The obese office worker seating problem

A field study was performed using 51 participants that were randomly selected from several Brazos Valley, Texas businesses to participate in an 8-hour assessment of office seating habits that influence seating design and testing. A control group was established as those with BMI’s 35. Data was collected through written survey and through data logging of seat and back contact pressure (average and peak), surface area, center of gravity and duration of contact by recording 8 metrics, once per second using the X-sensor pressure mapping device and software. Additionally, 50 days of caster roll distance was recorded for the participants using a caster mounted digital encoder. It was determined that at alpha = 0.05, using the Student’s T-test, a significant difference did exist between the groups in mean seat time per shift (p<.001) back contacts per shift (p<.002), seat contacts per shift (p<.01) and caster distance rolled per shift (p<.001). During a subsequent lab study, data were collected during 3 cycles of ingress, egress on the armrest use, along with anthropometry and critical chair testing parameters. Center of Gravity was measured from a fixed backrest (front to rear) for 16 participants. 4 male and 4 female obese with BMI greater than 35 and 4 male and 4 female with BMI less than 30 were compared. The purpose of this study was to determine whether a significant difference existed between anthropometric factors for normal and obese participants that would affect how a chair should be loaded during testing. The null hypothesis that normal means and obese means for each measure were equal was rejected by using independent samples T-test at alpha = 0.05 with p<.001 significance reported for all measures. These data suggest a need for a fresh look at several parameters used in the normal test standards as well as a need for a tougher test method for seating designed for the obese worker

Use of Stand-Biased Desks to Reduce Sedentary Time in High School Students: A Pilot Study

Background: The purpose of this pilot study was to identify differences between sitting and standing time in high school students’ pre and post stand-biased desk intervention. Methods: ActivPal3™ activity monitors were affixed to 25 Bryan Collegiate High School students’ to monitor their standing time and activity levels. Data were collected at the beginning of the school year (fall) in traditional seated desks and in the spring in stand-biased desks. After attrition, 18 of the original 25 students were included in the final analysis. The physical activity data (steps) as well as standing and sitting time data provided by the monitors was used for within subject intervention analyses. Results: Descriptive statistics and a two-sided t-test were used to analyse differences between pre and post intervention sitting and standing times. Analysis indicated a significant reduction of sitting time post stand-biased desk intervention (p&lt;0.0001) and a significant increase in standing time, post stand-biased desk intervention (p&lt;0.0001). Analysis also revealed a non-statistically significant (p &lt; 0.0619) average increase of 2,286 steps per school day when comparing mean steps pre-intervention (6,612) and post-intervention (8,898). Conclusions: Standing desks have the potential to reduce sedentary behavior and increase light to moderate physical activity for high school students during the school day

Modeling approaches for assessing device-based measures of energy expenditure in school-based studies of body weight status

BackgroundObesity has become an important threat to children’s health, with physical and psychological impacts that extend into adulthood. Limited physical activity and sedentary behavior are associated with increased obesity risk. Because children spend approximately 6 h each day in school, researchers increasingly study how obesity is influenced by school-day physical activity and energy expenditure (EE) patterns among school-aged children by using wearable devices that collect data at frequent intervals and generate complex, high-dimensional data. Although clinicians typically define obesity in children as having an age-and sex-adjusted body mass index (BMI) value in the high percentiles, the relationships between school-based physical activity interventions and BMI are analyzed using traditional linear regression models, which are designed to assess the effects of interventions among children with average BMI, limiting insight regarding the effects of interventions among children categorized as overweight or obese.MethodsWe investigate the association between wearable device–based EE measures and age-and sex-adjusted BMI values in data from a cluster-randomized, school-based study. We express and analyze EE levels as both a scalar-valued variable and as a continuous, high-dimensional, functional predictor variable. We investigate the relationship between school-day EE (SDEE) and BMI using four models: a linear mixed-effects model (LMEM), a quantile mixed-effects model (QMEM), a functional mixed-effects model (FMEM), and a functional quantile mixed-effects model (FQMEM). The LMEM and QMEM include SDEE as a summary measure, whereas the FMEM and FQMEM allow for the modeling of SDEE as a high-dimensional covariate. The FMEM and FQMEM allow the influence of the time of day at which physical activity is performed to be assessed, which is not possible using the LMEM or the QMEM. The FMEM assesses how frequently collected SDEE data influences mean BMI, whereas the FQMEM assesses the effects on quantile levels of BMI.ResultsThe LMEM and QMEM detected a statistically significant effect of overall mean SDEE on log (BMI) (the natural logarithm of BMI) after adjusting for intervention, age, race, and sex. The FMEM and FQMEM provided evidence for statistically significant associations between SDEE and log (BMI) for only a short time interval. Being a boy or being assigned a stand-biased desk is associated with a lower log (BMI) than being a girl or being assigned a traditional desk. Across our models, age was not a statistically significant covariate, and white students had significantly lower log (BMI) than non-white students in quantile models, but this significant effect was observed for only the 10th and 50th quantile levels of BMI. The functional regression models allow for additional interpretations of the influence of EE patterns on age-and sex-adjusted BMI, whereas the quantile regression models enable the influence of EE patterns to be assessed across the entire BMI distribution.ConclusionThe FQMEM is recommended when interest lies in assessing how device-monitored SDEE patterns affect children of all body types, as this model is robust and able to assess intervention effects across the full BMI distribution. However, the sample size must be sufficiently large to adequately power determinations of covariate effects across the entire BMI distribution, including the tails

The Evaluation of the Impact of a Stand-Biased Desk on Energy Expenditure and Physical Activity for Elementary School Students

Due to the increasing prevalence of childhood obesity, the association between classroom furniture and energy expenditure as well as physical activity was examined using a standing-desk intervention in three central-Texas elementary schools. Of the 480 students in the 24 classrooms randomly assigned to either a seated or stand-biased desk equipped classroom, 374 agreed to participate in a week-long data collection during the fall and spring semesters. Each participant’s data was collected using Sensewear® armbands and was comprised of measures of energy expenditure (EE) and step count. A hierarchical linear mixed effects model showed that children in seated desk classrooms had significantly lower (EE) and fewer steps during the standardized lecture time than children in stand-biased classrooms after adjusting for grade, race, and gender. The use of a standing desk showed a significant higher mean energy expenditure by 0.16 kcal/min (p &lt; 0.0001) in the fall semester, and a higher EE by 0.08 kcal/min (p = 0.0092) in the spring semester

Lung transplantation after allogeneic stem cell transplantation : a pan-European experience

Late-onset noninfectious pulmonary complications (LONIPCs) affect 6% of allogeneic stem cell transplantation (SCT) recipients within 5 years, conferring subsequent 5-year survival of 50%. Lung transplantation is rarely performed in this setting due to concomitant extrapulmonary morbidity, excessive immunosuppression and concerns about recurring malignancy being considered contraindications. This study assesses survival in highly selected patients undergoing lung transplantation for LONIPCs after SCT. SCT patients undergoing lung transplantation at 20 European centres between 1996 and 2014 were included. Clinical data pre- and post-lung transplantation were reviewed. Propensity score-matched controls were generated from the Eurotransplant and Scandiatransplant registries. Kaplan-Meier survival analysis and Cox proportional hazard regression models evaluating predictors of graft loss were performed. Graft survival at 1, 3 and 5 years of 84%, 72% and 67%, respectively, among the 105 SCT patients proved comparable to controls (p=0.75). Sepsis accounted for 15 out of 37 deaths (41%), with prior mechanical ventilation (HR 6.9, 95% CI 1.0-46.7; p Lung transplantation outcomes following SCT were comparable to other end-stage diseases. Lung transplantation should be considered feasible in selected candidates. No SCT-specific factors influencing outcome were identified within this carefully selected patient cohort.Peer reviewe

Development of a Multivariate Prediction Model for Early-Onset Bronchiolitis Obliterans Syndrome and Restrictive Allograft Syndrome in Lung Transplantation.

Chronic lung allograft dysfunction and its main phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS), are major causes of mortality after lung transplantation (LT). RAS and early-onset BOS, developing within 3 years after LT, are associated with particularly inferior clinical outcomes. Prediction models for early-onset BOS and RAS have not been previously described. LT recipients of the French and Swiss transplant cohorts were eligible for inclusion in the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years. These patients were assessed for early-onset BOS, RAS, or stable allograft function by an adjudication committee. Baseline characteristics, data on surgery, immunosuppression, and year-1 follow-up were collected. Prediction models for BOS and RAS were developed using multivariate logistic regression and multivariate multinomial analysis. Among patients fulfilling the eligibility criteria, we identified 149 stable, 51 BOS, and 30 RAS subjects. The best prediction model for early-onset BOS and RAS included the underlying diagnosis, induction treatment, immunosuppression, and year-1 class II donor-specific antibodies (DSAs). Within this model, class II DSAs were associated with BOS and RAS, whereas pre-LT diagnoses of interstitial lung disease and chronic obstructive pulmonary disease were associated with RAS. Although these findings need further validation, results indicate that specific baseline and year-1 parameters may serve as predictors of BOS or RAS by 3 years post-LT. Their identification may allow intervention or guide risk stratification, aiming for an individualized patient management approach

Student desk with stool

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Adjustable footrest for adjustable-height desk

An adjustable desk has base members or sidewalls supporting the desk on a surface. Each sidewall has at least one support movably vertically relative to the sidewall. A tabletop is disposed above the base member and is supported on the supports. A footrest is disposed between the base members beneath the tabletop and can move between a back position toward a back of the desk and a front position toward a front of the desk. One or more mechanisms operatively couple to at least one of the supports and to the footrest. The one or more mechanisms move the at least one support vertically relative to the base member to raise and lower the tabletop relative to the sidewall. Likewise, the one or more mechanisms move the footrest between the back and front positions. Preferably, movement of the footrest is coordinated with the movement of the tabletop so that the footrest moves to the front position when the tabletop is raised for standing and moves to the back position when the tabletop is lowered for sitting.U