The unanticipated challenges associated with implementing an observational study protocol in a large scale physical activity and GPS data collection

Background: Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. Objectives: In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. Methods: The SPACES (Studying Physical Activity in Children’s Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Results: Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. Conclusions: We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development

The validity of the Youth Physical Activity Questionnaire in 12-13 year old Scottish adolescents

Background: The development of accurate methods to measure health-behaviours forms an integral component in behavioural epidemiology. Population surveillance of physical activity often relies on self/proxy reported questionnaires due to cost and relative ease of administration. The aim of this study was to examine the criterion validity and measurement agreement between the Youth Physical Activity Questionnaire (YPAQ) and accelerometry before being included in a Scotland-wide study. Methods: Forty four participants (12–13 years old; 61% girls) completed the YPAQ following 7 days wearing the Actigraph GT3X+. Mean moderate-to-vigorous physical activity (MVPA) per day was derived from YPAQ and accelerometer and validity was assessed using Spearman's correlation; Bland-Altman plots examined absolute agreement between methods. Results: Pearson's and Spearman’s correlations between YPAQ and accelerometer were r = 0.47 and rs = 0.39 (p<0.01) respectively. The YPAQ over reported mean MVPA by 25.6 ± 50.2 minutes (95% CI 10.4-40.9 minutes; p <0.001), with 95% limits of agreement of −72.69 minutes and + 123.99 minutes. Evidence of underreporting at lower levels of activity and over reporting at higher levels of activity was evident (Pearson's r=0.81), in addition to heteroscedasticity, where variances increased as MVPA increased. Conclusions: Although a moderate correlation between the two methods was apparent, the YPAQ should not be used interchangeably with accelerometry. The YPAQ does demonstrate a reasonable ability to rank MVPA, although it tends to under-report lower levels and over-report higher levels. This, and other administering factors, should be taken into consideration if being used for group or individual level analyses

Integration of organic poultry in whole farm systems: manure nutrient budgets

This report was presented at the UK Organic Research 2002 Conference. The aim of this project was to examine how rotations incorporating organic poultry use the cycling of nutrients between soil, crops and birds. Poultry studies have measured nutrient values of manure in slow growing meat birds at about day 81 when fed typical broiler rations versus “Label Rouge” rations. Nutrient (N, P, K) balances were constructed to assess the viability of integrating poultry production within a theoretical organic rotation. The readilyplant- available nitrogen in manure from Ross 308 birds fed either presumed non-limiting rations or Label Rouge rations was within the range reported for intensive broilers. For ISA 657 birds, the manure readily-plant-available nitrogen was similar to the mean value reported for broilers, when fed presumed non limiting rations, but towards the lower range when fed Label Rouge rations. As breed growth and feed intakes differ it is suggested that to optimise the utilisation of nutrients, the nutrient content of table bird manures should be checked prior to land application. The nutrient budgets were similar for N and P regardless of the length of rotation or form of poultry production. On average, there was a surplus of 85 kg/ha N over all the scenarios. There tended to be a deficit of K in all scenarios (average: 10 kg/ha)

Giving Literacy, Learning Literacy: Service Learning and School Book Drives

Service‐learning can provide a range of literacy learning experiences for children as they work to solve real world problems and engage in inquiry, collaboration and reflection. Rather than being an extracurricular activity, service‐learning projects are designed to meet standards and align with existing curriculum. This article explores how teachers can engage their students in literacy‐based service learning using the example of a book drive that supported literacy and children\u27s libraries in Ethiopia. The article draws on both scholarly research and personal experience and provides practical information and resources

Wheat-free for the wrong reasons? College students' attitudes and information sources pertaining to the gluten-free diet

2016 Summer.Includes bibliographical references.The gluten-free diet has grown popular over the past years, with more people on the diet than simply celiac patients. Health professionals were concerned by the high number of people on the diet for reasons other than celiac disease because of dietary deficiencies that stem from eating gluten-free. Health scholars believed that misleading media messages touting the weight-loss and general health benefits of the diet were leading to the popularity of the gluten-free diet. However, these statements were not supported by research. In the pursuit of knowledge, research questions were developed for attitudes and information sources of the diet. Agenda setting and framing theory were used to examine survey results to better understand the possible influence media sources are having on attitudes towards the diet. To achieve a better understanding of attitudes and sources of information about the gluten-free diet, an online survey was given to 351 college students assessing their attitudes and both interpersonal and media information sources. College students were chosen as the study population based on their proclivity for fad dieting, changes in eating habits, and issues with weight. Results indicated that while students neither believed the diet was healthy nor unhealthy for everyone, they did hold negative attitudes about gluten-free as a fad diet, and believed others thought the diet was annoying and healthy. Search engine results were the most popular source of gluten-free diet information, and health type media sources were the most preferred type of media. Friends and family were the most used sources of interpersonal information, and health care providers were the least used interpersonal source of information. Students who had celiac disease or a gluten sensitivity were more likely to find gluten-free information on a search engine, on followed blogs or websites, and in magazine articles; these students were also more likely to discuss the diet with friends, family, and a health care provider. Implications and recommendations for future research were also discussed

Impact on maternity professionals of novel approaches to clinical audit feedback

We compared three approaches to feedback of clinical audit findings relating to miscarriage in 15 Scottish maternity services (printed report alone; report plus Action Planning Letter; report plus face-to-face Facilitated Action Planning). We surveyed clinicians to measure Theory of Planned Behaviour constructs (in the context of two audit criteria) before and after feedback (n=253) and assessed perceptions of the audit through in-depth interviews (n=17). Pre-feedback, clinicians had positive attitudes and strong subjective norms and intentions to comply, although perceived behavioural control was lower. Generally, positive attitudes, subjective norms and intentions increased after feedback but for one of the two criteria (providing a 7-day miscarriage service), perceived behavioural control decreased. No changes over time reached statistical significance and analysis of covariance (adjusting for pre-feedback scores) showed no consistent relationships between method of feedback and post-feedback construct scores. Interviews revealed positive perceptions of audit but frustration at lack of capacity to implement changes. While interventions which increased intensity of feedback proved feasible and acceptable to clinicians, we were unable to demonstrate that they increased intention to comply with audit criteria.This study was funded by NHS Quality Improvement Scotland

Three Essays on Economic Growth and Natural Resources

This dissertation is a collection of papers examining the relationship between resource intensity and economic growth in the Appalachian region of the United States. The first chapter develops a homogenous sample of counties within the Appalachian region and uses that sample to investigate how coal resources impact long-run per capita income growth. The Appalachian Regional Commission\u27s definition of the Appalachian region is the one used most often by researchers, politicians, and the popular press. The uncritical use of this definition of Appalachia raises issues of both selection bias and excess heterogeneity in regression analysis of Appalachian income and growth. The ARC was created as part of President Johnson\u27s war on poverty, and the geographical extent of its purview has been driven by politics and by the geography of poverty, neither of which is exogenous. It is well known that the use of endogenous variables to choose a sample creates bias and inconsistency in estimation of regression coefficients. To identify the counties that belong to the Appalachian region exogenously we use an algorithm based on three criteria: topography, contiguity, and prevalence of slavery in the 1860 census. We apply our sample to growth regressions using data from 1970 to 2008, addressing the question of the existence of a resource curse from coal extraction. For this model we find strong evidence of excess heterogeneity, but not bias.;In the second chapter, I extend the analysis by exploring different possible measures for coal resource abundance. I use both a geologic based measure of abundance and a flow based measure of dependence , and find evidence that coal abundance significantly reduces growth of per capita income over the long run with both measures. In addition, I use a wide variety of alternative measures of resource abundance suggested by the literature, all which indicate a negative systematic effect of resources on income growth. I account for the endogeneity of the each flow measure with instruments, and when I also account for the endogeneity of initial income, results indicate that a one standard deviation increase in the measure of resource intensity results in a 0.43 percentage point drop in average annual growth.;In the third chapter, I investigate several of the causes for the under-performance by many resource rich counties in the Appalachian region. I examine the effect of coal abundance on educational attainment, local (county) level education expenditure decisions, and local level taxation decisions. I find evidence that the educational attainment channel accounts for a significant portion of the negative effect of resource abundance. Coal resource abundance tends to reduce educational attainment, reducing human capital in a county, which in turn reduces per capita income growth over the long run. When attainment is measured by the share of the population that dropped out of high school, a one standard deviation increase in the measure of resource abundance reduces average annual growth by an estimated 0.125 percentage points. When educational attainment is measured instead by the share of the population that completed a college degree, average annual growth is reduced by an estimated 0.037 percentage points. I find no evidence that resource abundance affects the education expenditure allocation decisions of local county governments, nor do I find evidence that resource rich counties test to under tax their populations

Relationship between premenstrual symptoms and the ovarian cycle

The majority of women of reproductive age experience physical and / or emotional changes during the week to ten days before menstruation . In a proportion - probably 3 - 5 % - these changes are severe , and constitute the Premenstrual Syndrome ( PMS ) . The occurrence of these changes in the premenstrual phase has caused many theorists to postulate an aetiological link with the female reproductive cycle . The purpose of this research is to investigate the relationship between premenstrual symptoms and the ovarian hormones . A review of the literature suggests that previous research has been inconclusive for largely methodological reasons . These studies have focussed on PMS and normal cycles , attempting to delineate endocrinological differences between women with and without the syndrome. Inconsistencies have arisen in the definition and diagnosis of PMS and the frequency and type of assessment of ovarian activity . The occurrence of symptoms in anovulatory or otherwise abnormal menstrual cycles has received little attention . In this research , it was hypothesized that a link between premenstrual changes and ovarian hormones would be demonstrated by a change in symptomatology if the menstrual cycle were naturally or artificially abnormal . Hence , the focus in these studies is on premenstrual symptoms and their degree of change between cycles rather than on the diagnosis of PMS . Two studies were designed to investigate the hypothesis . The first involved the observation of naturally occuring abnormal menstrual cycles , comparing them symptomatically with normal cycles in the same individual . The second approach involved the comparison of women whose menstrual cycles had been artificially manipulated by the long term use of low-dose oral contraceptive ( oc ) pills , with matched women experiencing natural cycles . In both of these studies, symptoms were assessed by daily subjective ratings of eight physical and emotional variables using visual analogue scales . In the first study , ovarian activity was assessed by the analysis of daily , early morning urine samples for the major ovarian hormone metabolites - oestrone-3-glucuronide and pregnane- diol-3aglucuronide . In the second study , various components of the ovarian cycle were assessed by the comparison of combined oc's having a constant dose regime with oc's designed to mimic the normal cycle . In both studies daily ratings were continued for at least two complete cycles , and frequently longer. The data were analysed in several ways , taking cognisance of the inadequacy of conventional inferential statistical methods in this area . Clear evidence emerged from these studies to show that neither ovulation nor adequate luteal function are necessary for premenstrual symptom occurrence . A relationship did emerge between the symptom of breast tenderness and luteal hormones in approximately half of the women studied . Absolute hormone levels did not seem to be involved in this effect, suggesting a potential role for some other endocrine or biochemical factor associated with luteal function . The conclusions drawn from the study were that several different aetiological mechanisms may be involved in the manifestation of premenstrual symptoms . The relationship between symptoms and the ovarian cycle would appear to be purely temporal in the majority of cases . However , some symptoms , i.e. breast tenderness , may be more closely related to luteal function in some women