Ductal-lobar organisation of human breast tissue, its relevance in disease and a research objective: vector mapping of parenchyma in complete breasts (the Astley Cooper project)

A human breast has many lobes, which are highly variable in size and shape, each with one central duct, its peripheral branches and their associated glandular tissues. Realising the potential of new endoductal approaches to breast diagnosis and improving our understanding of breast cancer precursors will require greatly improved knowledge of this ductal-lobar anatomy and the distribution of cancer precursors within it. This architecture is very challenging to study in its entirety: whole-breast lobe mapping has only been achieved for two human breasts. Clearly, much more efficient techniques are required. Streamlined data capture and visualisation of breast parenchymal anatomy from thin and thick sections in a vector format would allow integrated mapping of whole-breast structure with conventional histology and molecular data. The 'Astley Cooper digital breast mapping project' is proposed as a name for this achievable research objective. Success would offer new insights into the development of breast cancer precursor lesions, allow testing of the important 'sick lobe' hypothesis, improve correlation with imaging studies and provide 'ground truth' for mathematical modelling of breast growth

The relationship between unsupervised time after school and physical activity in adolescent girls

BACKGROUND: Rising obesity and declining physical activity levels are of great concern because of the associated health risks. Many children are left unsupervised after the school day ends, but little is known about the association between unsupervised time and physical activity levels. This paper seeks to determine whether adolescent girls who are without adult supervision after school are more or less active than their peers who have a caregiver at home. METHODS: A random sample of girls from 36 middle schools at 6 field sites across the U.S. was selected during the fall of the 2002–2003 school year to participate in the baseline measurement activities of the Trial of Activity for Adolescent Girls (TAAG). Information was collected using six-day objectively measured physical activity, self-reported physical activity using a three-day recall, and socioeconomic and psychosocial measures. Complete information was available for 1422 out of a total of 1596 respondents. Categorical variables were analyzed using chi square and continuous variables were analyzed by t-tests. The four categories of time alone were compared using a mixed linear model controlling for clustering effects by study center. RESULTS: Girls who spent more time after school (≥2 hours per day, ≥2 days per week) without adult supervision were more active than those with adult supervision (p = 0.01). Girls alone for ≥2 hours after school, ≥2 days a week, on average accrue 7.55 minutes more moderate to vigorous physical activity (MVPA) per day than do girls who are supervised (95% confidence interval ([C.I]). These results adjusted for ethnicity, parent's education, participation in the free/reduced lunch program, neighborhood resources, or available transportation. Unsupervised girls (n = 279) did less homework (53.1% vs. 63.3%), spent less time riding in a car or bus (48.0% vs. 56.6%), talked on the phone more (35.5% vs. 21.1%), and watched more television (59.9% vs. 52.6%) than supervised girls (n = 569). However, unsupervised girls also were more likely to be dancing (14.0% vs. 9.3%) and listening to music (20.8% vs. 12.0%) (p < .05). CONCLUSION: Girls in an unsupervised environment engaged in fewer structured activities and did not immediately do their homework, but they were more likely to be physically active than supervised girls. These results may have implications for parents, school, and community agencies as to how to structure activities in order to encourage teenage girls to be more physically active

Designing healthy communities: A walkability analysis of LEED-ND

AbstractPrevailing city design in many countries has created sedentary societies that depend on automobile use. Consequently, architects, urban designers, and land planners have developed new urban design theories, which have been incorporated into the Leadership in Energy and Environmental Design for Neighborhood Development (LEED-ND) certification system. The LEED-ND includes design elements that improve human well-being by facilitating walking and biking, a concept known as walkability. Despite these positive developments, relevant research findings from other fields of study have not been fully integrated into the LEED-ND. According to Zuniga-Teran (2015), relevant walkability research findings from multiple disciplines were organized into a walkability framework (WF) that organizes design elements related to physical activity into nine categories, namely, connectivity, land use, density, traffic safety, surveillance, parking, experience, greenspace, and community. In this study, we analyze walkability in the LEED-ND through the lens of the nine WF categories. Through quantitative and qualitative analyses, we identify gaps and strengths in the LEED-ND and propose potential enhancements to this certification system that reflects what is known about enhancing walkability more comprehensively through neighborhood design analysis. This work seeks to facilitate the translation of research into practice, which can ultimately lead to more active and healthier societies

Parent Involvement in Diet or Physical Activity Interventions to Treat or Prevent Childhood Obesity: An Umbrella Review

Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research

Defining Accelerometer Thresholds for Activity Intensities in Adolescent Girls

Purpose - To derive a regression equation that estimates metabolic equivalent (MET) from accelerometer counts, and to define thresholds of accelerometer counts that can be used to delineate sedentary, light, moderate, and vigorous activity. Methods - Seventy-four healthy 8th grade girls, age 13-14 yr, were recruited from urban areas of Baltimore, MD, Minneapolis/St. Paul, MN, and Columbia, SC, to participate in the study. Accelerometer and oxygen consumption (VO2) data for 10 activities that varied in intensity from sedentary (e.g., TV watching) to vigorous (e.g., running) were collected. While performing these activities, the girls wore two accelerometers, a heart rate monitor and a Cosmed K4b2 portable metabolic unit for measurement of VO2. A random-coefficients model was used to estimate the relationship between accelerometer counts and VO2. Activity thresholds were defined by minimizing the false positive and false negative classifications. Results - The activities provided a wide range in VO2 (3-36 mL·kg-1·min-1) with a correspondingly wide range in accelerometer counts (1-3928 counts·30 s-1). The regression line for MET score versus counts was MET=2.01+0.00171 (counts·30 s-1) (mixed model R2=0.84, SEE=1.36). A threshold of 1500 counts·30 s-1 defined the lower end of the moderate intensity (~4.6 METs) range of physical activity. That cutpoint distinguished between slow and brisk walking, and gave the lowest number of false positive and false negative classifications. The threshold ranges for sedentary, light, moderate, and vigorous physical activity were found to be 0-50, 51-1499, 1500-2600, and \u3e2600 counts·30 s-1, respectively. Conclusion - The developed equation and these activity thresholds can be used for prediction of MET score from accelerometer counts and participation in various intensities of physical activity in adolescent girls

Age-Related Change in Physical Activity in Adolescent Girls

Purpose - To determine the annual rate at which physical activity changes in girls during middle school using both objective and self-report measures of physical activity. Methods - Participants were 6th and 8th grade girls from the control schools in the Trial of Activity for Adolescent Girls (TAAG). Random cross-sectional samples initially were drawn from 6th grade girls (n=786) and two years later from 8th grade girls (n=1545). A cohort of 501 girls was in both the 6th and 8th grade samples. The girls wore an accelerometer for six days and completed the 3-Day Physical Activity Recall (3DPAR). Data were summarized using 3.0-4.6- and 6.5-MET cutpoints for accelerometry and self-reported physical activity. Analyses were performed using repeated measures ANOVA in PROC MIXED. Results - More than 40% of the girls were White, approximately 20% were African-American, and 20% were Hispanic. The annual percent decrease in physical activity in the cross-sectional sample was approximately 4% (-1.76 min MVPA/day), using accelerometer data. The percent decrease in physical activity based on self-report data was higher, 6-13%, depending on the physical activity variable. Declines tended to be larger in African-American girls, but the ethnic differences were not statistically significant. Conclusions - Based on comparisons of cross-sectional samples of 6th and 8th grade girls, objectively-measured physical activity declined at a rate of 4% per year

Relationship of Sedentary Behavior and Physical Activity to Incident Cardiovascular Disease Results From the Women's Health Initiative

ObjectivesThe aim of this study was to examine the independent and joint associations of sitting time and physical activity with risk of incident cardiovascular disease (CVD).BackgroundSedentary behavior is recognized as a distinct construct beyond lack of leisure-time physical activity, but limited data exist on the interrelationship between these 2 components of energy balance.MethodsParticipants in the prospective Women’s Health Initiative Observational Study (n = 71,018), 50 to 79 years of age and free of CVD at baseline (1993 to 1998), provided information on sedentary behavior, defined as hours of sitting/day, and usual physical activity at baseline and during follow-up through September 2010. First CVD (coronary heart disease or stroke) events were centrally adjudicated.ResultsSitting ≥10 h/day compared with ≤5 h/day was associated with increased CVD risk (hazard ratio: 1.18, 95% confidence interval: 1.09 to 1.29) in multivariable models including physical activity. Low physical activity was also associated with higher CVD risk (p for trend &lt; 0.001). When women were cross-classified by sitting time and physical activity (p for interaction = 0.94), CVD risk was highest in inactive women (≤1.7 metabolic equivalent task-h/week) who also reported ≥10 h/day of sitting. Results were similar for coronary heart disease and stroke when examined separately. Associations between prolonged sitting and risk of CVD were stronger in overweight versus normal weight women and women 70 years of age and older compared with younger women.ConclusionsProlonged sitting time was associated with increased CVD risk, independent of leisure-time physical activity, in postmenopausal women without a history of CVD. A combination of low physical activity and prolonged sitting augments CVD risk

Associations of Body Size and Composition with Physical Activity in Adolescent Girls

To examine whether components of body composition (size, fat mass, and fat-free mass) were related to physical activity

A Longitudinal Study of Sedentary Behavior and Overweight in Adolescent Girls

To examine sedentary and light activity in relation to overweight in adolescent girls