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Chan JA, Bosma H, Lakerveld J, Schram MT, van Greevenbroek M, Koster A. Social cohesion and associations with sedentary time, physical activity and dietary quality in The Maastricht Study. Prev Med 2024; 183:107970. [PMID: 38653391 DOI: 10.1016/j.ypmed.2024.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/04/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
INTRO We aim to investigate the relationship between social cohesion and sedentary behavior (SB), total physical activity (PA), moderate-to-vigorous PA (MVPA), and dietary quality. Additionally, we assess whether these associations are independent of neighborhood walkability and the food environment. METHODS A total of 7641 participants from The Maastricht Study in the Netherlands between the ages of 40 and 75 years were analyzed. Neighborhood social cohesion was obtained by participant questionnaire completed at baseline and measured by the Dutch Livability meter. Home addresses were linked to geographic information system (GIS) data from the Geoscience and Health Cohort Consortium (GECCO) to create neighborhood exposures of walkability and food environment. A thigh worn accelerometer collected data to measure sedentary time, total daily PA, and MVPA. Dietary quality was measured with a food frequency questionnaire. Multivariate linear regression analyses were adjusted for age, sex, socioeconomic position, neighborhood walkability, and food environment. RESULTS Those living in the highest quartile area of perceived social cohesion had statistically significant lower levels of SB (Q4 B: -13.04; 95% CI = -20.23, -5.85), higher total PA (Q4 B: 4.39; 95% CI = 1.69, 7.10), and higher MVPA (Q4 B: 2.57; 95% CI = 0.83, 4.31) and better diet quality (Q4 B: 1.12; 95% CI = 0.24, 2.01) compared to the lowest quartile independent of walkability and food environment. Similar results were found using the Livability meter. CONCLUSION We discovered neighborhood social cohesion as an important obesogenic determinant that should be considered in policymaking to encourage higher levels of PA and higher diet quality.
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Affiliation(s)
- Jeffrey Alexander Chan
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands; Department of Physical Medicine and Rehabilitation, Northern California VA Healthcare System, Martinez, CA, USA.
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Miranda T Schram
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands; Heart and Vascular Centre, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Marleen van Greevenbroek
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands; Department of Internal Medicine, Maastricht University, Maastricht, the Netherlands
| | - Annemarie Koster
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Social Medicine, Maastricht University, Maastricht, the Netherlands
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Nigg C, Alothman SA, Alghannam AF, Schipperijn J, AlAhmed R, Alsukait RF, Rakic S, Cetinkaya V, Al-Hazzaa HM, Alqahtani SA. A systematic review on the associations between the built environment and adult's physical activity in global tropical and subtropical climate regions. Int J Behav Nutr Phys Act 2024; 21:59. [PMID: 38773559 DOI: 10.1186/s12966-024-01582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/08/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Physical inactivity is a major public health concern, exacerbated in countries with a (sub)tropical climate. The built environment can facilitate physical activity; however, current evidence is mainly from North American and European countries with activity-friendly climate conditions. This study explored associations between built environment features and physical activity in global tropical or subtropical dry or desert climate regions. METHODS A systematic review of four major databases (Web of Science, Scopus, PubMed, and SportDISCUS) was performed. To be included, studies had to investigate associations between perceived or objective built environment characteristics and adult's physical activity and had to be conducted in a location with (sub)tropical climate. Each investigated association was reported as one case and results were synthesized based upon perceived and objectively assessed environment characteristics as well as Western and non-Western countries. Study quality was evaluated using a tool designed for assessing studies on built environment and physical activity. RESULTS Eighty-four articles from 50 studies in 13 countries with a total of 2546 built environment-physical activity associations were included. Design (connectivity, walking/cycling infrastructure), desirability (aesthetics, safety), and destination accessibility were the built environment characteristics most frequently associated with physical activity across the domains active transport, recreational physical activity, total walking and cycling, and moderate-to-vigorous physical activity, particularly if multiple attributes were present at the same time. Very few studies assessed built environment attributes specifically relevant to physical activity in (sub)tropical climates. Most studies were conducted in Western countries, with results being largely comparable with non-Western countries. Findings were largely generalizable across gender and age groups. Results from natural experiments indicated that relocating to an activity-friendly neighborhood impacted sub-groups differently. CONCLUSIONS Built environment attributes, including destination accessibility, connectivity, walking and cycling infrastructure, safety, and aesthetics, are positively associated with physical activity in locations with (sub)tropical climate. However, few studies focus on built environment attributes specifically relevant in a hot climate, such as shade or indoor recreation options. Further, there is limited evidence from non-Western countries, where most of the urban population lives in (sub)tropical climates. Policy makers should focus on implementing activity-friendly environment attributes to create sustainable and climate-resilient cities.
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Affiliation(s)
- Carina Nigg
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern, 3012, Switzerland.
| | - Shaima A Alothman
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, PO Box 47330, Riyadh, 11552, Saudi Arabia
| | - Abdullah F Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, PO Box 47330, Riyadh, 11552, Saudi Arabia
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 39, Odense, 5230, Denmark
| | - Reem AlAhmed
- Biostatistics, Epidemiology and Scientific Computing Department (BESC), King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Reem F Alsukait
- Community Health Sciences, King Saud University, PO Box 145111, Riyadh, 11362, Saudi Arabia
| | - Severin Rakic
- The World Bank, 1818 H Street N.W, Washington, DC, 20433, USA
| | | | - Hazzaa M Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, PO Box 47330, Riyadh, 11552, Saudi Arabia
- School of Sport Sciences, University of Jordan, King Abdullah II St, Amman, Jordan
| | - Saleh A Alqahtani
- Liver Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, 11564, Saudi Arabia
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, 21287, USA
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Larsson K, Rossen J, Norman Å, Johansson UB, Hagströmer M. Predictors associated with an increase in daily steps among people with prediabetes or type 2 diabetes participating in a two-year pedometer intervention. BMC Public Health 2024; 24:1290. [PMID: 38734659 PMCID: PMC11088056 DOI: 10.1186/s12889-024-18766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND This study aimed to explore predictors associated with intermediate (six months) and post-intervention (24 months) increases in daily steps among people with prediabetes or type 2 diabetes participating in a two-year pedometer intervention. METHODS A secondary analysis was conducted based on data from people with prediabetes or type 2 diabetes from two intervention arms of the randomised controlled trial Sophia Step Study. Daily steps were measured with an ActiGraph GT1M accelerometer. Participants were divided into two groups based on their response to the intervention: Group 1) ≥ 500 increase in daily steps or Group 2) a decrease or < 500 increase in daily steps. Data from baseline and from six- and 24-month follow-ups were used for analysis. The response groups were used as outcomes in a multiple logistic regression together with baseline predictors including self-efficacy, social support, health-related variables, intervention group, demographics and steps at baseline. Predictors were included in the regression if they had a p-value < 0.2 from bivariate analyses. RESULTS In total, 83 participants were included. The mean ± SD age was 65.2 ± 6.8 years and 33% were female. At six months, a lower number of steps at baseline was a significant predictor for increasing ≥ 500 steps per day (OR = 0.82, 95% CI 0.69-0.98). At 24 months, women had 79% lower odds of increasing ≥ 500 steps per day (OR = 0.21, 95% CI 0.05-0.88), compared to men. For every year of increase in age, the odds of increasing ≥ 500 steps per day decreased by 13% (OR = 0.87, 95% CI 0.78-0.97). Also, for every step increase in baseline self-efficacy, measured with the Self-Efficacy for Exercise Scale, the odds of increasing ≥ 500 steps per day increased by 14% (OR = 1.14, 95% CI 1.02-1.27). CONCLUSIONS In the Sophia Step Study pedometer intervention, participants with a lower number of steps at baseline, male gender, lower age or higher baseline self-efficacy were more likely to respond to the intervention with a step increase above 500 steps per day. More knowledge is needed about factors that influence response to pedometer interventions. TRIAL REGISTRATION ClinicalTrials.gov, NCT02374788.
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Affiliation(s)
- Kristina Larsson
- Department of Health Promotion Science, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden.
| | - Jenny Rossen
- Department of Health Promotion Science, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden
| | - Åsa Norman
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Unn-Britt Johansson
- Department of Health Promotion Science, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Maria Hagströmer
- Department of Health Promotion Science, Sophiahemmet University, Box 5605, Stockholm, 114 86, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Care Center, Region Stockholm, Stockholm, Sweden
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Johnson AM, Zhou C, Haviland M, Mendoza JA. Evaluation of a walking school bus program: a cluster randomized controlled trial. Int J Behav Nutr Phys Act 2024; 21:55. [PMID: 38730407 PMCID: PMC11083767 DOI: 10.1186/s12966-024-01602-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effects of a walking school bus intervention on children's active commuting to school. METHODS We conducted a randomized controlled trial (RCT) in Houston, Texas (Year 1) and Seattle, Washington (Years 2-4) from 2012 to 2016. The study had a two-arm, cluster randomized design comparing the intervention (walking school bus and education materials) to the control (education materials) over one school year October/November - May/June). Twenty-two schools that served lower income families participated. Outcomes included percentage of days students' active commuting to school (primary, measured via survey) and moderate-to-vigorous physical activity (MVPA, measured via accelerometry). Follow-up took place in May or June. We used linear mixed-effects models to estimate the association between the intervention and outcomes of interest. RESULTS Total sample was 418 students [Mage=9.2 (SD = 0.9) years; 46% female], 197 (47%) in the intervention group. The intervention group showed a significant increase compared with the control group over time in percentage of days active commuting (β = 9.04; 95% CI: 1.10, 16.98; p = 0.015) and MVPA minutes/day (β = 4.31; 95% CI: 0.70, 7.91; p = 0.02). CONCLUSIONS These findings support implementation of walking school bus programs that are inclusive of school-age children from lower income families to support active commuting to school and improve physical activity. TRAIL REGISTRATION This RCT is registered at clinicaltrials.gov (NCT01626807).
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Affiliation(s)
- Ashleigh M Johnson
- School of Exercise and Nutritional Sciences, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA.
| | - Chuan Zhou
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, WA, 98101, USA
- Department of Pediatrics, University of Washington, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
| | | | - Jason A Mendoza
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, WA, 98101, USA
- Public Health Sciences, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
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Stankov I, Meisel JD, Sarmiento OL, Delclòs-Alió X, Hidalgo D, Guzman LA, Rodriguez DA, Hammond RA, Diez Roux AV. Uncovering physical activity trade-offs in transportation policy: A spatial agent-based model of Bogotá, Colombia. Int J Behav Nutr Phys Act 2024; 21:54. [PMID: 38720323 PMCID: PMC11077730 DOI: 10.1186/s12966-024-01570-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/10/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Transportation policies can impact health outcomes while simultaneously promoting social equity and environmental sustainability. We developed an agent-based model (ABM) to simulate the impacts of fare subsidies and congestion taxes on commuter decision-making and travel patterns. We report effects on mode share, travel time and transport-related physical activity (PA), including the variability of effects by socioeconomic strata (SES), and the trade-offs that may need to be considered in the implementation of these policies in a context with high levels of necessity-based physical activity. METHODS The ABM design was informed by local stakeholder engagement. The demographic and spatial characteristics of the in-silico city, and its residents, were informed by local surveys and empirical studies. We used ridership and travel time data from the 2019 Bogotá Household Travel Survey to calibrate and validate the model by SES. We then explored the impacts of fare subsidy and congestion tax policy scenarios. RESULTS Our model reproduced commuting patterns observed in Bogotá, including substantial necessity-based walking for transportation. At the city-level, congestion taxes fractionally reduced car use, including among mid-to-high SES groups but not among low SES commuters. Neither travel times nor physical activity levels were impacted at the city level or by SES. Comparatively, fare subsidies promoted city-level public transportation (PT) ridership, particularly under a 'free-fare' scenario, largely through reductions in walking trips. 'Free fare' policies also led to a large reduction in very long walking times and an overall reduction in the commuting-based attainment of physical activity guidelines. Differential effects were observed by SES, with free fares promoting PT ridership primarily among low-and-middle SES groups. These shifts to PT reduced median walking times among all SES groups, particularly low-SES groups. Moreover, the proportion of low-to-mid SES commuters meeting weekly physical activity recommendations decreased under the 'freefare' policy, with no change observed among high-SES groups. CONCLUSIONS Transport policies can differentially impact SES-level disparities in necessity-based walking and travel times. Understanding these impacts is critical in shaping transportation policies that balance the dual aims of reducing SES-level disparities in travel time (and time poverty) and the promotion of choice-based physical activity.
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Affiliation(s)
- Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, 7th Floor, Philadelphia, PA, 19104, USA.
- UniSA Allied Health & Human Performance, University of South Australia, North Terrace, Adelaide, SA, 5000, Australia.
| | - Jose D Meisel
- Facultad de Ingeniería, Universidad de Ibagué, Carrera 22 Calle 67, 730001, Ibagué, Colombia
- Social and Health Complexity Center, Universidad de Los Andes, Bogotá, Colombia
| | - Olga Lucia Sarmiento
- Department of Public Health, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Xavier Delclòs-Alió
- Research Group On Territorial Analysis and Tourism Studies (GRATET), Department of Geography, Facultat de Turisme I Geografia, Universitat Rovira I Virgili, C/ Joanot Martorell, 15, 43480, Vila-Seca, Spain
| | - Dario Hidalgo
- Department of Industrial Engineering, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis A Guzman
- Grupo de Sostenibilidad Urbana y Regional, SUR. Department of Civil and Environmental Engineering, Universidad de los Andes, Bogotá, Colombia
| | - Daniel A Rodriguez
- Department of City and Regional Planning and Institute of Transportation Studies, University of California, Berkeley, 228 Bauer-Wurster Hall #1820, Berkeley, CA, 94720-1820, USA
| | - Ross A Hammond
- The Brookings Institution, 1775 Massachusetts Avenue, N.W., Washington, DC, USA
- Brown School at Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO, 63130, USA
- The Santa Fe Institute, 1399 Hyde Park Road, Santa Fe, NM, 87501, USA
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market St, 7th Floor, Philadelphia, PA, 19104, USA
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Schaupp J, Hediger K, Wunderli JM, Schäffer B, Tobias S, Kolecka N, Bauer N. Psychophysiological effects of walking in forests and urban built environments with disparate road traffic noise exposure: study protocol of a randomized controlled trial. BMC Psychol 2024; 12:250. [PMID: 38711162 DOI: 10.1186/s40359-024-01720-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Stress is a widespread phenomenon and reality of everyday life, entailing negative consequences for physical and psychological wellbeing. Previous studies have indicated that exposure to greenspaces and nature-based interventions are promising approaches to reducing stress and promoting restoration. However, an increasing percentage of the population lives in urban regions with limited opportunities to spend time in greenspaces. In addition, urban settings typically feature increased levels of noise, which represents a major environmental stressor. Although various studies have compared the effects of exposure to greenspaces versus urban built environments, evidence of the effects of noise in this context is very limited. Psychophysiological benefits of exposure to greenspaces compared to urban built environments reported in earlier studies might be less (or at least not only) due to features of the greenspaces than to additional stressors, such as road traffic noise in the urban built environment. Hence, differences in the effects attributed to greenness in previous studies may also be due to potentially detrimental noise effects in comparison settings. This paper reports the study protocol for a randomized, controlled intervention study comparing the effects of walking in forest versus urban built environments, taking road traffic noise exposure during walks in the respective settings into account. METHODS The protocol envisages a field study employing a pretest-posttest design to compare the effects of 30-min walks in urban built environments and forests with different road traffic noise levels. Assessments will consist of self-reported measures, physiological data (salivary cortisol and skin conductance), an attention test, and noise, as well as greenness measurements. The outcomes will be restoration, stress, positive and negative affect, attention, rumination, and nature connectedness. DISCUSSION The results will inform about the restorative effect of walking in general, of exposure to different types of environments, and to different noise levels in these sites. The study will provide insights into the benefits of walking and nature-based interventions, taking into account the potential detrimental effects of noise exposure. It will thus facilitate a better understanding of low-threshold interventions to prevent stress and foster wellbeing. TRIAL REGISTRATION ISRCTN48943261 ; Registered 23.11.2023.
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Affiliation(s)
- Julia Schaupp
- Swiss Federal Institute for Forest, Snow and Landscape Research (WSL), Birmensdorf, Switzerland.
- Faculty of Psychology, Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland.
| | - Karin Hediger
- Faculty of Psychology, Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Faculty of Psychology, Open University, Heerlen, the Netherlands
| | - Jean-Marc Wunderli
- Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Beat Schäffer
- Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Silvia Tobias
- Swiss Federal Institute for Forest, Snow and Landscape Research (WSL), Birmensdorf, Switzerland
| | - Natalia Kolecka
- Swiss Federal Institute for Forest, Snow and Landscape Research (WSL), Birmensdorf, Switzerland
| | - Nicole Bauer
- Swiss Federal Institute for Forest, Snow and Landscape Research (WSL), Birmensdorf, Switzerland
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Appelhans BM, Lange-Maia BS, Yeh C, Jackson EA, Schiff MD, Barinas-Mitchell E, Derby CA, Karvonen-Gutierrez CA, Janssen I. Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation. Health Place 2024; 87:103257. [PMID: 38696876 PMCID: PMC11102830 DOI: 10.1016/j.healthplace.2024.103257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Neighborhood physical environments may influence cardiometabolic health, but prior studies have been inconsistent, and few included long follow-up periods. METHODS Changes in cardiometabolic risk factors were measured for up to 14 years in 2830 midlife women in the Study of Women's Health Across the Nation, a multi-ethnic/racial cohort of women from seven U.S. sites. Data on neighborhood food retail environments (modified Retail Food Environment Index) and walkability (National Walkability Index) were obtained for each woman's residence at each follow-up. Data on neighborhood access to green space, parks, and supermarkets were available for subsets (32-42%) of women. Models tested whether rates of change in cardiometabolic outcomes differed based on neighborhood characteristics, independent of sociodemographic and health-related covariates. RESULTS Living in more (vs. less) walkable neighborhoods was associated with favorable changes in blood pressure outcomes (SBP: -0.27 mmHg/year, p = 0.002; DBP: -0.22 mmHg/year, p < 0.0001; hypertension status: ratio of ORs = 0.79, p < 0.0001), and small declines in waist circumference (-0.09 cm/year, p = 0.03). Small-magnitude associations were also observed between low park access and greater increases in blood pressure outcomes (SBP: 0.37 mmHg/year, p = 0.003; DBP: 0.15 mmHg/year, p = 0.04; hypertension status: ratio of ORs = 1.16, p = .04), though associations involving DBP and hypertension were only present after adjustment for sociodemographic variables. Other associations were statistically unreliable or contrary to hypotheses. CONCLUSION Neighborhood walkability may have a meaningful influence on trajectories of blood pressure outcomes in women from midlife to early older adulthood, suggesting the need to better understand how individuals interact with their neighborhood environments in pursuit of cardiometabolic health.
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Affiliation(s)
- Bradley M Appelhans
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Brittney S Lange-Maia
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Chen Yeh
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Elizabeth A Jackson
- Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary D Schiff
- UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Emma Barinas-Mitchell
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carol A Derby
- Saul R. Korey Department of Neurology, and Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Imke Janssen
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
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Kong H, Wu J, Li P. Impacts of active mobility on individual health mediated by physical activities. Soc Sci Med 2024; 348:116834. [PMID: 38574590 DOI: 10.1016/j.socscimed.2024.116834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/08/2024] [Accepted: 03/24/2024] [Indexed: 04/06/2024]
Abstract
Active mobility, encompassing walking and cycling for transportation, is a potential solution to health issues arising from inadequate physical activity in modern society. However, the extent of active mobility's impact on individual physical activity levels, and its association with health as mediated by physical activities, is not fully quantified. This study aims to clarify the direct relationship between active mobility usage and individual health, as well as the indirect relationship mediated by physical activity, with a focus on varying levels of physical activity intensity. Utilizing data from the 2017 U.S. National Household Travel Survey (NHTS), we employed Poisson regression to predict active mobility usage based on socio-demographic and household socio-economic characteristics. A Structural Equation Model (SEM) was then used to investigate the direct and indirect effects of active mobility on individual health, mediated by physical activity. We further segmented individuals according to their intensity of physical activity to examine how such effect differs between different levels of physical activity. The study demonstrates that active mobility usage positively correlates with both the amount and intensity of physical activity. The effect of active mobility on individual health includes a direct positive effect (29% for intensity, 67.7% for amount) and an indirect effect mediated by physical activity (71% for intensity, 32.3% for amount). Notably, the mediation effect of active mobility on health is more substantial in the context of vigorous physical activities compared to light or moderate activities. Our findings reveal a significant positive influence of active mobility on individual health, encompassing both direct and indirect effects mediated by physical activities. These results quantitatively underscore the health benefits of active mobility and suggest the importance of promoting active mobility as a strategy to improve public health.
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Affiliation(s)
- Hui Kong
- School of Architecture and Civil Engineering, Xiamen University, Xiamen, 361005, China; Fujian Key Laboratory of Digital Simulations for Coastal Civil Engineering, School of Architecture and Civil Engineering, Xiamen University, Xiamen, 361005, China
| | - Jingyi Wu
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China; Institute of Medical Technology, Peking University, Beijing, 100191, China.
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Duffy RT, Larsen K, Bélanger M, Brussoni M, Faulkner G, Gunnell K, Tremblay MS, Larouche R. Children's Independent Mobility, School Travel, and the Surrounding Neighborhood. Am J Prev Med 2024; 66:819-831. [PMID: 38081375 DOI: 10.1016/j.amepre.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/05/2023] [Accepted: 12/05/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Children's active travel to and from school (AST) and children's independent mobility (CIM) are consistently positively associated with physical activity (PA); however, few researchers have investigated associations between objective measures of the environment and indicators of AST and CIM in national samples. METHODS A national sample of 2,067 Canadian parents of 7- to 12-year-old children was recruited in December 2020. Regression analyses were used in 2023 to assess the association between geographic information system measures of park density, blue space, population density, greenspace, intersection density, and CIM and AST to and from school. RESULTS Children in areas with high versus low park density (>0.025 vs. ≤0.025) had higher odds of travel to school via active modes (OR: 1.47 [1.14, 1.91], p=0.003). Children in neighborhoods in the highest quartile for neighborhood greenspace (Normalized Difference Vegetation Index) were more likely to travel to home actively than those in areas of lower greenspace (OR: 1.70 [1.18, 2.45], p=0.004). On average, children living in areas in the highest versus the lowest quartile for intersection density were more likely to engage in AST to (OR: 2.43 [1.58, 3.75], p<0.001) and from (OR: 2.77 [1.80, 4.29], p<0.001) school. CONCLUSIONS The observed associations underscore a need for city planners and policymakers to ensure sufficient access to parks and neighborhood greenspace, especially if findings are confirmed in longitudinal studies. More research is needed to investigate the role of intersection density in supporting AST and CIM.
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Affiliation(s)
- Robert T Duffy
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON, Canada
| | - Kristian Larsen
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, ON, Canada; Health Canada, Office of Environmental Health, Healthy Environments and Consumer Safety Branch, Environmental and Radiation Health Science Directorate, Ottawa, ON, Canada; Department of Geography and Planning, University of Toronto, Toronto, ON, Canada; Department of Public Health Sciences, Queen's University, Kingston, ON, Canada; CAREX Canada, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
| | - Mathieu Bélanger
- Faculté de Médecine et des Sciences de La Santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Mariana Brussoni
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, BC, Canada
| | - Katie Gunnell
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, ON, Canada; Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada; Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Richard Larouche
- Faculty of Health Sciences, University of Lethbridge, Lethbridge AB, Canada
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10
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Rachele JN, Mavoa S, Sugiyama T, Kavanagh A, Giles-Corti B, Brown WJ, Inoue S, Amagasa S, Turrell G. Changes in neighbourhood walkability and body mass index: An analysis of residential mobility from a longitudinal multilevel study in Brisbane, Australia. Health Place 2024; 87:103245. [PMID: 38631216 DOI: 10.1016/j.healthplace.2024.103245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
This study examined associations between changes in neighbourhood walkability and body mass index (BMI) among 1041 residents who relocated within Brisbane, Australia between 2007 and 2016 over five waves of the HABITAT study. Measures included spatially-derived neighbourhood walkability (dwelling density, street connectivity, and land use mix) and self-reported height and weight. No associations were found between any neighbourhood walkability characteristics and BMI. Examining these associations over the life course, and the impact of residential relocation in the younger years, remains a priority for future research.
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Affiliation(s)
- Jerome N Rachele
- College of Sport, Health and Engineering, Victoria University, Melbourne, Australia; Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Suzanne Mavoa
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.
| | - Anne Kavanagh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
| | | | - Wendy J Brown
- School of Human Movement and Nutrition Studies, University of Queensland, St Lucia, Australia.
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan.
| | - Shiho Amagasa
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan; Graduate School of Public Health, Teikyo University, Tokyo, Japan.
| | - Gavin Turrell
- Centre for Urban Research, RMIT University, Melbourne, Australia.
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11
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Sá R, Roquette R, Rebecchi A, Matias J, Rocha J, Buffoli M, Capolongo S, Ribeiro AI, Nunes B, Dias C, Sousa Uva M. Association between area-level walkability and glycated haemoglobin: a Portuguese population-based study. BMC Public Health 2024; 24:1116. [PMID: 38654178 PMCID: PMC11036776 DOI: 10.1186/s12889-024-18627-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/16/2024] [Indexed: 04/25/2024] Open
Abstract
Diabetes poses a substantial disease burden, prompting preventive interventions. Physical inactivity, a major risk factor for type 2 diabetes, can potentially be mitigated by enhancing area-level walkability. Despite this, limited population-based studies have investigated the link between walkability and objective diabetes measures. Our study aims to estimate the association between area-level walkability and individual glycated haemoglobin levels in the Portuguese adult population without the diagnosis of diabetes. Data from the 2011 census and an updated street map were obtained to construct a walkability index based on residential density, land-use mix, and street connectivity. Individual health data were sourced from The National Health Examination Survey (INSEF) 2015, a representative survey of the Portuguese adult population. Gamma regression was employed for estimation of the main associations, revealing that residing in moderately walkable areas significantly reduced average glycated haemoglobin levels (Exp(β) = 0.906; 95% CI: 0.821, 0.999) compared to the least walkable areas. The association was less pronounced and not statistically significant for the third tertile of walkability (Exp(β) = 0.919; 95% CI: 0.822, 1.028). Our findings highlight a nonlinear protective association between walkability and glycated haemoglobin, emphasizing the potential policy implications for urban planning, diabetes prevention, and health promotion.
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Affiliation(s)
- Regina Sá
- Unidade de Saúde Pública, Agrupamento de Centros de Saúde (ACES) do Baixo Vouga, Aveiro, Portugal.
- Unidade de Saúde Pública, Agrupamento de Centros de Saúde (ACES) Algarve I, Faro, Portugal.
| | - Rita Roquette
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
| | - Andrea Rebecchi
- Design & Health Lab, Department of Architecture, Built environment and Construction Engineering, Politecnico di Milano, Milan, Italy
| | - Judite Matias
- Unidade de Saúde Pública, Agrupamento de Centros de Saúde (ACES) do Baixo Vouga, Aveiro, Portugal
| | - Jorge Rocha
- Instituto de Geografia e Ordenamento do Território (IGOT), Universidade de Lisboa e Laboratório Associado TERRA, Lisbon, Portugal
| | - Maddalena Buffoli
- Design & Health Lab, Department of Architecture, Built environment and Construction Engineering, Politecnico di Milano, Milan, Italy
| | - Stefano Capolongo
- Design & Health Lab, Department of Architecture, Built environment and Construction Engineering, Politecnico di Milano, Milan, Italy
| | - Ana Isabel Ribeiro
- Unidade de Investigação em Epidemiologia (EPIUnit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Baltazar Nunes
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
- Centro de Investigação em Saúde Pública (CISP), Escola Nacional de Saúde Pública (ENSP-NOVA), Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - Carlos Dias
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
- Centro de Investigação em Saúde Pública (CISP), Escola Nacional de Saúde Pública (ENSP-NOVA), Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - Mafalda Sousa Uva
- Departamento de Epidemiologia, Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA), Lisboa, Portugal
- Centro de Investigação em Saúde Pública (CISP), Escola Nacional de Saúde Pública (ENSP-NOVA), Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Lisbon, Portugal
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12
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Arifwidodo SD, Chandrasiri O. Neighbourhood Walkability and Physical Activity during the COVID-19 Pandemic. Int J Environ Res Public Health 2024; 21:387. [PMID: 38673300 PMCID: PMC11050372 DOI: 10.3390/ijerph21040387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
This study investigated whether living in a walkable neighbourhood could mitigate the adverse effects of the lockdown and closure of public open spaces during the COVID-19 pandemic on physical activity among adults in Bangkok, Thailand. We conducted a telephone survey with 579 respondents and collected information on their physical activity, access to green open spaces, neighbourhood walkability, and socioeconomic characteristics during the pandemic. Our study indicates that living in a walkable neighbourhood is associated with a higher likelihood of engaging in sufficient physical activity during the pandemic. Furthermore, we confirm the influence of socioeconomic factors and health behaviours on physical activity levels, aligning with previous research. Notably, our study highlights the significant association between access to green open spaces during lockdown and increased physical activity. These results underscore the importance of promoting walkable neighbourhoods and ensuring accessible green spaces to enhance physical activity and improve health outcomes during and beyond the pandemic.
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Affiliation(s)
- Sigit D. Arifwidodo
- Department of Landscape Architecture, Faculty of Architecture, Kasetsart University, Chatuchak 10900, Thailand
| | - Orana Chandrasiri
- Activethai.org Research Center, Faculty of Architecture, Kasetsart University Chatuchak 10900, Thailand;
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13
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Harris E. Self-Reported Walking Limitations Linked With Higher Risk of Fractures. JAMA 2024; 331:635. [PMID: 38324290 DOI: 10.1001/jama.2024.0173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
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15
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Galloway R, Booker R, Loftin M, Holmes ME, Gdovin J. Physiological and perceptual responses during walking at set and preferred pace in normal and overweight adults. Int J Obes (Lond) 2022; 46:100-106. [PMID: 34508154 PMCID: PMC11008182 DOI: 10.1038/s41366-021-00963-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 08/16/2021] [Accepted: 08/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to investigate the influence of body weight, exercise modality, and pace on physiological and perceptual responses to determine the relation between perceptual and physiological responses. METHODS Aerobically untrained, normal weight, and overweight males and females participated. Participants were randomly assigned to one exercise condition for a 1-mile walk. RESULTS Prescribed pace resulted in a greater physiological stress than self-selected pace (all p < 0.001) through blood lactate (1.3 ± 0.4 vs 1.7 ± 0.5 mmol), systolic blood pressure (128.9 ± 10.3 vs 139.2 ± 13.2 mmHg), heart rate recovery (2.1 ± 1.7 vs 4.5 ± 2.6 min), oxygen consumption (15.1 ± 2.6 vs 18.1 ± 3.6 ml/kg/min), heart rate (111.7 ± 16.6 vs 134.4 ± 8.3 bpm), and energy expenditure (5.5 ± 1.4 vs 6.8 ± 1.7 kcal/min). Overweight individuals exhibited higher values than normal weight for heart rate (113 ± 8.8 vs 125.5 ± 13.2 bpm, p < 0.001), percentage of max heart rate (60.7 vs 69.0%, p < 0.001), percent of VO2peak (42.2 vs 55.6%, p < 0.001), and total energy expenditure (100.9 ± 27.4 vs 114.1 ± 33.5 kcal, p = 0.022). Greater perceived effort was seen on a treadmill (6.3 ± 0.5 vs 12.5 ± 2.0 RPE, p < 0.001) and at prescribed pace (6.5 ± 1.1 vs 8.9 ± 1.9 RPE, p < 0.001). CONCLUSION A novel finding of this study was the increased physiological stress and perception of effort on a treadmill and at a prescribed pace, while total energy expenditure showed no significant differences. This could indicate an unfavorable perception and less affective response to the treadmill modality. These results indicate exercise at self-selected pace in preferred environments promotes enjoyable experiences with similar health benefits as those during prescribed higher intensity exercise.
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Affiliation(s)
- R Galloway
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, USA.
| | - R Booker
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - M Loftin
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, MS, USA
| | - M E Holmes
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - J Gdovin
- Department of Physical Education, Sport, and Human Performance, Winthrop University, Rock Hill, MS, USA
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16
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Voelker R. Survey Describes How Patients With Arthritis Get Moving. JAMA 2021; 326:1783. [PMID: 34751710 DOI: 10.1001/jama.2021.19532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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17
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Guglielmo D, Murphy LB, Theis KA, Boring MA, Helmick CG, Watson KB, Duca LM, Odom EL, Liu Y, Croft JB. Walking and Other Common Physical Activities Among Adults with Arthritis - United States, 2019. MMWR Morb Mortal Wkly Rep 2021; 70:1408-1414. [PMID: 34618794 PMCID: PMC8519272 DOI: 10.15585/mmwr.mm7040a3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Lapa DA, Chmait RH, Gielchinsky Y, Yamamoto M, Persico N, Santorum M, Gil MM, Trigo L, Quintero RA, Nicolaides KH. Percutaneous fetoscopic spina bifida repair: effect on ambulation and need for postnatal cerebrospinal fluid diversion and bladder catheterization. Ultrasound Obstet Gynecol 2021; 58:582-589. [PMID: 33880811 PMCID: PMC9293198 DOI: 10.1002/uog.23658] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 06/02/2023]
Abstract
OBJECTIVE A trial comparing prenatal with postnatal open spina bifida (OSB) repair established that prenatal surgery was associated with better postnatal outcome. However, in the trial, fetal surgery was carried out through hysterotomy. Minimally invasive approaches are being developed to mitigate the risks of open maternal-fetal surgery. The objective of this study was to investigate the impact of a novel neurosurgical technique for percutaneous fetoscopic repair of fetal OSB, the skin-over-biocellulose for antenatal fetoscopic repair (SAFER) technique, on long-term postnatal outcome. METHODS This study examined descriptive data for all patients undergoing fetoscopic OSB repair who had available 12- and 30-month follow-up data for assessment of need for cerebrospinal fluid (CSF) diversion and need for bladder catheterization and ambulation, respectively, from eight centers that perform prenatal OSB repair via percutaneous fetoscopy using a biocellulose patch between the neural placode and skin/myofascial flap, without suture of the dura mater (SAFER technique). Univariate and multivariate logistic regression analyses were used to examine the effect of different factors on need for CSF diversion at 12 months and ambulation and need for bladder catheterization at 30 months. Potential cofactors included gestational age at fetal surgery and delivery, preoperative ultrasound findings of anatomical level of the lesion, cerebral lateral ventricular diameter, lesion type and presence of bilateral talipes, as well as postnatal findings of CSF leakage at birth, motor level, presence of bilateral talipes and reversal of hindbrain herniation. RESULTS A total of 170 consecutive patients with fetal OSB were treated prenatally using the SAFER technique. Among these, 103 babies had follow-up at 12 months of age and 59 had follow-up at 30 months of age. At 12 months of age, 53.4% (55/103) of babies did not require ventriculoperitoneal shunt or third ventriculostomy. At 30 months of age, 54.2% (32/59) of children were ambulating independently and 61.0% (36/59) did not require chronic intermittent catheterization of the bladder. Multivariate logistic regression analysis demonstrated that significant prediction of need for CSF diversion was provided by lateral ventricular size and type of lesion (myeloschisis). Significant predictors of ambulatory status were prenatal bilateral talipes and anatomical and functional motor levels of the lesion. There were no significant predictors of need for bladder catheterization. CONCLUSION Children who underwent prenatal OSB repair via the percutaneous fetoscopic SAFER technique achieved long-term neurological outcomes similar to those reported in the literature after hysterotomy-assisted OSB repair. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D. A. Lapa
- Fetal Therapy Team CoordinatorHospital Infantil SabaraSão PauloBrazil
- Fetal Therapy GroupHospital Israelita Albert EinsteinSão PauloBrazil
| | - R. H. Chmait
- Los Angeles Fetal Surgery, Department of Obstetrics and GynecologyKeck School of Medicine, University of Southern CaliforniaLos AngelesCAUSA
| | - Y. Gielchinsky
- Fetal Therapy, Helen Schneider Hospital for WomenRabin Medical CenterPetah TikvaIsrael
| | | | - N. Persico
- Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
- Fetal Medicine and Surgery Service, Fondazione IRCCS Ca' Granda, Ospedale Maggiore PoliclinicoMilanItaly
| | - M. Santorum
- Fetal Medicine Research InstituteKing's College HospitalLondonUK
| | - M. M. Gil
- Department of Obstetrics and GynecologyHospital Universitario de TorrejónMadridSpain
- School of MedicineUniversidad Francisco de VitoriaMadridSpain
| | - L. Trigo
- Fetal Therapy GroupHospital Israelita Albert EinsteinSão PauloBrazil
- BCNatal Fetal Medicine Research CenterBarcelonaSpain
| | | | - K. H. Nicolaides
- Fetal Medicine Research InstituteKing's College HospitalLondonUK
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Master H, Thoma LM, Neogi T, Dunlop DD, LaValley M, Christiansen MB, Voinier D, White DK. Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States. Arch Phys Med Rehabil 2021; 102:1888-1894. [PMID: 34175271 PMCID: PMC8487939 DOI: 10.1016/j.apmr.2021.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/14/2021] [Accepted: 05/25/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine the association of the volume and intensity of daily walking at baseline with the risk of knee replacement (KR) over 5 years in adults with advanced structural knee osteoarthritis. DESIGN Prospective, longitudinal, and multicenter observational study. SETTING Osteoarthritis Initiative study with follow-up from 2008-2015. PARTICIPANTS Community-dwelling adults with or at risk of knee osteoarthritis were recruited from 4 sites in the United States (N=516; mean age, 67.7±8.6y; body mass index, 29.3±4.7 kg/m2; 52% female). We included participants with advanced structural disease, without KR and had valid daily walking data (quantified using Actigraph GT1M), at baseline. INTERVENTIONS Not applicable. MAIN OUTCOMES KR. Walking volume was measured as steps/day and intensity as minutes/day spent not walking (0 steps/min) and walking at very light (1-49 steps/min), light (50-100 steps/min), or moderate (>100 steps/min) intensities. To examine the relationship of walking volume and intensity with the risk of KR, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusting for covariates. RESULTS Of 516 adults with advanced structural disease, 88 received a KR over 5 years (17%). Walking an additional 1000 steps/d was not associated with the risk of KR (adjusted HR=0.95; 95% CI, 0.84-1.04). Statistically, replacing 10 min/d of very light and light walking with 10 min/d of moderate walking reduced the risk of KR incidence by 35% and 37%, respectively (adjusted HR=0.65, 95% CI, 0.45-0.94, for very light and adjusted HR=0.63; 95% CI, 0.40-1.00, for light). CONCLUSIONS Daily walking volume and intensity did not increase KR risk over 5 years and may be protective in some cases in adults with advanced structural knee osteoarthritis.
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Affiliation(s)
- Hiral Master
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE; Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN
| | - Louise M Thoma
- Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, MA
| | - Dorothy D Dunlop
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL; Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | | | - Meredith B Christiansen
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE
| | - Dana Voinier
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE
| | - Daniel K White
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE; Biomechanics and Movement Science Interdisciplinary Program, University of Delaware, Newark, DE.
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Staples JA, Yuan Y, Meddings L, Brubacher JR. Are We There Yet? The American Journey to Safer City Streets. Am J Public Health 2021; 111:1586-1588. [PMID: 34410819 PMCID: PMC8589056 DOI: 10.2105/ajph.2021.306405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2021] [Indexed: 11/04/2022]
Affiliation(s)
- John A Staples
- John A. Staples is affiliated with the Department of Medicine, University of British Columbia, and the Centre for Clinical Epidemiology and Evaluation (C2E2), both in Vancouver, British Columbia, Canada. Yue Yuan and Louise Meddings are affiliated with the Department of Emergency Medicine, University of British Columbia. Jeffrey R. Brubacher is affiliated with the Department of Emergency Medicine, University of British Columbia, and C2E2
| | - Yue Yuan
- John A. Staples is affiliated with the Department of Medicine, University of British Columbia, and the Centre for Clinical Epidemiology and Evaluation (C2E2), both in Vancouver, British Columbia, Canada. Yue Yuan and Louise Meddings are affiliated with the Department of Emergency Medicine, University of British Columbia. Jeffrey R. Brubacher is affiliated with the Department of Emergency Medicine, University of British Columbia, and C2E2
| | - Louise Meddings
- John A. Staples is affiliated with the Department of Medicine, University of British Columbia, and the Centre for Clinical Epidemiology and Evaluation (C2E2), both in Vancouver, British Columbia, Canada. Yue Yuan and Louise Meddings are affiliated with the Department of Emergency Medicine, University of British Columbia. Jeffrey R. Brubacher is affiliated with the Department of Emergency Medicine, University of British Columbia, and C2E2
| | - Jeffrey R Brubacher
- John A. Staples is affiliated with the Department of Medicine, University of British Columbia, and the Centre for Clinical Epidemiology and Evaluation (C2E2), both in Vancouver, British Columbia, Canada. Yue Yuan and Louise Meddings are affiliated with the Department of Emergency Medicine, University of British Columbia. Jeffrey R. Brubacher is affiliated with the Department of Emergency Medicine, University of British Columbia, and C2E2
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21
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Lamberti N, Straudi S, Manfredini R, De Giorgi A, Gasbarro V, Zamboni P, Manfredini F. Don't stop walking: the in-home rehabilitation program for peripheral artery disease patients during the COVID-19 pandemic. Intern Emerg Med 2021; 16:1307-1315. [PMID: 33411263 PMCID: PMC7788170 DOI: 10.1007/s11739-020-02598-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/02/2020] [Indexed: 02/07/2023]
Abstract
We studied the outcomes of peripheral artery disease (PAD) patients enrolled in a structured in-home walking program right before the lockdown due to the SARS-CoV-2 epidemic emergency, to determine whether this intervention ensured the maintenance of mobility even in the case of movement restrictions.We selectively studied 83 patients (age 72 ± 11, males n = 65) enrolled in the program within 9-month before the lockdown. The usual intervention was based on two daily 8-min sessions of slow intermittent in-home walking prescribed in circa-monthly hospital visits. During the lockdown, the program was updated by phone. Six-minute (6MWD) and pain-free walking distance (PFWD) were measured pre- and post-lockdown as well as body weight (BW), blood pressure (BP), and ankle-brachial index (ABI). Sixty-six patients were measured 117 ± 23 days after their previous visit. A safe, pain-free execution of the prescribed sessions was reported (median distance: 74 km). Overall, the 6MWD was stable, while PFWD improved (p < 0.001). The improvement was not related to age/gender, comorbidities, type of home but to the time of enrollment before lockdown. The new-entry subjects (≤ 3 months; n = 35) obtained significant improvements post-lockdown for 6MWD and PFWD, while those previously enrolled (> 3 months; n = 31) were stable. Decreased BW with stable BP and ABI values were also recorded, with better outcomes for new-entry subjects. In PAD patients, a structured walking program performed inside home and purposely guided by phone was adhered to by patients and favored mobility and risk factor control during the COVID-19 pandemic, regardless of walking ability, type of home and external conditions.
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Affiliation(s)
- Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Sofia Straudi
- Rehabilitation Medicine Unit, University Hospital of Ferrara, Ferrara, Italy
| | - Roberto Manfredini
- Department of Medical Sciences, Clinical Medicine Unit, University Hospital of Ferrara, University of Ferrara, via Aldo Moro 8, 44123, Cona, Ferrara, Italy.
| | - Alfredo De Giorgi
- Department of Medical Sciences, Clinical Medicine Unit, University Hospital of Ferrara, University of Ferrara, via Aldo Moro 8, 44123, Cona, Ferrara, Italy
| | - Vincenzo Gasbarro
- Department of Medical Sciences, Vascular Surgery Unit, University of Ferrara, Ferrara, Italy
| | - Paolo Zamboni
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Rehabilitation Medicine Unit, University Hospital of Ferrara, Ferrara, Italy
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22
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Hunter RF, Garcia L, de Sa TH, Zapata-Diomedi B, Millett C, Woodcock J, Pentland A'S, Moro E. Effect of COVID-19 response policies on walking behavior in US cities. Nat Commun 2021; 12:3652. [PMID: 34135325 PMCID: PMC8209100 DOI: 10.1038/s41467-021-23937-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 05/24/2021] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic is causing mass disruption to our daily lives. We integrate mobility data from mobile devices and area-level data to study the walking patterns of 1.62 million anonymous users in 10 metropolitan areas in the United States. The data covers the period from mid-February 2020 (pre-lockdown) to late June 2020 (easing of lockdown restrictions). We detect when users were walking, distance walked and time of the walk, and classify each walk as recreational or utilitarian. Our results reveal dramatic declines in walking, particularly utilitarian walking, while recreational walking has recovered and even surpassed pre-pandemic levels. Our findings also demonstrate important social patterns, widening existing inequalities in walking behavior. COVID-19 response measures have a larger impact on walking behavior for those from low-income areas and high use of public transportation. Provision of equal opportunities to support walking is key to opening up our society and economy.
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Affiliation(s)
- Ruth F Hunter
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Leandro Garcia
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, Universtiy of São Paulo, São Paulo, Brazil
| | - Belen Zapata-Diomedi
- Healthy Liveable Cities Group, Centre for Urban Research, RMIT University, Melbourne, VIC, Australia
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - James Woodcock
- Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Esteban Moro
- Connection Science, Institute for Data Science and Society, MIT, Cambridge, MA, USA.
- Department of Mathematics and GISC, Universidad Carlos III de Madrid, Leganés, Spain.
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23
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Phelan S, Marquez F, Redman LM, Arteaga S, Clifton R, Grice BA, Haire-Joshu D, Martin CK, Myers CA, Pomeroy J, Vincent E, Van Horn L, Peaceman A, Ashby-Thompson M, Gallagher D, Pi-Sunyer X, Boekhoudt T, Drews K, Brown G. The moderating role of the built environment in prenatal lifestyle interventions. Int J Obes (Lond) 2021; 45:1357-1361. [PMID: 33637948 PMCID: PMC8164971 DOI: 10.1038/s41366-021-00782-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 01/07/2021] [Accepted: 02/01/2021] [Indexed: 11/25/2022]
Abstract
This study examined whether the neighborhood built environment moderated gestational weight gain (GWG) in LIFE-Moms clinical trials. Participants were 790 pregnant women (13.9 weeks' gestation) with overweight or obesity randomized within four clinical centers to standard care or lifestyle intervention to reduce GWG. Geographic information system (GIS) was used to map the neighborhood built environment. The intervention relative to standard care significantly reduced GWG (coefficient = 0.05; p = 0.005) and this effect remained significant (p < 0.03) after adjusting for built environment variables. An interaction was observed for presence of fast food restaurants (coefficient = -0.007; p = 0.003). Post hoc tests based on a median split showed that the intervention relative to standard care reduced GWG in participants living in neighborhoods with lower fast food density 0.08 [95% CI, 0.03,0.12] kg/week (p = 0.001) but not in those living in areas with higher fast food density (0.02 [-0.04, 0.08] kg/week; p = 0.55). Interaction effects suggested less intervention efficacy among women living in neighborhoods with more grocery/convenience stores (coefficient = -0.005; p = 0.0001), more walkability (coefficient -0.012; p = 0.007) and less crime (coefficient = 0.001; p = 0.007), but post-hoc tests were not significant. No intervention x environment interaction effects were observed for total number of eating establishments or tree canopy. Lifestyle interventions during pregnancy were effective across diverse physical environments. Living in environments with easy access to fast food restaurants may limit efficacy of prenatal lifestyle interventions, but future research is needed to replicate these findings.
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Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology & Public Health and Center for Health Research, Cal Poly, San Luis Obispo, CA, USA.
| | - Fred Marquez
- Department of Anthropology & Geography and Center for Health Research, Cal Poly, San Luis Obispo, CA, USA
| | | | - Sonia Arteaga
- The Environmental influences on Child Health Outcomes (ECHO) Program, The National Institutes of Health, Bethesda, MD, USA
| | - Rebecca Clifton
- The Biostatistics Center, George Washington University, Washington, DC, USA
| | - Brian A Grice
- Indiana University, School of Medicine, Indianapolis, IN, USA
| | - Debra Haire-Joshu
- Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, MO, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Jeremy Pomeroy
- Clinical Research Center, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA
| | - Eileen Vincent
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Alan Peaceman
- Department of Obstetrics & Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Maxine Ashby-Thompson
- New York Nutrition Obesity Research Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Dympna Gallagher
- New York Nutrition Obesity Research Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Xavier Pi-Sunyer
- New York Nutrition Obesity Research Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Trisha Boekhoudt
- The Biostatistics Center, George Washington University, Washington, DC, USA
| | - Kimberly Drews
- The Biostatistics Center, George Washington University, Washington, DC, USA
| | - Greg Brown
- Department of Natural Resources Management and Environmental Sciences, Cal Poly, San Luis Obispo, CA, USA
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Jones K, Hawke F, Newman J, Miller JA, Burns J, Jakovljevic DG, Gorman G, Turnbull DM, Ramdharry G. Interventions for promoting physical activity in people with neuromuscular disease. Cochrane Database Syst Rev 2021; 5:CD013544. [PMID: 34027632 PMCID: PMC8142076 DOI: 10.1002/14651858.cd013544.pub2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The World Health Organization (WHO) recommends that people of all ages take regular and adequate physical activity. If unable to meet the recommendations due to health conditions, international guidance advises being as physically active as possible. Evidence from community interventions of physical activity indicate that people living with medical conditions are sometimes excluded from participation in studies. In this review, we considered the effects of activity-promoting interventions on physical activity and well-being in studies, as well as any adverse events experienced by participants living with inherited or acquired neuromuscular diseases (NMDs). OBJECTIVES: To assess the effects of interventions designed to promote physical activity in people with NMD compared with no intervention or alternative interventions. SEARCH METHODS On 30 April 2020, we searched Cochrane Neuromuscular Specialised Register, CENTRAL, Embase, MEDLINE, and ClinicalTrials.Gov. WHO ICTRP was not accessible at the time. SELECTION CRITERIA We considered randomised or quasi-randomised trials, including cross-over trials, of interventions designed to promote physical activity in people with NMD compared to no intervention or alternative interventions. We specifically included studies that reported physical activity as an outcome measure. Our main focus was studies in which promoting physical activity was a stated aim but we also included studies in which physical activity was assessed as a secondary or exploratory outcome. DATA COLLECTION AND ANALYSIS We used standard Cochrane procedures. MAIN RESULTS The review included 13 studies (795 randomised participants from 12 studies; number of participants unclear in one study) of different interventions to promote physical activity. Most studies randomised a minority of invited participants. No study involved children or adolescents and nine studies reported minimal entry criteria for walking. Participants had one of nine inherited or acquired NMDs. Types of intervention included structured physical activity support, exercise support (as a specific form of physical activity), and behaviour change support that included physical activity or exercise. Only one included study clearly reported that the aim of intervention was to increase physical activity. Other studies reported or planned to analyse the effects of intervention on physical activity as a secondary or exploratory outcome measure. Six studies did not report results for physical activity outcomes, or the data were not usable. We judged 10 of the 13 included studies at high or unclear risk of bias from incomplete physical activity outcome reporting. We did not perform a meta-analysis for any comparison because of differences in interventions and in usual care. We also found considerable variation in how studies reported physical activity as an outcome measure. The studies that reported physical activity measurement did not always clearly report intention-to-treat (ITT) analysis or whether final assessments occurred during or after intervention. Based on prespecified measures, we included three comparisons in our summary of findings. A physical activity programme (weight-bearing) compared to no physical activity programme One study involved adults with diabetic peripheral neuropathy (DPN) and reported weekly duration of walking during and at the end of a one-year intervention using a StepWatch ankle accelerometer. Based on the point estimate and low-certainty evidence, intervention may have led to an important increase in physical activity per week; however, the 95% confidence interval (CI) included the possibility of no difference or an effect in either direction at three months (mean difference (MD) 34 minutes per week, 95% CI -92.19 to 160.19; 69 participants), six months (MD 68 minutes per week, 95% CI -55.35 to 191.35; 74 participants), and 12 months (MD 49 minutes per week, 95% CI -75.73 to 173.73; 70 participants). Study-reported effect estimates for foot lesions and full-thickness ulcers also included the possibility of no difference, a higher, or lower risk with intervention. A sensor-based, interactive exercise programme compared to no sensor-based, interactive exercise programme One study involved adults with DPN and reported duration of walking over 48 hours at the end of four weeks' intervention using a t-shirt embedded PAMSys sensor. It was not possible to draw conclusions about the effectiveness of the intervention from the very low-certainty evidence (MD -0.64 hours per 48 hours, 95% CI -2.42 to 1.13; 25 participants). We were also unable to draw conclusions about impact on the Physical Component Score (PCS) for quality of life (MD 0.24 points, 95% CI -5.98 to 6.46; 35 participants; very low-certainty evidence), although intervention may have made little or no difference to the Mental Component Score (MCS) for quality of life (MD 5.10 points, 95% CI -0.58 to 10.78; 35 participants; low-certainty evidence). A functional exercise programme compared to a stretching exercise programme One study involved adults with spinal and bulbar muscular atrophy and reported a daily physical activity count at the end of 12 weeks' intervention using an Actical accelerometer. It was not possible to draw conclusions about the effectiveness of either intervention (requiring compliance) due to low-certainty evidence and unconfirmed measurement units (MD -8701, 95% CI -38,293.30 to 20,891.30; 43 participants). Functional exercise may have made little or no difference to quality of life compared to stretching (PCS: MD -1.10 points, 95% CI -5.22 to 3.02; MCS: MD -1.10 points, 95% CI -6.79 to 4.59; 49 participants; low-certainty evidence). Although studies reported adverse events incompletely, we found no evidence of supported activity increasing the risk of serious adverse events. AUTHORS' CONCLUSIONS We found a lack of evidence relating to children, adolescents, and non-ambulant people of any age. Many people living with NMD did not meet randomised controlled trial eligibility criteria. There was variation in the components of supported activity intervention and usual care, such as physical therapy provision. We identified variation among studies in how physical activity was monitored, analysed, and reported. We remain uncertain of the effectiveness of promotional intervention for physical activity and its impact on quality of life and adverse events. More information is needed on the ITT population, as well as more complete reporting of outcomes. While there may be no single objective measure of physical activity, the study of qualitative and dichotomous change in self-reported overall physical activity might offer a pragmatic approach to capturing important change at an individual and population level.
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Affiliation(s)
- Katherine Jones
- Cochrane Pain, Palliative and Supportive Care, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Mental Health and Neuroscience Network and Acute and Emergency Care Network, Cochrane, London, UK
| | - Fiona Hawke
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Ourimbah, Australia
| | - Jane Newman
- Wellcome Centre for Mitochondrial Research, Newcastle University and NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - James Al Miller
- c/o Department of Neurology, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Joshua Burns
- University of Sydney School of Health Sciences, Faculty of Medicine and Health, Sydney, Australia
| | - Djordje G Jakovljevic
- Cardiovascular and Lifestyle Medicine Theme, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Grainne Gorman
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Douglass M Turnbull
- Mitochondrial Research Group, The Medical School, Newcastle University, Newcastle upon Tyne, UK
| | - Gita Ramdharry
- Queen Square Centre for Neuromuscular Diseases, University College Hospital NHS Foundation Trust and UCL Institute of Neurology, London, UK
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25
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Saad MF, Cheah WL, Hazmi H. The Effects of a 7000-Step Goal and Weekly Group Walking Program for Overweight and Obese Elderly People in Sarawak, Malaysia: A Quasi-experimental Study. J Prev Med Public Health 2021; 54:199-207. [PMID: 34092066 PMCID: PMC8190551 DOI: 10.3961/jpmph.20.584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/02/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities. METHODS A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m2. BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted. RESULTS In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m2), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%). CONCLUSIONS A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.
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Affiliation(s)
- Mohd Fakhree Saad
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Whye Lian Cheah
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Helmy Hazmi
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Kota Samarahan, Malaysia
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Zhang S, Abdel-Aty M, Wu Y, Zheng O. Modeling pedestrians' near-accident events at signalized intersections using gated recurrent unit (GRU). Accid Anal Prev 2020; 148:105844. [PMID: 33125922 DOI: 10.1016/j.aap.2020.105844] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/08/2020] [Accepted: 10/11/2020] [Indexed: 06/11/2023]
Abstract
Pedestrian safety plays an important role in the transportation system. Intersections are dangerous locations for pedestrians with mixed traffic. This paper aims to predict the near-accident events between pedestrians and vehicles at signalized intersections using PET (Post Encroachment Time) and TTC (Time to Collision). With automated computer vision techniques, mobility features of pedestrians and vehicles are generated. Extreme Value Theory (EVT) is used to model PET and minimum TTC values to select the most appropriate threshold values to label pedestrians' near-accident events. A Gated Recurrent Unit (GRU) neural network is further used to predict these events. The established model reaches an AUC (Area Under the Curve) value of 0.865 on the test data set. Moreover, the proposed model can also be applied to develop collision warning systems under the Connected Vehicle environment.
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Affiliation(s)
- Shile Zhang
- Department of Civil, Environmental and Construction Engineering, University of Central Florida, Orlando, FL, 32816, United States.
| | - Mohamed Abdel-Aty
- Department of Civil, Environmental and Construction Engineering, University of Central Florida, Orlando, FL, 32816, United States.
| | - Yina Wu
- Department of Civil, Environmental and Construction Engineering, University of Central Florida, Orlando, FL, 32816, United States.
| | - Ou Zheng
- Department of Civil, Environmental and Construction Engineering, University of Central Florida, Orlando, FL, 32816, United States.
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27
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Molina-García J, Campos S, García-Massó X, Herrador-Colmenero M, Gálvez-Fernández P, Molina-Soberanes D, Queralt A, Chillón P. Different neighborhood walkability indexes for active commuting to school are necessary for urban and rural children and adolescents. Int J Behav Nutr Phys Act 2020; 17:124. [PMID: 32993682 PMCID: PMC7526424 DOI: 10.1186/s12966-020-01028-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/21/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Literature focusing on youth has reported limited evidence and non-conclusive associations between neighborhood walkability measures and active commuting to and from school (ACS). Moreover, there is a lack of studies evaluating both macro- and micro-scale environmental factors of the neighborhood when ACS is analyzed. Likewise, most studies on built environment attributes and ACS focus on urban areas, whereas there is a lack of studies analyzing rural residential locations. Moreover, the relationship between built environment attributes and ACS may differ in children and adolescents. Hence, this study aimed to develop walkability indexes in relation to ACS for urban and rural children and adolescents, including both macro- and micro-scale school-neighborhood factors. METHODS A cross-sectional study of 4593 participants from Spain with a mean age of 12.2 (SD 3.6) years was carried out. Macro-scale environmental factors were evaluated using geographic information system data, and micro-scale factors were measured using observational procedures. Socio-demographic characteristics and ACS were assessed with a questionnaire. Several linear regression models were conducted, including all the possible combinations of six or less built environment factors in order to find the best walkability index. RESULTS Analyses showed that intersection density, number of four-way intersections, and residential density were positively related to ACS in urban participants, but negatively in rural participants. In rural children, positive streetscape characteristics, number of regulated crossings, traffic calming features, traffic lanes, and parking street buffers were also negatively related to ACS. In urban participants, other different factors were positively related to ACS: number of regulated crossings, positive streetscape characteristics, or crossing quality. Land use mix acted as a positive predictor only in urban adolescents. Distance to the school was a negative predictor on all the walkability indexes. However, aesthetic and social characteristics were not included in any of the indexes. CONCLUSIONS Interventions focusing on improving built environments to increase ACS behavior need to have a better understanding of the walkability components that are specifically relevant to urban or rural samples.
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Affiliation(s)
- Javier Molina-García
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022, Valencia, Spain.
- AFIPS research group, University of Valencia, Valencia, Spain.
| | - Sergio Campos
- Department of Urban and Spatial Planning, University of Granada, C/ Severo Ochoa, s/n, 18071, Granada, Spain
| | - Xavier García-Massó
- Department of Teaching of Musical, Visual and Corporal Expression, University of Valencia, Avda. dels Tarongers, 4, 46022, Valencia, Spain
- AFIPS research group, University of Valencia, Valencia, Spain
| | - Manuel Herrador-Colmenero
- "La Inmaculada" Teacher Training Centre, University of Granada, C/ Joaquina Eguaras, 114, 18013, Granada, Spain
| | - Patricia Gálvez-Fernández
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, PROFITH "Promoting FITness and Health through physical activity" research group, Ctra. Alfacar, s/n, 18011, Granada, Spain
| | - Daniel Molina-Soberanes
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Avda. de la Investigación, 11, 18016, Granada, Spain
| | - Ana Queralt
- AFIPS research group, University of Valencia, Valencia, Spain
- Department of Nursing, University of Valencia, Jaume Roig, s/n, 46010, Valencia, Spain
| | - Palma Chillón
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, PROFITH "Promoting FITness and Health through physical activity" research group, Ctra. Alfacar, s/n, 18011, Granada, Spain
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28
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Dalen T, Aune TK, Hjelde GH, Ettema G, Sandbakk Ø, McGhie D. Player load in male elite soccer: Comparisons of patterns between matches and positions. PLoS One 2020; 15:e0239162. [PMID: 32956408 PMCID: PMC7505455 DOI: 10.1371/journal.pone.0239162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/31/2020] [Indexed: 11/19/2022] Open
Abstract
Our primary aim was to explore the development of player load throughout match time (i.e., the pattern) using moving 5-min windows in an elite soccer team and our secondary aim was to compare player load patterns between different positions within the same team. The dataset included domestic home matches (n = 34) over three seasons for a Norwegian Elite League team. Player movements (mean ± SD age 25.5 ± 4.2 years, height 183.6 ± 6.6 cm, body mass 78.9 ± 7.4 kg) were recorded at 20 Hz using body-worn sensors. Data for each variable (player load, player load per meter, total distance, accelerations, decelerations, sprint distance, high-intensity running distance) were averaged within positions in each match, converted to z-scores and averaged across all matches, yielding one time series for each variable for each position. Pattern similarity between positions was assessed with cross-correlations. Overall, we observed a distinct pattern in player load throughout match time, which also occurred in the majority of individual matches. The pattern shows peaks at regular intervals (~15 min), each followed by a period of lower load, declining until the next peak. The same pattern was evident in player load per meter. The cross-correlation analyses support the visual evidence, with correlations ranging 0.88-0.97 (p < .001) in all position pairs. In contrast, no specific patterns were discernible in total distance, accelerations, decelerations, sprint distance and high-intensity running distance, with cross-correlations ranging 0.65-0.89 (p < .001), 0.32-0.64 (p < .005), 0.18-0.65 (p < .005 in nine position pairs), 0.02-0.38 (p < .05 in three pairs) and 0.01-0.52 (p < .05 in three pairs), respectively. This study demonstrated similarity in player load patterns between both matches and positions in elite soccer competition, which could indicate a physical "pacing pattern" employed by the team.
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Affiliation(s)
- Terje Dalen
- Department of Physical Education and Sport Science, Nord University, Levanger, Norway
- * E-mail:
| | - Tore Kristian Aune
- Department of Physical Education and Sport Science, Nord University, Levanger, Norway
| | | | - Gertjan Ettema
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Sandbakk
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - David McGhie
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Okhomina VI, Seals SR, Anugu P, Adu-Boateng G, Sims M, Marshall GD. Adherence and retention of African Americans in a randomized controlled trial with a yoga-based intervention: the effects of health promoting programs on cardiovascular disease risk study. Ethn Health 2020; 25:812-824. [PMID: 29609480 DOI: 10.1080/13557858.2018.1458073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
Objectives: Sedentary lifestyle is a risk factor for cardiovascular disease (CVD). Few alternative lifestyle interventions, such as yoga practice, focus on African Americans (AA), the population most vulnerable to CVD. Our objective is to compare the retention and adherence rates between yoga, walking, and health education interventions while providing information about the acceptance of various yoga regimens. Design: Three hundred seventy-five AA participants were recruited exclusively from an active cohort study and randomized into a 48-week study (24 weeks intervention, 24 weeks follow-up) with 5 health promotion interventions: high frequency yoga, moderate frequency yoga, low frequency yoga, guided walking, and health education. In addition to examining the separate yoga interventions, a pooled yoga intervention is considered for comparison to guided walking and health education. Participant retention, adherence, and vitals were monitored at each intervention session. Participants were also scheduled for four clinic visits throughout the study where blood panels, health behavior, and medication surveys were administered. Results: Of the 375 participants recruited, 31.7% did not complete the study. At baseline, in both the guided walking group and the high frequency yoga group, there were significant differences between those who completed the study and those who did not. Although intervention retention in the pooled yoga program (78.3%) was higher compared to the walking (60%) and education programs (74.3%) (p = 0.007), differences in post-intervention retention was not significant. Median adherence rates for the pooled yoga program exceeded rates for guided walking and education with moderate frequency yoga out performing high and low frequency yoga. Conclusion: Study-defined retention success rates were not reached by all health promotion programs. However, retention and adherence rates for the pooled yoga program show that older African Americans are receptive to participating in yoga-based health promotion practices.
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Affiliation(s)
- Victoria I Okhomina
- Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Samantha R Seals
- Department of Mathematics and Statistics, Hal Marcus College of Science and Engineering, University of West Florida, Pensacola, FL, USA
| | - Pramod Anugu
- Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Godwin Adu-Boateng
- Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Mario Sims
- Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gailen D Marshall
- Division of Clinical Immunology and Allergy, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
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Duarte-Clíments G, Sánchez-Gómez MB, Palenzuela-Luis N, González-Abreu J, Guzmán-Fernández CJ, Ramos-Santana S, Gómez-Salgado J, Rodríguez-Gómez JÁ, Romero-Martín M. Relationship between the self-concept and physical activity towards the prevention of chronic illnesses. Medicine (Baltimore) 2020; 99:e20884. [PMID: 32664080 PMCID: PMC7360304 DOI: 10.1097/md.0000000000020884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The objective of this work is to verify the relationship between the self-perception of health and the self-concept of physical appearance in adolescents, in order to check their influence on the physical activity they perform with the aim of preventing chronic illnesses. To this end, an observational, cross-sectional descriptive study with analytical components was carried out. Opportunistic activity, in which young people, between the ages of 16 and 22, were recruited from 5 secondary schools of the municipality of San Cristóbal de La Laguna, on the island of Tenerife (Spain). Data were collected through the General Health Questionnaire, the Rosemberg Self-esteem Scale, and the physical exercise habits test physical activity questionnaire for adolescents-A, revealing the first 2 that most percentage of responses were grouped on the positive side. The physical exercise habits test physical activity questionnaire for adolescents-A described that the most commonly performed physical activity was walking (75%).
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Affiliation(s)
- Gonzalo Duarte-Clíments
- University School of Nursing, University of La Laguna. Candelaria NS University Hospital, Canary Islands Health Service
| | - María Begoña Sánchez-Gómez
- University School of Nursing, University of La Laguna. Candelaria NS University Hospital, Canary Islands Health Service
| | | | | | | | - Sara Ramos-Santana
- Primary Care Management of Tenerife, Canary Islands Health Service, Tenerife
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva. Huelva, Spain
- Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - José Ángel Rodríguez-Gómez
- University School of Nursing, University of La Laguna. Candelaria NS University Hospital, Canary Islands Health Service
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Li F, Harmer P. Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment. Clin Interv Aging 2020; 15:945-952. [PMID: 32606636 PMCID: PMC7319501 DOI: 10.2147/cia.s254764] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/29/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To compare the prevalence of falls, physical performance, and dual-task cost during walking between cognitively healthy and impaired older adults at high risk of falling. METHODS A cross-sectional analysis of 670 community-dwelling older adults who were considered at high risk of falling, operationalized as 1) having fallen at least once in the preceding 12 months and having a health-care practitioner's referral indicating that the participant was at risk of falls or 2) having impaired mobility as evidenced by a Timed Up and Go (TUG) result ≥13.5 s. Participants (mean age = 77.7 years, SD = 5.6) were divided into cognitively healthy (n = 461) or cognitively impaired (n = 209) groups using a cutoff score of <23 on the Montreal Cognitive Assessment test. Assessment included self-reported number of falls over the previous 12 months, functional reach, TUG, Short Physical Performance Battery (SPPB), and single- and dual-task walk performance. Data were analyzed using Poisson regression to estimate the prevalence ratios of falls and analysis of variance to examine between-group differences on physical performance and dual-task cost during walking performance. RESULTS In the analysis, 82.3% of older adults with cognitive impairment and 69.4% of unimpaired older adults reported 1 or more falls in the previous 12 months. Compared with cognitively healthy participants, those with cognitive impairment were 2.57 (95% confidence interval [CI] = 2.17 to 3.05) times more likely to have any fall and 2.33 (95% CI = 1.95 to 2.78) times more likely to have multiple falls. Older adults with cognitive impairment performed worse on functional reach (mean difference [MD] = -2.33 cm, 95% CI = -3.21 to -1.46), TUG (MD = 3.05 s, 95% CI = 2.22 to 3.88), and SPPB (MD = -1.24 points, 95% CI = -1.55 to -0.92) and showed increase in dual-task costs (MD = 6.59%, 95% CI = 4.19 to 9.03) compared to those without cognitive impairment. CONCLUSION Older adults at high risk for falls and who have cognitive impairment are associated with a greater risk for falls and decrements in physical and dual-task performance.
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Affiliation(s)
- Fuzhong Li
- Oregon Research Institute, Eugene, OR97403, USA
| | - Peter Harmer
- Department of Exercise and Health Science, Willamette University, Salem, OR, 97301, USA
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Hall KS, Hyde ET, Bassett DR, Carlson SA, Carnethon MR, Ekelund U, Evenson KR, Galuska DA, Kraus WE, Lee IM, Matthews CE, Omura JD, Paluch AE, Thomas WI, Fulton JE. Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia. Int J Behav Nutr Phys Act 2020; 17:78. [PMID: 32563261 PMCID: PMC7305604 DOI: 10.1186/s12966-020-00978-9] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/28/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Daily step counts is an intuitive metric that has demonstrated success in motivating physical activity in adults and may hold potential for future public health physical activity recommendations. This review seeks to clarify the pattern of the associations between daily steps and subsequent all-cause mortality, cardiovascular disease (CVD) morbidity and mortality, and dysglycemia, as well as the number of daily steps needed for health outcomes. METHODS A systematic review was conducted to identify prospective studies assessing daily step count measured by pedometer or accelerometer and their associations with all-cause mortality, CVD morbidity or mortality, and dysglycemia (dysglycemia or diabetes incidence, insulin sensitivity, fasting glucose, HbA1c). The search was performed across the Medline, Embase, CINAHL, and the Cochrane Library databases from inception to August 1, 2019. Eligibility criteria included longitudinal design with health outcomes assessed at baseline and subsequent timepoints; defining steps per day as the exposure; reporting all-cause mortality, CVD morbidity or mortality, and/or dysglycemia outcomes; adults ≥18 years old; and non-patient populations. RESULTS Seventeen prospective studies involving over 30,000 adults were identified. Five studies reported on all-cause mortality (follow-up time 4-10 years), four on cardiovascular risk or events (6 months to 6 years), and eight on dysglycemia outcomes (3 months to 5 years). For each 1000 daily step count increase at baseline, risk reductions in all-cause mortality (6-36%) and CVD (5-21%) at follow-up were estimated across a subsample of included studies. There was no evidence of significant interaction by age, sex, health conditions or behaviors (e.g., alcohol use, smoking status, diet) among studies that tested for interactions. Studies examining dysglycemia outcomes report inconsistent findings, partially due to heterogeneity across studies of glycemia-related biomarker outcomes, analytic approaches, and sample characteristics. CONCLUSIONS Evidence from longitudinal data consistently demonstrated that walking an additional 1000 steps per day can help lower the risk of all-cause mortality, and CVD morbidity and mortality in adults, and that health benefits are present below 10,000 steps per day. However, the shape of the dose-response relation is not yet clear. Data are currently lacking to identify a specific minimum threshold of daily step counts needed to obtain overall health benefit.
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Affiliation(s)
- Katherine S. Hall
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, NC USA
- Claude D. Pepper Older Americans Independence Center, Duke Aging Center, and the Department of Medicine, Duke University, Durham, NC USA
| | - Eric T. Hyde
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - David R. Bassett
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, TN USA
| | - Susan A. Carlson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | | | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway and Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC USA
| | - Deborah A. Galuska
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - William E. Kraus
- Claude D. Pepper Older Americans Independence Center, Duke Aging Center, and the Department of Medicine, Duke University, Durham, NC USA
| | - I-Min Lee
- Brigham and Women’s Hospital, Harvard Medical School; Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Charles E. Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD USA
| | - John D. Omura
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Amanda E. Paluch
- Department of Kinesiology, Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA USA
| | - William I. Thomas
- Office of Library Science, Office of Science, Centers for Disease Control and Prevention, Atlanta, GA USA
| | - Janet E. Fulton
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA USA
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Omura JD, Hyde ET, Whitfield GP, Hollis ND, Fulton JE, Carlson SA. Differences in perceived neighborhood environmental supports and barriers for walking between US adults with and without a disability. Prev Med 2020; 134:106065. [PMID: 32194096 PMCID: PMC10962532 DOI: 10.1016/j.ypmed.2020.106065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/13/2020] [Accepted: 03/14/2020] [Indexed: 11/25/2022]
Abstract
People with disabilities are at increased risk of chronic diseases, many of which physical activity can help prevent and manage. Certain environmental features can support or hinder participation in important activities like walking, particularly for people with disabilities. The purpose of this study is to examine differences in the prevalence of perceived neighborhood environmental supports and barriers for walking, by disability status, among US adults. Participants in the 2015 National Health Interview Survey Cancer Control Supplement (N = 15,280) reported their disability status (mobility disability, non-mobility disability, or no disability) and perceptions of neighborhood environmental supports (walkable roads, sidewalks, paths, trails; sidewalks on most streets; and walkable shops; transit; movies, libraries, churches; relaxing places) and barriers (traffic, crime, animals) for walking. Adjusted models conducted in 2019 included demographic characteristics. Prevalence of most supports was lower among adults with mobility or non-mobility disabilities versus no disability. For example, 54.9% and 57.5% of adults with mobility and non-mobility disabilities respectively reported sidewalks on most streets, compared to 64.1% of adults with no disability. After adjustment, significant differences remained when comparing adults with a mobility disability versus no disability for two supports (roads, sidewalks, paths, trails; relaxing places). All perceived barriers were significantly more common among adults with any disability versus no disability, regardless of adjustment. In the United States, adults with disabilities perceive fewer neighborhood environmental supports and more barriers for walking than their counterparts. Strategies that increase supports and address barriers for walking may help promote physical activity among adults with disabilities.
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Affiliation(s)
- John D Omura
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Bufford Highway NE, MS S107-5, Atlanta, GA 30341, USA.
| | - Eric T Hyde
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Bufford Highway NE, MS S107-5, Atlanta, GA 30341, USA.
| | - Geoffrey P Whitfield
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Bufford Highway NE, MS S107-5, Atlanta, GA 30341, USA.
| | - NaTasha D Hollis
- Division of Human Development and Disability, National Center For Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Bufford Highway NE, MS E-88, Atlanta, GA 30341, USA.
| | - Janet E Fulton
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Bufford Highway NE, MS S107-5, Atlanta, GA 30341, USA.
| | - Susan A Carlson
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Bufford Highway NE, MS S107-5, Atlanta, GA 30341, USA.
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Pfeiffer SJ, Davis-Wilson HC, Pexa B, Szymczak J, Wistreich C, Sorensen R, Wikstrom EA, Blackburn JT, Pietrosimone B. Assessing Step Count-Dependent Changes in Femoral Articular Cartilage Using Ultrasound. J Ultrasound Med 2020; 39:957-965. [PMID: 31763713 DOI: 10.1002/jum.15180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate changes in the femoral cartilage cross-sectional area (CSA) measured with ultrasound (US) between baseline and 1000, 2000, 3000, 4000, and 5000 steps of walking on a treadmill. METHODS Forty-one healthy individuals completed a single testing session. Participants rested with their knees extended on a plinth for 45 minutes to unload the femoral cartilage. Ultrasound was used to acquire images of the femoral cartilage before the treadmill-walking protocol. After the baseline US acquisition, participants walked on a treadmill at their preferred overground walking speed for 1000 steps, after which additional US images of the femoral cartilage were acquired. This process was repeated after 2000, 3000, 4000, and 5000 steps. A 1-way repeated-measures analysis of variance compared the CSA across the 6 step counts. An analysis of variance with repeated measures on time and Bonferroni corrected planned comparisons (.05/5) were used to evaluate differences in the femoral cartilage at each step count compared to baseline. RESULTS The study included 20 male and 21 female participants (mean age ± SD, 21.5 ± 2.8 years; mean body mass index, 24.3 ± 3.4 kg/m 2 ). The CSAs were significantly greater at the 2000-step (1.27 ± 1.75 mm 2 ; P < .001), 4000-step (0.89 ± 1.17 mm2; P < .001), and 5000-step (2.10 ± 1.73 mm 2 ; P < .001) points compared to baseline. The CSA was significantly less at the 3000-step point (1.05 ± 1.29 mm 2 ; P < .001) compared to baseline. CONCLUSIONS Changes in the CSA after walking may be dependent on the number of steps. The participants had a significant decrease in the CSA after 3000 steps of normal walking and a significant increase in the CSA after 2000, 4000, and 5000 steps of normal walking.
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Affiliation(s)
- Steven J Pfeiffer
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Hope C Davis-Wilson
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brett Pexa
- Department of Athletic Training, High Point University, High Point, NC, USA
| | - Jessica Szymczak
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Catherine Wistreich
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rachel Sorensen
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Erik A Wikstrom
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
| | - J Troy Blackburn
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Brian Pietrosimone
- MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA
- Human Movement Science Curriculum, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Orthopedics, University of North Carolina, Chapel Hill, North Carolina, USA
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Rasch A, Panero G, Boda CN, Dozza M. How do drivers overtake pedestrians? Evidence from field test and naturalistic driving data. Accid Anal Prev 2020; 139:105494. [PMID: 32203729 DOI: 10.1016/j.aap.2020.105494] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 03/05/2020] [Accepted: 03/05/2020] [Indexed: 06/10/2023]
Abstract
For pedestrians, the risk of dying in a traffic accident is highest on rural roads, which are often characterized by a lack of sidewalks and high traffic speed. In fact, hitting the pedestrian during an overtaking attempt is a common crash scenario. To develop active safety systems that avoid such crashes, it is necessary to understand and model driver behavior during the overtaking maneuvers, so that system interventions are acceptable because they happen outside drivers' comfort zone. Previous modeling of driver behavior in interactions with pedestrians primarily focused on road crossing scenarios. The aim of this study was, instead, to address pedestrian-overtaking maneuvers on rural roads. We focused our analysis on how drivers adjust their behavior with respect to three safety metrics (in order of importance): 1) minimum lateral clearance when passing the pedestrian, 2) overtaking speed at that moment, and 3) the time-to-collision at the moment of steering away to start the overtaking maneuver. The influence of three factors on the safety metrics was investigated: 1) walking direction (same as the overtaking vehicle or opposite), 2) walking position (on the edge of the vehicle lane or 0.5 m away from the edge on the paved shoulder), and 3) oncoming traffic (absent or present). Seventy-seven overtaking maneuvers in France from the naturalistic driving study UDRIVE and 297 maneuvers in Sweden from field tests were analyzed. Bayesian regression was used to model how minimum lateral clearance and overtaking speed depended on the three factors. Results showed that drivers maintained smaller minimum lateral clearance and lower overtaking speed when the pedestrian was walking in the opposite direction, on the lane edge, or when oncoming traffic was present. Minimum lateral clearance and time-to-collision were only weakly correlated with overtaking speed. The regression models predicted distributions similar to those actually observed in the data. The time-to-collision at the moment of steering away was comparable in value to the time-to-collision used by Euro NCAP for testing active safety systems in car-to-pedestrian longitudinal scenarios since 2018. This study is the first to analyze driver behavior when overtaking pedestrians, based on field test and naturalistic driving data. Results suggest that pedestrian safety is particularly endangered in situations when the pedestrian is walking opposite to traffic, close to the lane, and when oncoming traffic is present. The Bayesian regression models from this study can be used in active safety systems to model drivers' comfort in overtaking maneuvers.
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Affiliation(s)
- Alexander Rasch
- Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Hörselgången 4, 41756, Göteborg, Sweden.
| | - Gabriele Panero
- Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Hörselgången 4, 41756, Göteborg, Sweden.
| | - Christian-Nils Boda
- Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Hörselgången 4, 41756, Göteborg, Sweden.
| | - Marco Dozza
- Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Hörselgången 4, 41756, Göteborg, Sweden.
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Kartschmit N, Sutcliffe R, Sheldon MP, Moebus S, Greiser KH, Hartwig S, Thürkow D, Stentzel U, van den Berg N, Wolf K, Maier W, Peters A, Ahmed S, Köhnke C, Mikolajczyk R, Wienke A, Kluttig A, Rudge G. Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts. BMJ Open 2020; 10:e033941. [PMID: 32350013 PMCID: PMC7213856 DOI: 10.1136/bmjopen-2019-033941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To examine three walkability measures (points of interest (POI), transit stations and impedance (restrictions to walking) within 640 m of participant's addresses) in different regions in Germany and assess the relationships between walkability, walking/cycling and body mass index (BMI) using generalised additive models. SETTING Five different regions and cities of Germany using data from five cohort studies. PARTICIPANTS For analysing walking/cycling behaviour, there were 6269 participants of a pooled sample from three cohorts with a mean age of 59.2 years (SD: 14.3) and of them 48.9% were male. For analysing BMI, there were 9441 participants of a pooled sample of five cohorts with a mean age of 62.3 years (SD: 12.8) and of them 48.5% were male. OUTCOMES (1) Self-reported walking/cycling (dichotomised into more than 30 min and 30 min and less per day; (2) BMI calculated with anthropological measures from weight and height. RESULTS Higher impedance was associated with lower prevalence of walking/cycling more than 30 min/day (prevalence ratio (PR): 0.95; 95% CI 0.93 to 0.97), while higher number of POI and transit stations were associated with higher prevalence (PR 1.03; 95% CI 1.02 to 1.05 for both measures). Higher impedance was associated with higher BMI (ß: 0.15; 95% CI 0.04 to 0.25) and a higher number of POI with lower BMI (ß: -0.14; 95% CI -0.24 to 0.04). No association was found between transit stations and BMI (ß: 0.005, 95% CI -0.11 to 0.12). Stratified by cohort we observed heterogeneous associations between BMI and transit stations and impedance. CONCLUSION We found evidence for associations of walking/cycling with walkability measures. Associations for BMI differed across cohorts.
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Affiliation(s)
- Nadja Kartschmit
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Robynne Sutcliffe
- Centre for Urban Epidemiology, University Clinics Essen, Essen, Germany
| | | | - Susanne Moebus
- Centre for Urban Epidemiology, University Clinics Essen, Essen, Germany
| | - Karin Halina Greiser
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Cancer Research Centre, Heidelberg, Baden-Württemberg, Germany
| | - Saskia Hartwig
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Detlef Thürkow
- Institute of Geosciences and Geography, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Ulrike Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Wolf
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Werner Maier
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany
| | - Salman Ahmed
- Centre for Urban Epidemiology, University Clinics Essen, Essen, Germany
| | - Corinna Köhnke
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Nordrhein-Westfalen, Germany
| | - Rafael Mikolajczyk
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Andreas Wienke
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Alexander Kluttig
- Institute of Med. Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Gavin Rudge
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Cerin E, Barnett A, Zhang CJP, Lai PC, Sit CHP, Lee RSY. How urban densification shapes walking behaviours in older community dwellers: a cross-sectional analysis of potential pathways of influence. Int J Health Geogr 2020; 19:14. [PMID: 32299439 PMCID: PMC7164360 DOI: 10.1186/s12942-020-00210-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/09/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Population growth, population ageing, and urbanisation are major global demographic trends that call for an examination of the impact of urban densification on older adults' health-enhancing behaviours, such as walking. No studies have examined the pathways through which urban densification may affect older adults' walking. This information is key to evidence-based, health-oriented urban and transport planning. This study aimed to identify neighbourhood environment characteristics potentially responsible for the effects of neighbourhood densification on older adults' frequency and amount of transportation and recreation walking within and outside the neighbourhood. METHODS The Active Lifestyle and the Environment in Chinese Seniors (ALECS) project collected self-reported data from 909 older adults (≥ 65 years) living in 128 physically and socially diverse neighbourhoods in Hong Kong (71% response rate). Walking was measured using the Neighbourhood Walking Questionnaire for Chinese Seniors. Objective residential density and other neighbourhood environmental attributes were assessed using Geographic Information Systems. Generalised additive mixed models examined the total effects of neighbourhood residential density on walking and the mediating role of other environmental attributes and car ownership. RESULTS A complex network of potential pathways of positive and negative influences of neighbourhood residential density on different aspects of walking was revealed. While residential density was positively related to within-neighbourhood transportation and outside-neighbourhood recreation walking only, it exhibited positive and/or negative nonlinear indirect effects on all examined aspects of walking via recreation, public transport, food/retail and street intersection densities, and/or car ownership. CONCLUSIONS High-density environments appear to support within-neighbourhood walking by providing access to food and retail outlets via well-connected street networks and discouraging car ownership. However, extreme density may lead to reductions in walking. Public transport density accompanying high-density areas may facilitate outside-neighbourhood walking but deter within-neighbourhood walking. The development of activity-friendly communities for ageing populations need to consider these opposing influences.
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Affiliation(s)
- Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia.
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia.
| | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Casper J P Zhang
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Poh-Chin Lai
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ruby S Y Lee
- Elderly Health Service, Department of Health, The Government of Hong Kong SAR, Hong Kong, Hong Kong SAR, China
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Abstract
Although the health benefits of physical activity are well documented, a large proportion of the population fails to meet current guidelines for physical activity. In order to develop evidence-based public health policies, surveillance of physical activity prevalence and trends is essential. The main aim of this study was to present updated data on physical activity trends in a Norwegian general population over the last decades. Data were collected from 40 690 individuals (50% men) aged ≥20 years participating in at least one of six surveys of the population-based Tromsø Study between 1979 and 2016. Age-standardized prevalences and trends in leisure-time and occupational physical activity were obtained from three questionnaires used in the different surveys. We observed an increase in the proportion engaging in exercise in leisure-time between 1994–95 and 2001 (p <0.001). Based on a different questionnaire, the age-standardized prevalence of engagement in exercise in leisure-time increased significantly from 16% in 2001 to 23% in 2007–08, and further to 28% in 2015–16 (p <0.001). The proportion who reported exercising approximately every day increased from 19% in 2007–08 to 28% in 2015–16 (p <0.001). The age-standardized prevalence of sedentary occupational activity increased from 53% in 2007–08 to 57% in 2015–16 (p <0.001), which extends the gradual increase from 36% in 1979-80.The present study extends previous findings from the Tromsø Study by demonstrating an increase in the proportion exercising regularly over the last three decades. This increase may partially counteract the gradual increase in the proportion with sedentary occupational activity.
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Affiliation(s)
- Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- * E-mail:
| | - Laila Arnesdatter Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Bosch LSMM, Wells JCK, Lum S, Reid AM. Associations of the objective built environment along the route to school with children's modes of commuting: A multilevel modelling analysis (the SLIC study). PLoS One 2020; 15:e0231478. [PMID: 32271830 PMCID: PMC7145202 DOI: 10.1371/journal.pone.0231478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/24/2020] [Indexed: 12/03/2022] Open
Abstract
As active commuting levels continue to decline among primary schoolchildren, evidence about which built environmental characteristics influence walking or cycling to school remains inconclusive and is strongly context-dependent. This study aimed to identify the objective built environmental drivers of, and barriers to, active commuting to school for a multi-ethnic sample of 1,889 healthy primary schoolchildren (aged 5-11) in London, UK. Using cross-sectional multilevel ordered logistic regression modelling, supported by the spatial exploration of built environmental characteristics through cartography, the objective built environment was shown to be strongly implicated in children's commuting behaviour. In line with earlier research, proximity to school emerged as the prime variable associated with the choice for active commuting. However, other elements of the urban form were also significantly associated with children's use of active or passive modes of transport. High levels of accidents, crime and air pollution along the route to school were independently correlated with a lower likelihood of children walking or cycling to school. Higher average and minimum walkability and higher average densities of convenience stores along the way were independently linked to higher odds of active commuting. The significance of the relations for crime, air pollution and walkability disappeared in the fully-adjusted model including all built environmental variables. In contrast, relationships with proximity, traffic danger and the food environment were maintained in this comprehensive model. Black children, pupils with obesity, younger participants and those from high socioeconomic families were less likely to actively commute to school. There is thus a particular need to ensure that roads with high volumes of actively commuting children are kept safe and clean, and children's exposure to unhealthy food options along the way is limited. Moreover, as short commuting distances are strongly correlated with walking or cycling, providing high-quality education near residential areas might incite active transport to school.
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Affiliation(s)
- Lander S. M. M. Bosch
- Department of Geography, University of Cambridge, Cambridge, England, United Kingdom
| | - Jonathan C. K. Wells
- UCL Great Ormond Street Institute of Child Health, London, England, United Kingdom
| | - Sooky Lum
- Respiratory, Critical Care & Anaesthesia Section, London, England, United Kingdom
| | - Alice M. Reid
- Department of Geography, University of Cambridge, Cambridge, England, United Kingdom
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Chen B, Waters CN, Compier T, Uijtdewilligen L, Petrunoff NA, Lim YW, van Dam R, Müller-Riemenschneider F. Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach. BMJ Open 2020; 10:e030606. [PMID: 32265237 PMCID: PMC7245386 DOI: 10.1136/bmjopen-2019-030606] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study investigated physical activity (PA) and sedentary behaviour (SB) among preschool-aged children in Singapore and potential correlates at multiple levels of the socioecological model from in-school and out-of-school settings. DESIGN A cross-sectional study using a mixed-methods approach. PARTICIPANTS Parent-child dyads from six preschools in Singapore. METHODS PA and SB of children (n=72) were quantified using wrist-worn accelerometers for seven consecutive days. Three focus group discussions (FGDs) among 12 teachers explored diverse influences on children's activities, and System for Observing Play and Leisure Activity in Youth (SOPLAY) assessed PA environment and children's activity levels at preschools. Seventy-three parents completed questionnaires on home and neighbourhood factors influencing children's PA and SB. Descriptive analyses of quantitative data and thematic analysis of FGDs were performed. RESULTS Based on accelerometry, children (4.4±1.1 years) spent a median of 7.8 (IQR 6.4-9.0) hours/day in SB, and 0.5 (0.3-0.8) hours/day in moderate-to-vigorous physical activity (MVPA). MVPA was similar throughout the week, and SB was slightly higher on non-school days. In preschools, SOPLAY showed more children engaging in MVPA outdoors (34.0%) than indoors (7.7%), and absence of portable active play equipment. FGDs revealed issues that could restrict active time at preschool, including academic requirements of the central curriculum and its local implementation. The teachers had varying knowledge about PA guidelines and perceived that the children were sufficiently active. In out-of-school settings, parents reported that their children rarely used outdoor facilities for active play and spent little time in active travel. Few children (23.5%) participated in extracurricular sports, but most (94.5%) reported watching screens for 1.5 (0.5-3.0) hours/day. CONCLUSION MVPA was low and SB was high in preschool-aged children in an urban Asian setting. We identified diverse in-school and out-of-school correlates of PA and SB that should be taken into account in health promotion strategies.
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Affiliation(s)
- Bozhi Chen
- Saw Swee Hock School of Public Health, National University Singapore, Singapore
| | | | - Thomas Compier
- VUmc School of Medical Sciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Leonie Uijtdewilligen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Yee Wei Lim
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Rob van Dam
- Saw Swee Hock School of Public Health, National University Singapore, Singapore
- T H Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University Singapore, Singapore
- Institute of Social Medicine Epidemiology and Health Economics, Charite University Hospital Berlin, Berlin, Germany
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Richardson AS, Ghosh-Dastidar M, Collins RL, Hunter GP, Troxel WM, Colabianchi N, Cohen DA, Dubowitz T. Improved Street Walkability, Incivilities, and Esthetics Are Associated with Greater Park Use in Two Low-Income Neighborhoods. J Urban Health 2020; 97:204-212. [PMID: 31989419 PMCID: PMC7101449 DOI: 10.1007/s11524-019-00416-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parks may provide opportunities for people to increase their physical activity and improve health. Yet, parks are generally less plentiful and underutilized in low-income urban neighborhoods compared with more advantaged neighborhoods. Renovations within and around parks may improve park utilization but the empirical evidence supporting this relationship is scarce. This study assessed the impact of greenspace, housing, and commercial investments on street characteristics (walkability, amenities, incivilities/poor esthetics) and park use by examining park use over time in two low-income neighborhoods in Pittsburgh, PA (n = 17 parks), before and after neighborhood-based renovations that were primarily centered in one neighborhood. We used systematic observation of parks, park use, and street blocks surrounding parks to examine the impact of neighborhood changes on park use. We used difference-in-differences to test whether park use and street characteristics surrounding the parks improved more in the intervention neighborhood than in the comparison neighborhood. We also used zero-inflated negative binomial regression with interactions by time to test whether changes in street characteristics were associated with changes in park use over time. We found that improved walkability, incivilities, and esthetics surrounding parks in socioeconomically disadvantaged neighborhoods were associated with greater park use and may help increase visits to underutilized parks.
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Affiliation(s)
- Andrea S Richardson
- Social and Economic Wellbeing Division, RAND Corporation, Pittsburgh, PA, 15213, USA.
| | | | - Rebecca L Collins
- Social and Economic Wellbeing Division, RAND Corporation, Pittsburgh, PA, 15213, USA
| | - Gerald P Hunter
- Social and Economic Wellbeing Division, RAND Corporation, Pittsburgh, PA, 15213, USA
| | - Wendy M Troxel
- Social and Economic Wellbeing Division, RAND Corporation, Pittsburgh, PA, 15213, USA
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, Ann Arbor, MI, 48109-2013, USA
| | - Deborah A Cohen
- School of Kinesiology, University of Michigan, Ann Arbor, MI, 48109-2013, USA
| | - Tamara Dubowitz
- Social and Economic Wellbeing Division, RAND Corporation, Pittsburgh, PA, 15213, USA
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Gong W, Yuan F, Feng G, Ma Y, Zhang Y, Ding C, Chen Z, Liu A. Trends in Transportation Modes and Time among Chinese Population from 2002 to 2012. Int J Environ Res Public Health 2020; 17:ijerph17030945. [PMID: 32033007 PMCID: PMC7036899 DOI: 10.3390/ijerph17030945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/22/2020] [Accepted: 01/31/2020] [Indexed: 11/18/2022]
Abstract
Giving the rising trends in obesity and chronic diseases in China, strategies to increase physical activity are important. Transport-related activity is a substantial source of physical activity and can be easily incorporated into the daily lives. It is a key social factor of health, which can help improve people’s mental and physical health and decrease environmental pollution. However, little is known about recent trends in transportation modes and time in China. Between 2002 and 2010–2012, information about transportation behaviors of Chinese population aged 15 years or older were collected within two Chinese Nutrition and Health Surveys. A stratified multistage cluster sampling method was conducted to select participants. Sociodemographic information, transportation modes, and time were collected during face-to-face interviews. The study included 82,377 (mean age 41.2 years) and 143,075 (mean age 48.7 years) participants in the 2002 and 2010–2012 surveys respectively. The weighted prevalence of active transportation (including walking and cycling) decreased from 83.8% in 2002 to 54.3% in 2010–2012 (p < 0.001). During the same period, the number of participants using public transportation (including taking the bus, subway, or shuttle bus) has doubled (7.5% and 15.7%, respectively, for 2002 and 2010–2012, (p < 0.001)), and the proportion of inactive transportation (including driving or taking a car, motorcycle, taxi, or electric bicycle) more than tripled. Concurrently, the transportation time almost doubled with an increase of 25.9 min over the 10 years (p < 0.001). The prevalence of active transportation increased with age. Participants with higher family income and education reported a lower prevalence of active transportation. Females were more likely to use active transportation (OR (95% CI): 4.41 (4.14–4.70) and 2.50 (2.44–2.57), respectively, for 2002 and 2010–2012, where males were the reference). Before the prevalence of active transportation and physical activity gets lower, there is a need for the public health sector and the transport and land use sector to work together to develop related policies and initiatives with the aim of promoting active transportation and public transportation to increase the levels of physical activity and to decrease the risks of chronic diseases.
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Affiliation(s)
| | | | | | | | | | | | | | - Ailing Liu
- Correspondence: ; Tel.: +86-10-6623-7059
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Fallah Zavareh M, Mehdizadeh M, Nordfjærn T. "If I know when you will arrive, I will let you walk to school:" The role of information technology. J Safety Res 2020; 72:267-277. [PMID: 32199572 DOI: 10.1016/j.jsr.2019.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 09/06/2019] [Accepted: 12/26/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Providing a sense of supervision for parents may facilitate their children's involvement in physical outdoor activities, such as walking to school. Information technology (IT) solutions could bring more parental supervision, which in turn has the potential to enhance the proportion of walking trips to school. This study aimed to examine the role of a proposed hypothetical IT solution that gives parents real-time information about children's entrance to and exit from the school, for the intention of parents letting their children walk to school. METHOD A total of 820 questionnaires were distributed among pupils aged 7-9-years across 28 elementary schools to be completed by their parents (82% return rate). RESULTS Compared to the group of walking pupils, increased parental intention to let their children walk to school under the proposed solution could be explained by considerably more variables in the group of pupils who did not walk to school. The findings revealed that increased parental intention was higher among the walking pupils compared to the non-walking pupils. For the non-walking pupils, enhancement of walking facilities across the school area could potentiate the use of the proposed solution by the parents, which in turn may increase the proportion of walking on school trips. In addition, boy pupils, the pupils whose parents evaluated walking more favorable, those from lower socioeconomic backgrounds, and those living in close proximity to the school could more likely benefit by shifting from non-walking to walking modes of travel, after implementation of the solution.
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Affiliation(s)
- Mohsen Fallah Zavareh
- Kharazmi University, Department of Civil Engineering, Faculty of Engineering, Tehran, Iran.
| | - Milad Mehdizadeh
- School of Civil Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Trond Nordfjærn
- Norwegian University of Science and Technology (NTNU), Department of Psychology, Trondheim, Norway
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Salerno S, Giliberti C. Non-vehicle commuting in Italy: need for ergonomic action for women's lower limbs? Appl Ergon 2020; 83:102982. [PMID: 31698225 DOI: 10.1016/j.apergo.2019.102982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The aim of this paper is to examine gender differences in the occurrence of accidents among workers while walking to or from their workplace (non-vehicle commuting accidents). We have previously found that the lower limb is more often injured at work among women, compared to men, so the paper concentrates on lower limb injuries. METHODS Using the records of the National Institute for Insurance against Injuries at Work (INAIL), we focused on the non-vehicle commuting accidents of women and men recognized as work-related for the period 2013-2017. In particular, we examined the gender difference by work sector and type of trauma suffered with particular attention to lower limb injuries. RESULTS The rate of non-vehicle commuting accidents (n. 60,936) among women was significantly higher than for men (1.29‰ vs 0.40‰ men, p < 0.001) for the period studied. Lower limb injuries (50.5% for women and 43.7% for men, p < 0.001) constituted the large majority of these injuries. In particular, dislocation of the ankle (78% for women vs 65.5% for men, p < 0.001), bruise of the knee (71.2% for women vs 54.9% for men, p < 0.001) and fracture of the foot (41% for women vs 33.6% for men, p < 0.001) were all significantly higher among women. The work sectors with higher injury rates were: Transport and Warehouse, Public Administration, Health and care services and Wholesale and retail trade. This result may be due to wear and tear from conditions at work. The women injured were on the average, a decade older than men (50-59 vs 40-49 years old). CONCLUSIONS Non-vehicle commuting represents an important, albeight neglected, preventable risk for women workers, causing lower limb trauma particularly at the ankle, the foot and the knee. These areas may be particularly injure-prone among women in specific sectors, due to the work environment. Effective prevention of these injuries requires gender-oriented ergonomic actions at work and in the commuting environment.
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Affiliation(s)
- Silvana Salerno
- ENEA, National Agency for New Technologies, Energy and Sustainable Economic Environment, SP Anguillarese SP 015, 00123, Rome, Italy.
| | - Claudia Giliberti
- INAIL, National Institute for Insurance Against Accidents at Work, Via Roberto Ferruzzi 38-40, 00143, Rome, Italy
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Tribby CP, Berrigan D, Perna FM. Cross-sectional Association between Walking and Sunburn: A Potential Trade-off between Cancer Prevention and Risk Factors. Ann Behav Med 2020; 54:125-131. [PMID: 31287553 PMCID: PMC7170729 DOI: 10.1093/abm/kaz028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The positive association between physical activity and sunburn is a health behavior trade-off between the health benefits of physical activity and increased risk of skin cancer. PURPOSE We assessed walking, which is a common source of physical activity, and the prevalence of sunburn. METHODS This research used the 2015 National Health Interview Survey of adults (N = 26,632), age ≥ 18 years. We defined four exclusive categories of walking: (a) those who reported not walking; (b) only transportation (to get some place, such as work, a store, or public transit stop); (c) only leisure (such as for fun, relaxation, or exercise); and (d) both categories. We estimated the adjusted prevalence of sunburn by walking category and separately for walking duration; we stratified by gender and sun sensitivity. RESULTS The adjusted sunburn prevalence was not different between walking categories for women, but it was for men. Specifically, prevalence was lower for men who reported not walking, 34.1% (95% confidence interval [CI]: 32.2%-36.1%) compared to 38.8% (95% CI: 36.5%-41.2%) who walked for both purposes (p = .003). Walking duration was not associated with sunburn prevalence. CONCLUSION We could not determine whether sunburn occurred during walking trips because the questions were not asked as such. However, the results suggest that walking, unlike leisure-time physical activity (such as exercise, sports, or physically active hobbies), may not generally be associated with sunburn, except for the higher sunburn prevalence for men who walked for both leisure and transportation purposes.
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Affiliation(s)
- Calvin P Tribby
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Frank M Perna
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Nakagawa T, Koan I, Chen C, Matsubara T, Hagiwara K, Lei H, Hirotsu M, Yamagata H, Nakagawa S. Regular Moderate- to Vigorous-Intensity Physical Activity Rather Than Walking Is Associated with Enhanced Cognitive Functions and Mental Health in Young Adults. Int J Environ Res Public Health 2020; 17:ijerph17020614. [PMID: 31963639 PMCID: PMC7014044 DOI: 10.3390/ijerph17020614] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/10/2020] [Accepted: 01/14/2020] [Indexed: 01/21/2023]
Abstract
The beneficial effect of physical activity (PA) on the brain has been well established. Both acute and regular PA can boost a range of cognitive functions and enhance mood and mental health. Notably, the effect of acute PA on the brain and cognitive functions is generally found to be dose-dependent, in terms of both the amount and intensity of the exercise episode. In contrast, in the case of regular PA, the literature has primarily focused on the amount of exercise, and limited studies have assessed the influence of the exercise intensity. Since PA in higher intensity causes more extensive, more powerful, and longer-lasting neurobiological changes, it may prove more beneficial to cognitive functions and mental health. In the present study, we set out to test this hypothesis by employing a battery of questionnaires and laboratory tests with a sample of young adults. We found that more frequent vigorous- and moderate-intensity PA rather than walking (considered low to moderate intensity) was associated with better cognitive and mental health measures. Meanwhile, compared with no moderate- to vigorous-intensity physical activity (MVPA) at all, as few as 1~2 days per week (lasting at least 10 min each time) of MVPA was associated with a variety of benefits, particularly related to coping with challenging situations. In light of the neurobiological literature, the present study speaks to the value of moderate- to vigorous- rather than low-intensity PA in enhancing cognitive functions and mental health.
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Affiliation(s)
| | | | - Chong Chen
- Correspondence: ; Tel.: +81-836-22-2255; Fax: +81-836-22-2253
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Kartschmit N, Sutcliffe R, Sheldon MP, Moebus S, Greiser KH, Hartwig S, Thürkow D, Stentzel U, van den Berg N, Wolf K, Maier W, Peters A, Ahmed S, Köhnke C, Mikolajczyk R, Wienke A, Kluttig A, Rudge G. Walkability and its association with prevalent and incident diabetes among adults in different regions of Germany: results of pooled data from five German cohorts. BMC Endocr Disord 2020; 20:7. [PMID: 31931801 PMCID: PMC6958624 DOI: 10.1186/s12902-019-0485-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/27/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Highly walkable neighbourhoods may increase transport-related and leisure-time physical activity and thus decrease the risk for obesity and obesity-related diseases, such as type 2 diabetes (T2D). METHODS We investigated the association between walkability and prevalent/incident T2D in a pooled sample from five German cohorts. Three walkability measures were assigned to participant's addresses: number of transit stations, points of interest, and impedance (restrictions to walking due to absence of intersections and physical barriers) within 640 m. We estimated associations between walkability and prevalent/incident T2D with modified Poisson regressions and adjusted for education, sex, age at baseline, and cohort. RESULTS Of the baseline 16,008 participants, 1256 participants had prevalent T2D. Participants free from T2D at baseline were followed over a mean of 9.2 years (SD: 3.5, minimum: 1.6, maximum: 14.8 years). Of these, 1032 participants developed T2D. The three walkability measures were not associated with T2D. The estimates pointed toward a zero effect or were within 7% relative risk increase per 1 standard deviation with 95% confidence intervals including 1. CONCLUSION In the studied German settings, walkability differences might not explain differences in T2D.
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Affiliation(s)
- Nadja Kartschmit
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Robynne Sutcliffe
- Centre for Urban Epidemiology, University Clinics Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Mark Patrick Sheldon
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Susanne Moebus
- Centre for Urban Epidemiology, University Clinics Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Karin Halina Greiser
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- German Cancer Research Center DKFZ (Deutsches Krebsforschungszentrum) Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Saskia Hartwig
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Detlef Thürkow
- Institute of Geosciences and Geography, Martin-Luther-University Halle-Wittenberg, 06099, Halle (Saale), Germany
| | - Ulrike Stentzel
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Neeltje van den Berg
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstr. 1-2, 17487, Greifswald, Germany
| | - Kathrin Wolf
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Werner Maier
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Annette Peters
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Salman Ahmed
- Centre for Urban Epidemiology, University Clinics Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - Corinna Köhnke
- Institute of Epidemiology and Social Medicine, University of Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biometrics and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
- German Center for Diabetes Research (Deutsches Zentrum für Diabetesforschung DZD), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany.
| | - Gavin Rudge
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Tarlov E, Silva A, Wing C, Slater S, Matthews SA, Jones KK, Zenk SN. Neighborhood Walkability and BMI Change: A National Study of Veterans in Large Urban Areas. Obesity (Silver Spring) 2020; 28:46-54. [PMID: 31804004 PMCID: PMC6925327 DOI: 10.1002/oby.22611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/15/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas. METHODS In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014. RESULTS Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period. CONCLUSIONS Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population.
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Affiliation(s)
- Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Illinois, USA
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Abigail Silva
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | - Sandy Slater
- School of Pharmacy, Concordia University Wisconsin, Mequon, WI, USA
| | - Stephen A. Matthews
- Department of Sociology and Criminology, Department of Anthropology, The Pennsylvania State University, University Park, PA, USA
| | - Kelly K. Jones
- National Socio-Environmental Synthesis Center, Annapolis, MD, USA
| | - Shannon N. Zenk
- College of Nursing, University of Illinois at Chicago, Illinois, USA
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Lee AM, Sénéchal M, Hrubeniuk TJ, Bouchard DR. Is sitting time leading to mobility decline in long-term care residents? Aging Clin Exp Res 2020; 32:183-186. [PMID: 30778873 DOI: 10.1007/s40520-019-01148-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/11/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Little is known about the sitting time in long-term care (LTC) facilities, or if sedentary behaviour affects changes in mobility over time. AIMS The objectives were to document the sitting time of LTC residents and to examine if sitting time could predict changes in mobility. METHODS Twenty residents of an LTC facility, representing three mobility statuses (independent, assisted transfer, and dependent transfer) were included. Sitting time was defined using an ActivPAL. Mobility statuses were reviewed 12 months later. RESULTS Participants spent an average of 21.9 h per day sedentary. At follow-up, five residents experienced a decline in mobility status, but no baseline sitting time variables were associated with the changes in mobility status (P > 0.05). DISCUSSION/CONCLUSION People living in LTC are highly sedentary. Sitting time differs amongst the mobility statues, but is unable to predict upcoming changes in mobility status.
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Affiliation(s)
- A M Lee
- Cardiometabolic Exercise and Lifestyle Laboratory, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, 90 Mackay Drive, (Room 322), Fredericton, NB, E3B 5A3, Canada
| | - M Sénéchal
- Cardiometabolic Exercise and Lifestyle Laboratory, Fredericton, NB, Canada
- Faculty of Kinesiology, University of New Brunswick, 90 Mackay Drive, (Room 322), Fredericton, NB, E3B 5A3, Canada
| | - T J Hrubeniuk
- Cardiometabolic Exercise and Lifestyle Laboratory, Fredericton, NB, Canada
- Interdisciplinary Studies, University of New Brunswick, Fredericton, NB, Canada
| | - D R Bouchard
- Cardiometabolic Exercise and Lifestyle Laboratory, Fredericton, NB, Canada.
- Faculty of Kinesiology, University of New Brunswick, 90 Mackay Drive, (Room 322), Fredericton, NB, E3B 5A3, Canada.
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Domènech-Abella J, Mundó J, Leonardi M, Chatterji S, Tobiasz-Adamczyk B, Koskinen S, Ayuso-Mateos JL, Haro JM, Olaya B. Loneliness and depression among older European adults: The role of perceived neighborhood built environment. Health Place 2019; 62:102280. [PMID: 32479358 DOI: 10.1016/j.healthplace.2019.102280] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 12/13/2019] [Accepted: 12/18/2019] [Indexed: 12/21/2022]
Abstract
Depression and loneliness act in a synergistic way among older adults. We tested two indicators of the perceived neighborhood built environment (BE) as moderators of the association between these conditions in older European adults. Positive perceptions of neighborhood BE were related to lower levels of loneliness but not to major depressive disorder (MDD). Reporting low BE usability was significantly related to a higher likelihood of feeling lonely except for those suffering from MDD, whereas reporting low BE walkability was significantly related with a high likelihood of loneliness particularly among those with MDD. Therefore, improving neighborhood BE and, specifically, its walkability, might result in a reduction in the prevalence of loneliness.
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Affiliation(s)
- Joan Domènech-Abella
- Department of Sociology, Universitat de Barcelona, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Jordi Mundó
- Department of Sociology, Universitat de Barcelona, Barcelona, Spain
| | - Matilde Leonardi
- Department of Neurology, Public Health and Disability, Italian National Neurological Institute "Carlo Besta" Foundation IRCCS (Istituto di ricovero e cura a carattere scientifico), Milan, Italy
| | - Somnath Chatterji
- Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
| | - Beata Tobiasz-Adamczyk
- Chair of Epidemiology and Preventive Medicine, Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland
| | - Seppo Koskinen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Jose Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Kind Saud University, Riyadh, Saudi Arabia
| | - Beatriz Olaya
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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