Using Mixed-Methods to Examine Factors that Influence Exercise Prescription from Healthcare Providers: A Community-Engaged Research Project

Background: The American College of Sports Medicine\u27s Exercise is Medicine initiative supports promotion of physical activity by health care providers (HCPs). Exercise is Medicine recommends HCPs utilize strategies such as exercise prescriptions to increase and promote regular exercise and referrals to community-based exercise facilities (ExRx+). Research is needed to identify factors that will increase African-American patients\u27 ExRx+ engagement since little is known about factors that serve as facilitators or barriers to adherence. Aims: Using a community-engaged participatory research approach, the aims are to: 1) examine individual, interpersonal and environmental factors associated with ExRx+ adherence and 2) explore barriers and facilitators related to the referral process that are associated with ExRx+ adherence. Setting: Healthworks Community Fitness, a non-profit women\u27s fitness facility located in Dorchester, MA. Healthworks is the only gym in the Boston metro area which allows patients to exchange ExRx+ for a 3-month gym membership. Methods: Based on a socio-ecological framework, the mixed-methods protocol includes qualitative and quantitative methods implemented sequentially in two phases to explore factors associated with ExRx+ adherence. Adherence will be operationally defined as: 1) activation: patient redeems the ExRx+ for membership and 2) utilization: attendance during the 3 month membership. Quantitative data will focus on the patient\u27s individual (i.e, body mass index, self-efficacy) interpersonal (i.e, social support), and environmental (i.e, walkability, transportation) levels. Qualitative data will involve one-on-one interviews with patients, HCPs and Healthworks staff exploring facilitators and barriers to ExRx+ adherence. Results will inform the development of a culturally tailored intervention to promote ExRx+ adherence

A Longitudinal Study of the Reliability of Acupuncture Deqi Sensations in Knee Osteoarthritis

Deqi is one of the core concepts in acupuncture theory and encompasses a range of sensations. In this study, we used the MGH Acupuncture Sensation Scale (MASS) to measure and assess the reliability of the sensations evoked by acupuncture needle stimulation in a longitudinal clinical trial on knee osteoarthritis (OA) patients. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as the clinical outcome. Thirty OA patients were randomized into one of three groups (high dose, low dose, and sham acupuncture) for 4 weeks. We found that, compared with sham acupuncture, real acupuncture (combining high and low doses) produced significant improvement in knee pain (P = .025) and function in sport (P = .049). Intraclass correlation analysis showed that patients reliably rated 11 of the 12 acupuncture sensations listed on the MASS and that heaviness was rated most consistently. Overall perceived sensation (MASS Index) (P = .014), ratings of soreness (P = .002), and aching (P = .002) differed significantly across acupuncture groups. Compared to sham acupuncture, real acupuncture reliably evoked stronger deqi sensations and led to better clinical outcomes when measured in a chronic pain population. Our findings highlight the MASS as a useful tool for measuring deqi in acupuncture research

Telemetry-validated nitrogen stable isotope clocks identify ocean-to-estuarine habitat shifts in mobile organisms

Throughout their life history, many animals transition among heterogeneous environments to facilitate behaviours such as reproduction, foraging and predator avoidance. The dynamic environmental and biological conditions experienced by mobile species are integrated in the chemical composition of their tissues, providing retrospective insight into movement. Here, we present a unique application of nitrogen stable isotope clocks (‘isotopic clocks’), which integrate tissue turnover rates, consumer stable isotope ratios and habitat-specific isotope baselines to predict time-since-immigration and the timing of habitat shifts in a migratory species. Nitrogen stable isotope values of blood plasma collected from juvenile sand tiger sharks Carcharias taurus, a species known to undertake seasonal movements between ocean and estuarine environments, were used to derive estimates of time-since-immigration and the timing of seasonal habitat shifts undertaken by this species. Nitrogen isotopic clocks estimated for 65 juvenile sand tiger sharks sampled across 6 years indicated that individual sharks predominantly arrived to estuarine habitats between June and July, with some individuals arriving as early as mid-May. These estimates were validated by comparing isotope-derived estuarine arrival times with those from acoustically tracked individuals. The median estuarine arrival day estimates from our isotopic approach aligned with estimates from acoustic telemetry for each sampling population. Sensitivity analyses indicated that isotopically inferred time-since-immigration and estuarine arrival estimates were robust to variation in isotopic turnover rate and diet tissue discrimination factors under multiple modelling scenarios. This suggests that parameterization of the nitrogen isotopic clock provides reliable estimates of time-since-immigration and day of arrival into new habitats if isotopic variation exists between origin and new locations. Our study presents a unique application of telemetry-validated isotope clocks to derive retrospective estimates of time-since-immigration and timing of habitat shifts for animals that seasonally traverse heterogeneous environments. This approach can be readily applied across many temporal and spatial scales, and to other species and ecosystems, to facilitate rapid assessment of changes in animal habitat use and broader ecosystem structure

Choice of activity-intensity classification thresholds impacts upon accelerometer-assessed physical activity-health relationships in children

It is unknown whether using different published thresholds (PTs) for classifying physical activity (PA) impacts upon activity-health relationships. This study explored whether relationships between PA (sedentary [SED], light PA [LPA], moderate PA [MPA], moderate-to-vigorous PA, vigorous PA [VPA]) and health markers differed in children when classified using three different PTs

Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study

Clustering of cardiometabolic risk factors can occur during childhood and predisposes individuals to cardiometabolic disease. This study calculated clustered cardiometabolic risk in 100 children and adolescents aged 10-14 years (59 girls) and explored differences according to cardiorespiratory fitness (CRF) levels and time spent at different physical activity (PA) intensities. CRF was determined using a maximal cycle ergometer test, and PA was assessed using accelerometry. A cardiometabolic risk score was computed as the sum of the standardised scores for waist circumference, blood pressure, total cholesterol/high-density lipoprotein ratio, triglycerides and glucose. Differences in clustered cardiometabolic risk between fit and unfit participants, according to previously proposed health-related threshold values, and between tertiles for PA subcomponents were assessed using ANCOVA. Clustered risk was significantly lower (p < 0.001) in the fit group (mean 1.21 ± 3.42) compared to the unfit group (mean -0.74 ± 2.22), while no differences existed between tertiles for any subcomponent of PA. Conclusion These findings suggest that CRF may have an important cardioprotective role in children and adolescents and highlights the importance of promoting CRF in youth

Transitions in Metabolic Risk and Longâ Term Cardiovascular Health: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139081/1/jah31816.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139081/2/jah31816_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139081/3/jah31816-sup-0001-TableS1-FigureS1.pd

Reactive direction control for a mobile robot: A locust-like control of escape direction emerges when a bilateral pair of model locust visual neurons are integrated

Locusts possess a bilateral pair of uniquely identifiable visual neurons that respond vigorously to the image of an approaching object. These neurons are called the lobula giant movement detectors (LGMDs). The locust LGMDs have been extensively studied and this has lead to the development of an LGMD model for use as an artificial collision detector in robotic applications. To date, robots have been equipped with only a single, central artificial LGMD sensor, and this triggers a non-directional stop or rotation when a potentially colliding object is detected. Clearly, for a robot to behave autonomously, it must react differently to stimuli approaching from different directions. In this study, we implement a bilateral pair of LGMD models in Khepera robots equipped with normal and panoramic cameras. We integrate the responses of these LGMD models using methodologies inspired by research on escape direction control in cockroaches. Using ‘randomised winner-take-all’ or ‘steering wheel’ algorithms for LGMD model integration, the khepera robots could escape an approaching threat in real time and with a similar distribution of escape directions as real locusts. We also found that by optimising these algorithms, we could use them to integrate the left and right DCMD responses of real jumping locusts offline and reproduce the actual escape directions that the locusts took in a particular trial. Our results significantly advance the development of an artificial collision detection and evasion system based on the locust LGMD by allowing it reactive control over robot behaviour. The success of this approach may also indicate some important areas to be pursued in future biological research

Strategy Change in Vibrissal Active Sensing during Rat Locomotion

During exploration, rats and other small mammals make rhythmic back-and-forth sweeps of their long facial whiskers (macrovibrissae) [1, 2 and 3]. These “whisking” movements are modulated by head movement [4] and by vibrissal sensory input [5 and 6] and hence are often considered “active” in the Gibsonian sense of being purposive and information seeking [7 and 8]. An important hallmark of active sensing is the modification of the control strategy according to context [9]. Using a task in which rats were trained to run circuits for food, we tested the hypothesis that whisker control, as measured by high-speed videography, changes with contextual variables such as environment familiarity, risk of collision, and availability of visual cues. In novel environments, functionally blind rats moved at slow speeds and performed broad whisker sweeps. With greater familiarity, however, they moved more rapidly, protracted their whiskers further, and showed decreased whisking amplitude. These findings indicate a strategy change from using the vibrissae to explore nearby surfaces to using them primarily for “look ahead.” In environments with increased risk of collision, functionally blind animals moved more slowly but protracted their whiskers further. Sighted animals also showed changes in whisker control strategy with increased familiarity, but these changes were different to those of the functionally blind strain. Sighted animals also changed their vibrissal behavior when visual cues were subsequently removed (by being placed in darkness). These contextual influences provide strong evidence of active control and demonstrate that the vibrissal system provides an accessible model of purposive behavior in mammals

Global Diversity Hotspots and Conservation Priorities for Sharks

Sharks are one of the most threatened groups of marine animals, as high exploitation rates coupled with low resilience to fishing pressure have resulted in population declines worldwide. Designing conservation strategies for this group depends on basic knowledge of the geographic distribution and diversity of known species. So far, this information has been fragmented and incomplete. Here, we have synthesized the first global shark diversity pattern from a new database of published sources, including all 507 species described at present, and have identified hotspots of shark species richness, functional diversity and endemicity from these data. We have evaluated the congruence of these diversity measures and demonstrate their potential use in setting priority areas for shark conservation. Our results show that shark diversity across all species peaks on the continental shelves and at mid-latitudes (30–40 degrees N and S). Global hotspots of species richness, functional diversity and endemicity were found off Japan, Taiwan, the East and West coasts of Australia, Southeast Africa, Southeast Brazil and Southeast USA. Moreover, some areas with low to moderate species richness such as Southern Australia, Angola, North Chile and Western Continental Europe stood out as places of high functional diversity. Finally, species affected by shark finning showed different patterns of diversity, with peaks closer to the Equator and a more oceanic distribution overall. Our results show that the global pattern of shark diversity is uniquely different from land, and other well-studied marine taxa, and may provide guidance for spatial approaches to shark conservation. However, similar to terrestrial ecosystems, protected areas based on hotspots of diversity and endemism alone would provide insufficient means for safeguarding the diverse functional roles that sharks play in marine ecosystems