Measuring activity in patients with sarcoidosis - a pilot trial of two wrist-worn accelerometer devices

Introduction: Increasing physical activity is associated with health benefits. Reduced physical activity has been noted in sarcoidosis, particularly where fatigue co-exists. Monitoring physical activity is possible with wrist-worn devices. This study compared two available devices to determine patient preference and compare wear-time, with a secondary outcome of comparing device outputs with fatigue scores. Methods: Patients with sarcoidosis wore two wrist-worn activity monitors (GENEActiv actiwatch and Actigraph GT3X-bt) separately for seven days each. Participants were randomly allocated to receive either device first. Participants completed the Fatigue Assessment Scale (FAS) questionnaire immediately before wearing the first device. All participants completed a questionnaire of their perception regarding each device after the wear period. Data from the devices was analysed for total wear time, time spent in moderate or vigorous activity (MVPA) and for time spent in sedentary behaviours. Results: Twelve patients with sarcoidosis were included. The GENEActiv device was preferred by ten (83.3%) participants. Wear time was greater with the GENEActiv device (1354 minutes/day vs 1079 minutes/day). Time spent in MVPA was slightly higher when recorded by the GENEActiv compared with the Actigraph. Moderately strong correlation was seen between FAS scores and sedentary time (r=-0.554), light activity (r=-0.585) and moderate activity (r=0.506). Discussion: A clear preference was demonstrated for the GENEActiv. This was reflected in higher wear time and suggests the device can be comfortably worn 24 hours per day. Data from this small cohort also suggests there is correlation between fatigue and activity scores in patients with sarcoidosis

"Parasite-induced aposematism" protects entomopathogenic nematode parasites against invertebrate enemies

Aposematism is a well-known strategy in which prey defend themselves from predation by pairing defenses such as toxins, with warning signals that are often visually conspicuous color patterns. Here, we examine the possibility that aposematism can be induced in a host by colonies of infectious parasites in order to protect the parasites from the consequences of attacks on the host. Earlier studies show that avian predators are reluctant to feed on carcasses of host prey that are infected with the entomopathogenic nematode, Heterorhabditis bacteriophora. As the age of infection increases, the parasites kill and preserve the host and subsequently cause its color to change, becoming bright pink then red. Nematode colonies in dead hosts may also be vulnerable, however, to nocturnally active foragers that do not use vision in prey detection. Here, then we test a novel hypothesis that the nematode parasites also produce a warning odor, which functions to repel nocturnally active predators (in this case, the beetle Pterostichus madidus). We show that beetles decrease their feeding on infected insect prey as the age of infection increases and that olfactory cues associated with the infections are effective mechanisms for deterring beetle predation, even at very early stages of infection. We propose that “parasite-induced aposematism” from the nematodes serves to replace the antipredator defenses of the recently killed host. Because sessile carcasses are exposed to a greater range of predators than the live hosts, several alternative defense mechanisms are required to protect the colony, hence aposematic signals are likely diverse in such “parasite-induced aposematism.

Reducing grains/loss asymmetry: A virtual reality choice experiment (VRCE) valuing land use change

Recent research suggests that, in some situations, numeric information may lack the 'evaluability' of visual representations of the same data. In such cases, reliance upon numeric information exacerbates tendencies for survey respondents to rely upon heuristics rather than their underlying preferences in formulating responses. Adapting such insights to the field of non-market valuation, for certain environmental goods, information on increases or decreases in the numeric levels of an attributes may trigger reliance upon the loss aversion heuristic, leading to an exacerbation of the well know gains/loss asymmetry problem (Horowitz and McConnell, 2002). A split sample choice experiment (CE) is described in which standard approaches to conveying a land use change scenario (relying principally on numeric information) are contrasted with an alternative treatment in which objectively identical information is presented in visual form via virtual reality (VR) visualisations. A third treatment combines both formats. Results show that the gains/loss asymmetry is roughly twice as strong under a conventional numeric CE design than in the presence of visual information. The combined VRCE methodology developed in the paper therefore significantly ameliorates this pervasive anomaly and, we contend, represents an exciting prospect for the incorporation of complex real world environments within economic analyses

Comparing Forage Biomass Estimation Between Forager-Mounted Near Infrared Spectroscopy (NIRS) and Rising Plate-Meter (RPM) Techniques

Quantifying the forage mass harvested per paddock is essential for informing late-season management decisions on grazing livestock farms. This information can be used to calculate winter feed budgets and thus support decisions such as area of land to defer for autumn grazing, and head of stock to sell before winter housing. However, there are practical limitations associated with existing measurement methods, which can influence the accuracy of forage biomass estimates. The purpose of the current study was therefore to compare biomass estimation from two alternative precision farming methods — near infrared spectroscopy (NIRS) integrated within-spout of a self-propelled forage harvester, against a rising plate meter (RPM). Data were collected from the North Wyke Farm Platform (NWFP) in South- West England. RPM readings were taken within seven days preceding harvest, and Harvester measurements taken at the point of harvest. Data from two paddocks were collected during 2021 (figure 2, points a and b) and two from 2020 (points c and d). Three of the sampled paddocks (a, c and d) contained permanent pasture and one (b) contained reseeded white clover and perennial ryegrass. Paddocks c and d in figure 2 suggest a good correspondence between methods, demonstrated by proximity to the 1:1 line which passes through the origin. However, points a and b lie parallel to the 1:1 line, suggesting a systematic underestimation from the RPM. This underestimation could be linked to the tendency of grass to lodge at high yields, or due to an unquantified factor linked to the year of harvest, such as weather conditions which are known to indirectly influence RPM readings. With suitable calibration and consideration of practical limitations, forager mounted NIRS technology can provide valuable farm management data quickly, and at a relatively low cost compared to manual methods of biomass estimation

Associations between BMI and home, school and route environmental exposures estimated using GPS and GIS: do we see evidence of selective daily mobility bias in children?

BACKGROUND: This study examined whether objective measures of food, physical activity and built environment exposures, in home and non-home settings, contribute to children's body weight. Further, comparing GPS and GIS measures of environmental exposures along routes to and from school, we tested for evidence of selective daily mobility bias when using GPS data. METHODS: This study is a cross-sectional analysis, using objective assessments of body weight in relation to multiple environmental exposures. Data presented are from a sample of 94 school-aged children, aged 5-11 years. Children's heights and weights were measured by trained researchers, and used to calculate BMI z-scores. Participants wore a GPS device for one full week. Environmental exposures were estimated within home and school neighbourhoods, and along GIS (modelled) and GPS (actual) routes from home to school. We directly compared associations between BMI and GIS-modelled versus GPS-derived environmental exposures. The study was conducted in Mebane and Mount Airy, North Carolina, USA, in 2011. RESULTS: In adjusted regression models, greater school walkability was associated with significantly lower mean BMI. Greater home walkability was associated with increased BMI, as was greater school access to green space. Adjusted associations between BMI and route exposure characteristics were null. The use of GPS-actual route exposures did not appear to confound associations between environmental exposures and BMI in this sample. CONCLUSIONS: This study found few associations between environmental exposures in home, school and commuting domains and body weight in children. However, walkability of the school neighbourhood may be important. Of the other significant associations observed, some were in unexpected directions. Importantly, we found no evidence of selective daily mobility bias in this sample, although our study design is in need of replication in a free-living adult sample.Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research and the Wellcome Trust under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This study was supported, in part, by a grant from the Robert Wood Johnson Foundation, Active Living Research.This is the final published version. It first appeared at http://www.ij-healthgeographics.com/content/14/1/8

London Schools Excellence Fund: Final Report: Enhancing the teaching of STEM through Design and Technology

London Schools Excellence Fund: Final Report: Enhancing the teaching of STEM through Design and Technolog

School polices, programmes and facilities, and objectively measured sedentary time, LPA and MVPA: associations in secondary school and over the transition from primary to secondary school.

BACKGROUND: There is increasing policy interest in ensuring that the school environment supports healthy behaviours. We examined the cross-sectional and longitudinal associations between schools' policies, programmes and facilities for physical activity (PA) and adolescents' objectively-measured activity intensity during the school day and lunchtime. METHODS: Accelerometer-derived PA (proportion of time spent in sedentary (SED), light PA (LPA) and moderate-to-vigorous PA (MVPA)) during school hours and lunchtime from 325 participants in the SPEEDY study were obtained from baseline measurements (primary school, age 9/10 years) and +4y follow-up (secondary school). School environment characteristics were assessed by teacher questionnaire. Multivariable multi-level linear regression analyses accounting for school and adjusted for sex, age, BMI and family socio-economic status assessed cross-sectional associations with lunchtime and school-day SED, LPA and MVPA; effect modification by sex was investigated. The association of changes in school environment with changes in outcomes was examined using multivariable cross-classified linear regression models. RESULTS: There were significant differences between primary and secondary schools for 6/10 school environment characteristics investigated (including secondary schools reporting shorter breaks, more lunchtime PA opportunities, and higher number of sports facilities). Cross-sectional analyses showed that boys attending secondary schools with longer breaks spent significantly less time in SED and more time in MVPA during the school day. Longitudinally, an increase in break-time duration between primary and secondary school was associated with smaller reductions in MVPA during the school day. Moreover, participants who moved from a primary school that did not provide opportunities for PA at lunchtime to a secondary school that did provide such opportunities exhibited smaller increases in SED and smaller reductions in MVPA at lunchtime. CONCLUSIONS: Schools should consider the potential negative impact of reducing break time duration on students' MVPA and SED during the school day. School-based interventions that combine longer breaks and more PA opportunities during lunchtime may be a fruitful direction for future research. Further research should also explore other factors in the school environment to explain the school-level clustering observed, and study sex differences in the way that the school environment influences activity intensity for adolescent populations.This report is independent research commissioned and funded by the Department of Health Policy Research Programme (Opportunities within the school environment to shift the distribution of activity intensity in adolescents, PR-R5-0213-25001). The views expressed in this publication are those of the author(s) and not necessarily those of the department of health. The SPEEDY study is funded by the National Prevention Research Initiative (http://​www.​npri.​org.​uk), consisting of the following Funding Partners: British Heart Foundation; Cancer Research UK; Department of Health; Diabetes UK; Economic and Social Research Council; Medical Research Council; Health and Social Care Research and Development Office for the Northern Ireland; Chief Scientist Office, Scottish Government Health Directorates; Welsh Assembly Government and World Cancer Research Fund. This work was also supported by the Medical Research Council (Unit Programme numbers MC_UU_12015/7, MC_UU_12015/4, and MC_UU_12015/3) and the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.This is the final version of the article. It first appeared from BioMed Central via http://dx.doi.org/10.1186/s12966-016-0378-

Improving primary care Access in Context and Theory (I-ACT trial): a theory-informed randomised cluster feasibility trial using a realist perspective

Background Primary care access can be challenging for older, rural, socio-economically disadvantaged populations. Here we report the I-ACT cluster feasibility trial which aims to assess the feasibility of trial design and context-sensitive intervention to improve primary care access for this group and so expand existing theory. Methods Four general practices were recruited; three randomised to intervention and one to usual care. Intervention practices received £1500, a support manual and four meetings to develop local, innovative solutions to improve the booking system and transport. Patients aged over 64 years old and without household car access were recruited to complete questionnaires when booking an appointment or attending the surgery. Outcome measures at 6 months included: self-reported ease of booking an appointment and transport; health care use; patient activation; capability; and quality of life. A process evaluation involved observations and interviews with staff and participants. Results Thirty-four patients were recruited (26 female, eight male, mean age 81.6 years for the intervention group and 79.4 for usual care) of 1143 invited (3% response rate). Most were ineligible because of car access. Twenty-nine participants belonged to intervention practices and five to usual care. Practice-level data was available for all participants, but participant self-reported data was unavailable for three. Fifty-six appointment questionnaires were received based on 150 appointments (37.3%). Practices successfully designed and implemented the following context-sensitive interventions: Practice A: a stacked telephone system and promoting community transport; Practice B: signposting to community transport, appointment flexibility, mobility scooter charging point and promoting the role of receptionists; and Practice C: local taxi firm partnership and training receptionists. Practices found the process acceptable because it gave freedom, time and resource to be innovative or provided an opportunity to implement existing ideas. Data collection methods were acceptable to participants, but some found it difficult remembering to complete booking and appointment questionnaires. Expanded theory highlighted important mechanisms, such as reassurance, confidence, trust and flexibility. Conclusions Recruiting older participants without access to a car proved challenging. Retention of participants and practices was good but only about a third of appointment questionnaires were returned. This study design may facilitate a shift from one-size-fits-all interventions to more context-sensitive interventions

The cross-sectional associations of chronic conditions and disability with self-reported physical activity among adults in England

Objective: Using cross-sectional data from the 2018 Health Survey for England, this study describes the types of impairment reported by people with chronic conditions and the association of chronic conditions and impairments with physical activity(PA).   Methods: Participants self-reported the presence of seven chronic health conditions (diabetes; stroke/ischemic heart disease; hypertension; chronic obstructive pulmonary disease (COPD); asthma; arthritis/rheumatism/fibrositis; back problems), 11 types of impairment (vision, hearing, mobility, dexterity; learning; memory; mental health; stamina; social or behavioural; other; none); and their PA using the International Physical Activity Questionnaire. Multivariable Poisson regression was used to estimate the association of a)impairment type, b)number of impairments, and c)impairment type and chronic condition (mutually adjusted) with PA.   Results: In total, 2243 adults (55% female, 44% age > 55 yrs) reported having a chronic condition. PA volume (MET minutes per week: median (IQR)) was highest in participants with asthma (2093 (693–4479)), and lowest in those with COPD (454 (0–2079)). There was a negative association between number of impairments and levels of PA. After adjustment for age, sex, ethnicity and education, and mutually adjusting for all other conditions and impairments, diabetes (Incident rate ratio (95% confidence interval): 0.83 (0.73–0.94)), COPD (0.76 (0.59–0.99)), a mobility impairment (0.63 (0.56–0.72)), a dexterity impairment (0.86 (0.75–0.98)), or a memory impairment (0.84 (0.72–0.99)) was negatively associated with PA.   Conclusion: Future PA research requires consideration of the number and types of impairments that individuals experience, as well as assessing chronic conditions. This will improve understanding of the barriers to PA participation and inform interventions

A review of sedentary behavior assessment in national surveillance systems

Background: Temporal changes in sedentary behavior patterns reflect the evolving nature of our built and social environments, particularly the expanding availability of electronic media. It is important to understand what types of sedentary behavior are assessed in national surveillance to determine whether, and to what extent, they reflect contemporary patterns. The aims of this review were to describe the characteristics of questionnaires used for national surveillance of sedentary behavior and to identify the types of sedentary behaviors being measured. Method: We reviewed questionnaires from national surveillance systems listed on the Global Observatory for Physical Activity (GoPA!) country cards to locate items on sedentary behavior. Questionnaire characteristics were categorized using the Taxonomy of Self-reported Sedentary Behavior Tools (TASST). The purpose and type of sedentary behaviors captured were classified using the Sedentary Behavior International Taxonomy (SIT). Results: Overall, 346 surveillance systems were screened for eligibility, of which 93 were included in this review. Most questionnaires used a single-item direct measure of sitting time (n = 78, 84%). Work and domestic were the most frequently captured purposes of sedentary behavior, while television viewing and computer use were the most frequently captured types of behaviors. Conclusion: National surveillance systems should be periodically reviewed in response to evidence on contemporary behavior patterns in the population and the release of updated public health guidelines