An evaluation of energy expenditure estimation by three activity monitors

This is an Author's Accepted Manuscript of an article published in European Journal of Sport Science, 13(6), 681 - 688, 2013 [date of publication] [copyright Taylor & Francis], available online at: http://www.tandfonline.com/ 10.1080/17461391.2013.776639.A comparative evaluation of the ability of activity monitors to predict energy expenditure (EE) is necessary to aid in the investigation of the effect of EE on health. The purpose of this study was to validate and compare the RT3, the SWA and the IDEEA at measuring EE in adults and children. Twenty-six adults and 22 children completed a resting metabolic rate (RMR) test and performed four treadmill activities at 3 km.h−1, 6 km.h−1, 6 km.h−1 at a 10% incline, 9 km.h−1. EE was assessed throughout the protocol by the RT3, the SWA and the IDEEA. Indirect calorimetry (IC) was used as a criterion measure of EE against which each monitor was compared. Mean bias was assessed by subtracting EE from IC from EE from each monitor for each activity. Limit of agreement plots were used to assess the agreement between each monitor and IC. Limits of agreement for resting EE were narrowest for the RT3 for adults and children. Although the IDEEA displayed the smallest mean bias between measures at 3 km.h−1, 6 km.h−1 and 9 km.h−1 in adults and children, the SWA agreed closest with IC at 6 km.h−1, 6 km.h−1 at a 10% incline and 9 km.h−1. Limits of agreement were closest for the SWA at 9 km.h−1 in adults representing 42% of the overall mean EE. Although the RT3 provided the best estimate of resting EE in adults and children, the SWA provided the most accurate estimate of EE across a range of physical activity intensities

Leam & Serve Higher Education Programs in Minnesota: The Impact and Sustainability of Service-Learning

This article provides a descriptive evaluation of 12 higher education, service-learning programs in Minnesota funded in part by the Corporation for National Service: Learn and Serve America Program.\u27 The research for this project was conducted in 45 days during the summer of 1995 using a phenomenological methodology to examine the impact and sustainability of the programs. The data for this research were derived from interviews with individuals involved in local initiatives. Three main categories of information became evident after analyzing the data: (I) program design, (2) success and impact of programs, and (3) sustainability and the future of service-learning. These data demonstrate how service-learning experiences are appreciated by most involved, that the quality of programs vary significantly, and that sustainability is uncertain from a long term perspective

Waist circumference provides an indication of numerous cardiometabolic risk factors in adults with cerebral palsy

This article has been made available through the Brunel Open Access Publishing Fund.Objective: To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors. Design: Cross-sectional study. Setting: Testing took place in a laboratory setting. Participants: Adults with CP (NZ55; mean age, 37.5 13.3y; Gross Motor Function Classification System levels, IeV) participated in this study. Interventions: Not applicable. Main Outcome Measures: Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement. Results: The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (bZ.451; P<.01). WC was associated with HOMA-IR (bZ.480; P<.01), triglycerides (bZ.450; P<.01), and systolic blood pressure (bZ.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713e.763). Conclusions: A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP

Learning to manage complexity through simulation: students' challenges and possible strategies

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students&rsquo; challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.&nbsp; Wearing video glasses, participants took part in asimulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as atheoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.&nbsp; Students&rsquo; challenges in coping with clinical complexity included being: a)unprepared for &lsquo;diving in&rsquo;, b)caught in an escalating system, c)captured by the patient, and d)unable to assert boundaries of acceptable practice.&nbsp; Many characteristics of complexity can be recreated in award-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a)taking time to size up the system, b)attuning to what emerges, c)reducing complexity, d)boundary practices, and e)working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity

Clustering South African households based on their asset status using latent variable models

The Agincourt Health and Demographic Surveillance System has since 2001 conducted a biannual household asset survey in order to quantify household socio-economic status (SES) in a rural population living in northeast South Africa. The survey contains binary, ordinal and nominal items. In the absence of income or expenditure data, the SES landscape in the study population is explored and described by clustering the households into homogeneous groups based on their asset status. A model-based approach to clustering the Agincourt households, based on latent variable models, is proposed. In the case of modeling binary or ordinal items, item response theory models are employed. For nominal survey items, a factor analysis model, similar in nature to a multinomial probit model, is used. Both model types have an underlying latent variable structure - this similarity is exploited and the models are combined to produce a hybrid model capable of handling mixed data types. Further, a mixture of the hybrid models is considered to provide clustering capabilities within the context of mixed binary, ordinal and nominal response data. The proposed model is termed a mixture of factor analyzers for mixed data (MFA-MD). The MFA-MD model is applied to the survey data to cluster the Agincourt households into homogeneous groups. The model is estimated within the Bayesian paradigm, using a Markov chain Monte Carlo algorithm. Intuitive groupings result, providing insight to the different socio-economic strata within the Agincourt region.Comment: Published in at http://dx.doi.org/10.1214/14-AOAS726 the Annals of Applied Statistics (http://www.imstat.org/aoas/) by the Institute of Mathematical Statistics (http://www.imstat.org

Incidence of symptomatic toxoplasma eye disease: aetiology and public health implications.

Ocular disease is the commonest disabling consequence of toxoplasma infection. Incidence and lifetime risk of ocular symptoms were determined by ascertaining affected patients in a population-based, active reporting study involving ophthalmologists serving a population of 7.4 million. Eighty-seven symptomatic episodes were attributed to toxoplasma infection. Bilateral visual acuity of 6/12 or less was found in seven episodes (8%) and was likely to have been transient in most cases. Black people born in West Africa had a 100-fold higher incidence of symptoms than white people born in Britain. Only two patients reported symptoms before 10 years of age. The estimated lifetime risk of symptoms in British born individuals (52% of all episodes) was 18/100000 (95% confidence interval: 10.8-25.2). The low risk and mild symptoms in an unscreened British population indicate limited potential benefits of prenatal or postnatal screening. The late age at presentation suggests a mixed aetiology of postnatally acquired and congenital infection for which primary prevention may be appropriate, particularly among West Africans