistency in specific features of intervention responses from before to after the pandemic declaration. CONCLUSIONS Generalizing models of behavioral dynamics across dramatically different environmental contexts (and participants) may lead to flawed decision rules for just-in-time physical activity interventions. Periodic model-based adaptations to person-specific decision rules (i.e., continuous tuning interventions) for digital messages are recommended when contexts change.
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Affiliation(s)
- Sahar Hojjatinia
- School of Electrical Engineering and Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - Alexandra M Lee
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | | | - Constantino M Lagoa
- School of Electrical Engineering and Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - Deborah Brunke-Reese
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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Gonzales A, Lin JH, Cha JS. Physical activity changes among office workers during the COVID-19 pandemic lockdown and the agreement between objective and subjective physical activity metrics. APPLIED ERGONOMICS 2022; 105:103845. [PMID: 35930899 PMCID: PMC9296707 DOI: 10.1016/j.apergo.2022.103845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
After the onset of the COVID-19 pandemic, many office workers transitioned to working-from-home (WFH) which altered routine physical activity (PA). To understand how these workers' PA were affected throughout the pandemic, PA data collected in January, April, June, and December 2020 with an activity tracker and a validated survey were analyzed. Between January and December, it was found that step counts during the weekday decreased (p < 0.01), weekday heart rate was higher than weekends (p < 0.01), activity-tracker and self-reported PA decreased (p < 0.01), and sitting time increased (p < 0.01). To understand the agreement between the objective and subjective METs, Bland-Altman analyses were completed and demonstrated an acceptable level of agreement. Findings show decreased level of PA amongst WFH office workers and that the activity tracker and survey are reliable methods of recording WFH PA.
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Affiliation(s)
- Alec Gonzales
- Department of Industrial Engineering, Clemson University, USA
| | - Jia-Hua Lin
- SHARP, Washington State Department of Labor & Industries, USA
| | - Jackie S Cha
- Department of Industrial Engineering, Clemson University, USA.
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Butāne L, Spilva-Ekerte L, Šablinskis M, Skride A, Šmite D. Individually tailored home-based physiotherapy program makes sustainable improvement in exercise capacity and daily physical activity in patients with pulmonary arterial hypertension. Ther Adv Respir Dis 2022; 16:17534666221132477. [PMID: 36314474 PMCID: PMC9629575 DOI: 10.1177/17534666221132477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a rare, chronic, progressive, and life-threatening cardiopulmonary disease. This study investigated the impact of an individually tailored 12 weeks home-based physiotherapy program in PAH patients, with the aim to evaluate change in exercise capacity and daily physical activity level. METHODS This was an analysis of secondary outcomes from a prospective, randomized, controlled intervention study. Twenty-one participants were recruited from the Latvian PH registry based on inclusion criteria and randomized in a training group (TG) and control group (CG). Both groups continued a medical target therapy, but for TG, the individually tailored home-based physiotherapy program was added including physical exercises, relaxation, self-control, education, and supervision with telehealth elements. Outcomes included a 6-min walk test (6MWT) (m) and daily physical activity based on accelerometry results assessed at baseline, after 12 weeks, and at follow-up 6 months after commencement of intervention. RESULTS 6MWT distance significantly (p < 0.05) and clinically (>33 m) increased within TG after 12 weeks (51.8 m, 95% CI = 25.7-77.9 m, Cohen's d = 1.7) and at follow-up (75.5 m, 95% CI = 46.1-104.8 m, Cohen's d = 2.1). A significant difference in 6MWT results between the groups at 12 weeks and follow-up was approved. In TG, low-intensity activities significantly (p < 0.05) increased both after 12 weeks (Cohen's d = 1.6) and at follow-up (Cohen's d = 1.2), moderate-intensity activities significantly (p < 0.05) increased at follow-up (Cohen's d = 1.3), and no significant improvements were present in CG. CONCLUSION The individually tailored 12 weeks home-based physiotherapy program comprising comprehensive physical exercise training, relaxation, self-control skills training, and education, added to stable medical target therapy and supervised by physiotherapist through telehealth elements, is effective in improving exercise capacity and increasing daily time in low or moderate physical activities 6 months after commencement of the intervention in patients with PAH.
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Affiliation(s)
| | | | - Matīss Šablinskis
- Department of Cardiology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
| | - Andris Skride
- Department of Internal Diseases, Riga Stradiņš University, Riga, Latvia,Department of Cardiology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia
| | - Daina Šmite
- Faculty of Rehabilitation, Riga Stradiņš University, Riga, Latvia
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Santos M, Moreira H, Cabral JA, Gabriel R, Teixeira A, Bastos R, Aires A. Contribution of Home Gardens to Sustainable Development: Perspectives from A Supported Opinion Essay. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013715. [PMID: 36294295 PMCID: PMC9603381 DOI: 10.3390/ijerph192013715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 05/07/2023]
Abstract
Home gardening has a long history that started when humans became sedentary, being traditionally considered an accessible source of food and medicinal plants to treat common illnesses. With trends towards urbanization and industrialization, particularly in the post-World War II period, the importance of home gardens as important spaces for growing food and medicinal plants reduced and they began to be increasingly seen as decorative and leisure spaces. However, the growing awareness of the negative impacts of agricultural intensification and urbanization for human health, food quality, ecosystem resilience, and biodiversity conservation motivated the emergence of new approaches concerning home gardens. Societies began to question the potential of nearby green infrastructures to human wellbeing, food provisioning, and the conservation of traditional varieties, as well as providers of important services, such as ecological corridors for wild species and carbon sinks. In this context. and to foster adaptive and resilient social-ecological systems, our supported viewpoint intends to be more than an exhaustive set of perceptions, but a reflection of ideas about the important contribution of home gardens to sustainable development. We envision these humble spaces strengthening social and ecological components, by providing a set of diversified and intermingled goods and services for an increasingly urban population.
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Affiliation(s)
- Mário Santos
- Laboratory of Fluvial and Terrestrial Ecology, Innovation and Development Center, University of Trás-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal
- Laboratory of Ecology and Conservation, Federal Institute of Education, Science and Technology of Maranhão, Rua do Comercio, 100, Buriticupu 65393-000, MA, Brazil
- CITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro) and Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Correspondence: ; Tel.: +351-259350000
| | - Helena Moreira
- CITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro) and Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Department of Sports, Exercise and Health Sciences, University of Trás-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal
- CIDESD—Research Center in Sports Sciences, Health Sciences and Human Development, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - João Alexandre Cabral
- Laboratory of Fluvial and Terrestrial Ecology, Innovation and Development Center, University of Trás-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal
- CITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro) and Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
| | - Ronaldo Gabriel
- CITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro) and Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Department of Sports, Exercise and Health Sciences, University of Trás-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal
| | - Andreia Teixeira
- Department of Sports, Exercise and Health Sciences, University of Trás-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal
| | - Rita Bastos
- Laboratory of Fluvial and Terrestrial Ecology, Innovation and Development Center, University of Trás-os-Montes e Alto Douro, 5000-911 Vila Real, Portugal
- CIBIO/InBIO/BioPolis, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade do Porto, 4485-661 Vairão, Portugal
| | - Alfredo Aires
- CITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production (Inov4Agro) and Department of Biology and Environment, University of Trás-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal
- Department of Agronomy, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, UTAD, Quinta de Prados, 5000-801 Vila Real, Portugal
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Physical Activity Among Older Women Living in Rural Areas in Canada: A Scoping Review. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09380-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractAlthough there is strong evidence linking physical activity in older age with wellbeing and health benefits, these relationships tend to be under-researched in a rural context. A scoping review was conducted to identify what is known about physical activity among older women living in rural Canada. The search strategy was intentionally broad, with eight databases, academic journals, and websites scanned for research and grey literature related to Canada, in English, from 2000 to 2022. 33 studies, reviews, and reports were included in the final selection. These articles indicate that physical activity among older women living in rural Canada is influenced by a multitude of layers, contexts, conditions, and environments, with outcomes dependent on a mixture of personal, relational, community, societal, and governmental factors. In general, the women are committed to creating and maintaining an active lifestyle, and supporting their local rural community to enable these activities. While the social environment can proscribe physical activity through ageist attitudes and restrictive socio-cultural norms, social support from family and community members mitigates against these constraints. Rural infrastructure, geography, climate (seasons and weather), as well as transportation and policy issues may also impede the physical activity opportunities of the women. Some of the problems related to sustaining and resourcing recreational activity in rural communities are partly addressed through the implications presented in the articles. Among others, these suggestions relate to leadership and learning opportunities, public engagement, and the partnership working involved in supporting physical activity in rural areas. However, further research is long overdue.
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Zerón-Rugerio MF, Alda JA, Carpio-Arias TV, Izquierdo-Pulido M, Cambras T. Seasonality and ADHD: Summer time is associated with less symptoms of inattention among children and adolescents with ADHD. J Affect Disord 2022; 314:259-262. [PMID: 35878839 DOI: 10.1016/j.jad.2022.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/13/2022] [Accepted: 07/17/2022] [Indexed: 10/17/2022]
Affiliation(s)
- María Fernanda Zerón-Rugerio
- Department of Nutrition, Food Science and Gastronomy, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain; Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain
| | - Jose A Alda
- Children and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Deu Barcelona, Barcelona, Spain
| | | | - Maria Izquierdo-Pulido
- Department of Nutrition, Food Science and Gastronomy, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain; Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain
| | - Trinitat Cambras
- Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona, Barcelona, Spain.
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Koch M, Matzke I, Huhn S, Gunga HC, Maggioni MA, Munga S, Obor D, Sié A, Boudo V, Bunker A, Dambach P, Bärnighausen T, Barteit S. Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e39532. [PMID: 36083624 PMCID: PMC9508665 DOI: 10.2196/39532] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/20/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Although climate change is one of the biggest global health threats, individual-level and short-term data on direct exposure and health impacts are still scarce. Wearable electronic devices (wearables) present a potential solution to this research gap. Wearables have become widely accepted in various areas of health research for ecological momentary assessment, and some studies have used wearables in the field of climate change and health. However, these studies vary in study design, demographics, and outcome variables, and existing research has not been mapped.
Objective
In this review, we aimed to map existing research on wearables used to detect direct health impacts and individual exposure during climate change–induced weather extremes, such as heat waves or wildfires.
Methods
We conducted a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework and systematically searched 6 databases (PubMed [MEDLINE], IEEE Xplore, CINAHL [EBSCOhost], WoS, Scopus, Ovid [MEDLINE], and Google Scholar). The search yielded 1871 results. Abstracts and full texts were screened by 2 reviewers (MK and IM) independently using the inclusion and exclusion criteria. The inclusion criteria comprised studies published since 2010 that used off-the-shelf wearables that were neither invasive nor obtrusive to the user in the setting of climate change–related weather extremes. Data were charted using a structured form, and the study outcomes were narratively synthesized.
Results
The review included 55,284 study participants using wearables in 53 studies. Most studies were conducted in upper–middle-income and high-income countries (50/53, 94%) in urban environments (25/53, 47%) or in a climatic chamber (19/53, 36%) and assessed the health effects of heat exposure (52/53, 98%). The majority reported adverse health effects of heat exposure on sleep, physical activity, and heart rate. The remaining studies assessed occupational heat stress or compared individual- and area-level heat exposure. In total, 26% (14/53) of studies determined that all examined wearables were valid and reliable for measuring health parameters during heat exposure when compared with standard methods.
Conclusions
Wearables have been used successfully in large-scale research to measure the health implications of climate change–related weather extremes. More research is needed in low-income countries and vulnerable populations with pre-existing conditions. In addition, further research could focus on the health impacts of other climate change–related conditions and the effectiveness of adaptation measures at the individual level to such weather extremes.
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Affiliation(s)
- Mara Koch
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ina Matzke
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sophie Huhn
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment Berlin, Berlin, Germany
| | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment Berlin, Berlin, Germany
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Ali Sié
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Centre de Recherche en Santé, Nouna, Burkina Faso
| | | | - Aditi Bunker
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Peter Dambach
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
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40
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Caldeira TCM, Soares MM, da Silva LES, Veiga IPA, Claro RM. Chronic disease risk and protective behaviors in Brazilian state capitals and the Federal District, according to the National Health Survey and the Chronic Disease Risk and Protective Factors Telephone Survey Surveillance System, 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2022; 31:e2021367. [PMID: 35946669 PMCID: PMC9897819 DOI: 10.1590/ss2237-9622202200009.especial] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 11/08/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To describe and compare the results of the main risk and protective factors for chronic non-communicable diseases, in the 26 Brazilian capitals and the Federal District, obtained through the National Health Survey (PNS) and the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (VIGITEL) in 2019. METHODS Cross-sectional study, in which the difference in prevalence between health behavior indicators investigated by PNS and VIGITEL was calculated. RESULTS The largest discrepancy between the surveys, PNS (n = 32,111) and VIGITEL (n = 52,443), were observed in relation to leisure-time physical activity (6.8 in percentage points - p.p.), recommended physical activity in the transport domain (7.4 p.p.), and high screen time (21.8 p.p.). Both surveys presented similar prevalence regarding nutritional status, food consumption, smoking, alcohol abuse and negative self-rated health. CONCLUSION Prevalence in both surveys presented small differences, but point to results in the same direction.
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Affiliation(s)
| | - Marcela Mello Soares
- Universidade Federal de Minas Gerais, Programa de Pós-graduação em
Saúde Pública, Belo Horizonte, MG, Brazil
| | - Luiza Eunice Sá da Silva
- Universidade Federal de Minas Gerais, Programa de Pós-graduação em
Saúde Pública, Belo Horizonte, MG, Brazil
| | - Izabella Paula Araújo Veiga
- Universidade Federal de Minas Gerais, Programa de Pós-graduação em
Nutrição e Saúde, Belo Horizonte, MG, Brazil
| | - Rafael Moreira Claro
- Universidade Federal de Minas Gerais, Departamento de Nutrição, Belo
Horizonte, MG, Brazil
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Schweda S, Munz B, Burgstahler C, Niess AM, Roesel I, Sudeck G, Krauss I. Proof of Concept of a 6-Month Person-Oriented Exercise Intervention 'MultiPill-Exercise' among Patients at Risk of or with Multiple Chronic Diseases: Results of a One-Group Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9469. [PMID: 35954825 PMCID: PMC9368673 DOI: 10.3390/ijerph19159469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 12/03/2022]
Abstract
Physical exercise has been shown to be effective in the treatment of non-communicable chronic diseases. However, patients with multiple chronic diseases (multimorbidity) have received little attention in health policy. This pilot trial served as a proof of concept of a 6-months person-oriented exercise intervention for people at risk of or with diagnosed cardiovascular diseases, diabetes mellitus type 2, overweight and/or hip/knee osteoarthritis, regarding effects on health outcomes as well as adherence and safety. The intervention (‘MultiPill-Exercise’) was designed to promote physical exercise participation, considering an individual perspective by addressing personal and environmental factors. Outcomes were assessed at baseline (t0) and after three- (t3) and six-months (t6). The primary outcome was self-reported physical exercise participation in minutes/week comparing t3 and t6 vs. t0. Secondary outcomes included cardio-respiratory fitness (maximum oxygen uptake VO2peak during incremental cycling ergometry), isometric peak torque of knee extensors and flexors, health-related quality of life (Veterans Rand 12 with its subscales of perceived general health (GH), mental health (MCS), and physical health (PCS)) and blood levels. Adherence to exercise (% of attended sessions during the first 12-weeks of the intervention) and adverse events were monitored as well. Data were analyzed using a non-parametric procedure for longitudinal data, estimating rank means (MRank) and relative treatment effects (RTE) as well as linear-mixed effect models for parametric data. The primary endpoint of physical exercise participation was significantly higher at t3 and t6 compared to baseline (t3 vs. t0: MRank = 77.1, p < 0.001, RTE: 0.66; t6 vs. t0: MRank = 70.6, p < 0.001, RTE = 0.60). Improvements at both follow-up time points compared to t0 were also found for relative VO2peak (t3 vs. t0 = 2.6 mL/kg/min, p < 0.001; t6 vs. t0 = 2.0 mL/kg/min, p = 0.001), strength of knee extensors (t3 vs. t0 = 11.7 Nm, p = 0.007; t6 vs. t0= 18.1 Nm, p < 0.001) and GH (t3 vs. t0 = 16.2, p = 0.003; t6 vs. t0 = 13.4, p = 0.008). No changes were found for MCS, PCS and for blood levels. Overall exercise adherence was 77%. No serious adverse events were recorded. Results of this pilot trial represent a first proof of concept for the intervention ‘MultiPill-Exercise’ that will now be implemented and evaluated in a real-world health care setting.
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Affiliation(s)
- Simone Schweda
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Barbara Munz
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Christof Burgstahler
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Andreas Michael Niess
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
| | - Inka Roesel
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
- Institute for Clinical Epidemiology and Applied Biostatistics, University of Tuebingen, 72074 Tuebingen, Germany
| | - Gorden Sudeck
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
- Institute of Sports Science, Eberhard Karls University, 72076 Tuebingen, Germany
| | - Inga Krauss
- Department of Sports Medicine, University Hospital, Medical Clinic, 72074 Tuebingen, Germany; (B.M.); (C.B.); (A.M.N.); (I.R.); (I.K.)
- Interfaculty Research Institute for Sports and Physical Activity, 72074 Tuebingen, Germany;
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42
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Weaver RG, Hensing C, Armstrong B, Adams EL, Beets M. Seasonal Shifts in Children's Sedentary Behaviors, Physical Activity, and Sleep: A Systematic Review and meta-Analysis. Pediatr Clin North Am 2022; 69:671-693. [PMID: 35934493 DOI: 10.1016/j.pcl.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Children's movement behaviors (ie, sedentary behaviors, physical activity, and sleep) are related to obesity risk and may vary throughout the year. The purpose of this systematic review is to summarize existing literature on the seasonal variation in physical activity and sleep in children. This study found that children's behaviors fluctuate seasonally and thus, interventions must target behaviors during the times when children's behaviors are the least healthy, specifically during the summer (when children are not in school) and winter. Finally, the paucity of data on seasonal variation in sleep indicates a need for further research in this area.
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Affiliation(s)
- R Glenn Weaver
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Caroline Hensing
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Bridget Armstrong
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Elizabeth L Adams
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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43
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Chevance G, Fresán U, Hekler E, Edmondson D, Lloyd SJ, Ballester J, Litt J, Cvijanovic I, Araújo-Soares V, Bernard P. Thinking Health-related Behaviors in a Climate Change Context: A Narrative Review. Ann Behav Med 2022; 57:193-204. [PMID: 35861123 PMCID: PMC10074036 DOI: 10.1093/abm/kaac039] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to, climate change. PURPOSE This article aims to identify potential bi-directional associations between climate change impacts and health-related behaviors, as well as a set of key actions for the behavioral medicine community. METHODS We synthesized the existing literature about (i) the impacts of rising temperatures, extreme weather events, air pollution, and rising sea level on individual behaviors (e.g., eating behaviors, physical activity, sleep, substance use, and preventive care) as well as the structural factors related to these behaviors (e.g., the food system); and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change. RESULTS Based on this literature review, we propose a first conceptual model of climate change and health-related behavior feedback loops. Key actions are proposed, with particular consideration for health equity implications of future behavioral interventions. Actions to bridge the fields of behavioral medicine and climate sciences are also discussed. CONCLUSIONS We contend that climate change is among the most urgent issues facing all scientists and should become a central priority for the behavioral medicine community.
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Affiliation(s)
| | | | - Eric Hekler
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, San Diego, CA, USA.,Center for Wireless and Population Health Systems, Qualcomm Institute, UC San Diego, San Diego, CA, USA
| | - Donald Edmondson
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Jill Litt
- ISGlobal, Barcelona, Spain.,Environmental Studies, University of Colorado Boulder, CO, USA
| | | | - Vera Araújo-Soares
- Health Technology & Services Research, University of Twente, The Netherlands
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, Québec, Canada.,Research Center, University Institute of Mental Health at Montreal, Montréal, Quebec, Canada
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44
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Herbuela VRDM, Karita T, Furukawa Y, Wada Y, Toya A, Senba S, Onishi E, Saeki T. Machine learning-based classification of the movements of children with profound or severe intellectual or multiple disabilities using environment data features. PLoS One 2022; 17:e0269472. [PMID: 35771797 PMCID: PMC9246124 DOI: 10.1371/journal.pone.0269472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 05/16/2022] [Indexed: 11/19/2022] Open
Abstract
Communication interventions have broadened from dialogical meaning-making, assessment approaches, to remote-controlled interactive objects. Yet, interpretation of the mostly pre-or protosymbolic, distinctive, and idiosyncratic movements of children with intellectual disabilities (IDs) or profound intellectual and multiple disabilities (PIMD) using computer-based assistive technology (AT), machine learning (ML), and environment data (ED: location, weather indices and time) remain insufficiently unexplored. We introduce a novel behavior inference computer-based communication-aid AT system structured on machine learning (ML) framework to interpret the movements of children with PIMD/IDs using ED. To establish a stable system, our study aimed to train, cross-validate (10-fold), test and compare the classification accuracy performance of ML classifiers (eXtreme gradient boosting [XGB], support vector machine [SVM], random forest [RF], and neural network [NN]) on classifying the 676 movements to 2, 3, or 7 behavior outcome classes using our proposed dataset recalibration (adding ED to movement datasets) with or without Boruta feature selection (53 child characteristics and movements, and ED-related features). Natural-child-caregiver-dyadic interactions observed in 105 single-dyad video-recorded (30-hour) sessions targeted caregiver-interpreted facial, body, and limb movements of 20 8-to 16-year-old children with PIMD/IDs and simultaneously app-and-sensor-collected ED. Classification accuracy variances and the influences of and the interaction among recalibrated dataset, feature selection, classifiers, and classes on the pooled classification accuracy rates were evaluated using three-way ANOVA. Results revealed that Boruta and NN-trained dataset in class 2 and the non-Boruta SVM-trained dataset in class 3 had >76% accuracy rates. Statistically significant effects indicating high classification rates (>60%) were found among movement datasets: with ED, non-Boruta, class 3, SVM, RF, and NN. Similar trends (>69%) were found in class 2, NN, Boruta-trained movement dataset with ED, and SVM and RF, and non-Boruta-trained movement dataset with ED in class 3. These results support our hypotheses that adding environment data to movement datasets, selecting important features using Boruta, using NN, SVM and RF classifiers, and classifying movements to 2 and 3 behavior outcomes can provide >73.3% accuracy rates, a promising performance for a stable ML-based behavior inference communication-aid AT system for children with PIMD/IDs.
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Affiliation(s)
| | - Tomonori Karita
- Faculty of Education, Center of Inclusive Education, Ehime University, Ehime, Japan
| | - Yoshiya Furukawa
- Graduate School of Humanities and Social Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshinori Wada
- Faculty of Education, Center of Inclusive Education, Ehime University, Ehime, Japan
| | - Akihiro Toya
- Faculty of Education, Center of Inclusive Education, Ehime University, Ehime, Japan
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45
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Edmondson D, Conroy D, Romero-Canyas R, Tanenbaum M, Czajkowski S. Climate change, behavior change and health: a multidisciplinary, translational and multilevel perspective. Transl Behav Med 2022; 12:503-515. [PMID: 35613001 DOI: 10.1093/tbm/ibac030] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The climate crisis provides a critical new lens through which health and health behaviors need to be viewed. This paper has three goals. First, it provides background on the climate crisis, the role of human behavior in creating this crisis, and the health impacts of climate change. Second, it proposes a multilevel, translational approach to investigating health behavior change in the context of the climate crisis. Third, it identifies specific challenges and opportunities for increasing the rigor of behavioral medicine research in the context of the climate crisis. The paper closes with a call for behavioral medicine to be responsive to the climate crisis.
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Affiliation(s)
| | - David Conroy
- The Pennsylvania State University, State College, PA, USA
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46
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Turrisi TB, Lagoa CM, Conroy DE. Affective judgments, environmental determinants, and physical activity in emerging and young adults. Psychol Health 2022:1-20. [PMID: 35535727 PMCID: PMC9767299 DOI: 10.1080/08870446.2022.2074419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/14/2022] [Accepted: 04/29/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Affective judgements represent a promising target for promoting physical activity among adults. This study examined whether relations between affective judgments and physical activity are robust after adjusting for social, built, and natural environmental determinants. DESIGN Prospective cross-sectional study with 173 adults (70.1% female) aged 18-29 years who self-reported less than 90 minutes of moderate-to-vigorous physical activity. MAIN OUTCOME MEASURE Physical activity volume (total daily step count, total activity counts) and durations of intensity-specific physical activity (light-intensity activity and moderate-to-vigorous intensity) were assessed for a seven-day period via waist-worn ActiGraph wGT3X-BT accelerometer. RESULTS Affective judgements were not statistically associated with measures of physical activity volume or intensity-specific physical activity after adjusting for environmental influences. Support for exercise from friends was positively associated with measures of physical activity volume and moderate-to-vigorous physical activity duration. More favorable perceptions of the built environment were positively associated with moderate-to-vigorous intensity physical activity and negatively associated with duration of light-intensity physical activity. Longer photoperiods were associated with more light-intensity physical activity. CONCLUSION Physical activity interventions for young and emerging adults reporting inactivity should target environmental determinants first and possibly wait until participants have a motivational stake in physical activity before targeting affective judgments.
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Affiliation(s)
- Taylor B Turrisi
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Constantino M Lagoa
- School of Electrical Engineering & Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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47
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A Comparison of Meeting Physical Activity and Screen Time Recommendations between Canadian Youth Living in Rural and Urban Communities: A Nationally Representative Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074394. [PMID: 35410073 PMCID: PMC8998429 DOI: 10.3390/ijerph19074394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 02/07/2023]
Abstract
Meeting the physical activity (PA) and recreational screen time recommendations for children and young people is associated with several health benefits. The purpose of this study was to compare the odds of meeting PA and recreational screen time recommendations between the Canadian youth living in urban versus rural communities. We analyzed nationally representative cross-sectional data collected as part of the 2017–2018 cycles of the Canadian Community Health Survey among young people aged 12–17 years. PA and screen time were self-reported. Sex-specific multivariable logistic regression models were used to estimate the odds of meeting individual and combined PA and recreational screen time recommendations by rural and urban status after adjusting for individual, socioeconomic, and seasonal covariates. The odds of meeting the PA recommendation were not statistically significantly different among males (OR = 1.01, 95% CI: 0.86–1.18) or females (OR 1.05, 95% CI: 0.99–1.11) living in urban versus rural communities. The odds of meeting the recreational screen time recommendations were statistically significantly lower among male (OR = 0.71, 95% CI: 0.65–0.77) and female (OR = 0.71, 95% CI: 0.59–0.86) youth living in urban compared to those in rural communities. The odds of meeting the combined PA and screen time recommendations were statistically significantly lower among urban males (OR = 0.75, 95% CI: 0.71–0.81) but not females (OR = 0.82, 95% CI: 0.58–1.15) than those from rural communities. These findings suggest that residential context (i.e., urban versus rural) may have a differential impact on meeting the combined PA and screen time recommendations among the male and female Canadian youth. Future research should investigate these differences using device-based measures.
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Dalene KE, Kolle E, Steene-Johannessen J, Hansen BH, Ekelund U, Grydeland M, Anderssen SA, Tarp J. Device-measured sedentary time in Norwegian children and adolescents in the era of ubiquitous internet access: secular changes between 2005, 2011 and 2018. Int J Epidemiol 2022; 51:1556-1567. [PMID: 35362538 PMCID: PMC9557841 DOI: 10.1093/ije/dyac063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/21/2022] [Indexed: 01/06/2023] Open
Abstract
Background Access to screen-based media has been revolutionized during the past two decades. How this has affected sedentary time (ST) accumulation in children is poorly understood. Methods This study, based on the Physical Activity among Norwegian Children Study (PANCS), uses accelerometer data from population-based samples of 9- and 15‐year-olds, collected in 2005 (n = 1722), 2011 (n = 1587) and 2018 (n = 1859). Secular changes between surveys were analysed using random-effects linear regression models adjusted for survey-specific factors. Data on ST were collected using hip-worn ActiGraphs and ST was defined using a threshold equivalent to <100 counts/min. Sedentary bouts were grouped by duration: <1, 1–5, 5–15, 15–30 and ≥30 min. Results Between 2005 and 2018, ST increased by 29 min/day in 9-year-old boys (95% CI: 19, 39; P <0.001), by 21 min/day in 15-year-old boys (95% CI: 8, 34; P = 0.002) and by 22 min/day in 15-year-old girls (95% CI: 10, 35; P <0.001), but not in 9-year-old girls at 6 min/day (95% CI: -3, 16; P = 0.191). All age-sex groups accumulated less ST in bouts lasting <5 min and more ST in longer bouts, particularly in 5–15-min bouts. Adolescent girls also increased ST accumulation in 15–30-min and ≥30-min bouts. Changes were largely mirrored before, during and after school on weekdays and during weekend days. Conclusions Coinciding with the introduction of smartphones, tablets and near-universal internet access, total daily ST and ST accumulated in prolonged sedentary bouts increased between 2005 and 2018 in children and adolescents.
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Affiliation(s)
- Knut Eirik Dalene
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Elin Kolle
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | | | - Bjørge H Hansen
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - May Grydeland
- Department of Physical Performance, Norwegian School of Sports Sciences, Oslo, Norway
| | | | - Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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Examining adolescents' obesogenic behaviors on structured days: a systematic review and meta-analysis. Int J Obes (Lond) 2022; 46:466-475. [PMID: 34987203 DOI: 10.1038/s41366-021-01040-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The structured days hypothesis posits that 'structured days' (i.e., days with pre-planned, segmented, and adult-supervised environments) reduce youth obesogenic behaviors. Structured days may be especially important for adolescents', as adolescence (12-19 years) is a period of developmental milestones and increased autonomy. Therefore, the objective of this systematic review and meta-analysis is to evaluate the relationship between structured days and adolescents' obesogenic behaviors (i.e., physical activity, diet, screen time, and/or sleep). METHODS From February to April of 2020, four databases (i.e., Embase, PubMed, Web of Science, and PsychINfo) were searched for cross-sectional, longitudinal, and intervention (i.e., baseline data only) studies reporting obesogenic behaviors on more structured versus less structured days (i.e., weekday versus weekend or school year versus summer/holiday). RESULTS A total of 42,878 unique titles and abstracts were screened with 2767 full-text articles retrieved. After review of full-text articles, 296 studies were identified (sleep k = 147, physical activity k = 88, screen time k = 81, diet k = 8). Most studies were conducted in North America, Europe & Central Asia, or East Asia & the Pacific used self-report measures and compared school days to weekend days. Meta-analyses indicated that adolescents' physical activity (standardized mean difference [SMD] = -0.25 [95%CI - 0.48, -0.03]) and screen time (SMD = -0.48 [95%CI - 0.66, -0.29]) were less healthy on less structured days. Differences did not reach statistical significance for sleep (SMD = -0.23 [95%CI - 0.48, 0.02]) and diet (SMD = -0.13 [95%CI - 0.77, 0.51]), however, sleep timing (SMD = -1.05 [95%CI - 1.31, -0.79]) and diet quantity (SMD = -0.29 [95%CI - 0.35, -0.23]) were less healthy on less structured days. The review identified studies with large heterogeneity. CONCLUSIONS Findings indicate that adolescents' physical activity, screen time, sleep timing, and diet quantity are less healthy on less structured days. Interventions for adolescents to prevent and treat obesity may be more successful if they are designed to target times that are less structured.
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50
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Tan SY, Curtis AR, Leech RM, Ridgers ND, Crawford D, McNaughton SA. A systematic review of temporal body weight and dietary intake patterns in adults: implications on future public health nutrition interventions to promote healthy weight. Eur J Nutr 2022; 61:2255-2278. [DOI: 10.1007/s00394-021-02791-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/20/2021] [Indexed: 11/04/2022]
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