Physical activity, obesity and mortality: does pattern of physical activity have stronger epidemiological associations?

Background Most studies of physical activity (PA) epidemiology use behaviour measured at a single time-point. We examined whether ‘PA patterns’ (consistently low, consistently high or inconsistent PA levels over time) showed different epidemiological relationships for anthropometric and mortality outcomes, compared to single time-point measure of PA. Methods Data were the Danish MONICA (MONItoring Trends and Determinants in CArdiovascular Disease) study over three waves 1982–3 (time 1), 1987–8 (time 2) and 1993–4 (time 3). Associations between leisure time single time-point PA levels at time 1 and time 3, and sport and active travel at times 1 and 2 with BMI, waist, hip circumference and mortality (death from coronary heart disease (CHD) and cardiovascular disease (CVD)) were compared to ‘PA patterns’ spanning multiple time points. PA pattern classified participants’ PA as either 1) inactive or low PA at both time points; 2) moderate level PA at time 1 and high activity at time 3; or 3) a ‘mixed PA pattern’ indicating a varying levels of activity over time. Similarly, sport and active travel were also classified as indicating stable low, stable high and mixed patterns. Results The moderately and highly active groups for PA at times 1 and 3 had up to 1.7 cm lower increase in waist circumference compared with the inactive/low active group. Across ‘PA patterns’, ‘active maintainers’ had a 2.0 cm lower waist circumference than ‘inactive/low maintainers’. Waist circumference was inversely related to sport but not active travel. CHD risk did not vary by activity levels at time 1, but was reduced significantly by 43% for high PA at time 3 (vs ‘inactive’ group) and among ‘active maintainers’ (vs ‘inactive/low maintainers’) by 62%. ‘Sport pattern’ showed stronger reductions in mortality for cardiovascular disease and CHD deaths among sport maintainers, than the single time point measures. Conclusions PA patterns demonstrated a stronger association with a number of anthropometric and mortality outcomes than the single time-point measures. Operationalising PA as a sustained behavioural pattern may address some of the known under-estimation of risk for poor health in PA self-report measurements and better reflect exposure for epidemiological analysis of risk of health outcomes

Ökosystemleistungen in Instrumenten der Stadt- und Regionalplanung

Die Raumnutzung in komplexen stadtregionalen Gefügen und ihre künftige Entwicklung ist unsicher, auch angesichts (globaler) Wandelbedingungen und der diskutierten planetaren Grenzen. Vor diesem Kontext wird eine umfassende Auseinandersetzung darüber vordringlicher, was Ökosysteme für die stadtregionalen Gesellschaften leisten und inwiefern dieses Leistungsangebot und Leistungspotenzial gesichert und genutzt werden kann, auch im Sinne einer resilienten Stadt- und Regionalentwicklung. In der wissenschaftlichen Diskussion um die Rolle von Ökosystemleistungen in der räumlichen Planung wird nur teilweise untersucht, inwiefern bereits jetzt Bezüge zu Ökosystemleistungen in den Planungsinstrumenten zu finden sind. Der vorliegende Beitrag präsentiert Ergebnisse aus zwei Fallstudien in Großstadtregionen zu Bezugnahmen auf Ökosystemleistungen in bestehenden verbindlichen und nichtverbindlichen Planungsinstrumenten. Obwohl in keinem der untersuchten Planungsinstrumente explizit mit dem Begriff "Ökosystemleistungen" gearbeitet wird, sind in allen Instrumenten mitunter unterschiedliche Bezüge zu Ökosystemleistungen auszumachen. Die Mehrheit der klassifizierten Ökosystemleistungen ist allerdings nicht mit konkreten Zielsetzungen verknüpft. Dies wirft Fragen dahingehend auf, ob die räumliche Planung sich im Sinne einer resilienten Raumentwicklung genügend künftige Handlungsoptionen offenhält und was die aufgedeckten blinden Flecken über die Interpretation des Leitbildes der nachhaltigen Raumentwicklung aussagen.Land-use in complex urban regions and their future development is uncertain, especially in view of (global) change conditions and the planetary boundaries discussed. An encompassing discussion and weighting within planning is necessary, on what ecosystems offer which kind of services to urban and regional societies and how this current supply and further potentials can be sustainably used. This is essential to contribute to a resilient urban and regional development. Scientific discussions on the role of ecosystem services in spatial planning do partly investigate the current status-quo of references to ecosystem services. This paper presents results from two German case study regions on the extent of references to ecosystem services in existing spatial planning instruments. Both binding as well as non-binding regional and urban development concepts were considered. Although none of the planning instruments explicitly uses the term "ecosystem services", references to ecosystem services can be identified in all instruments. However, the majority of classified ecosystem services is not linked to specific objectives. This evokes questions on if spatial planning is oriented on keeping options open to act in the future and what the detected blind spots tell about the interpretation of the vision of sustainable spatial development

Conjugated oligomers with alternating heterocycles from a single monomer:synthesis and demonstration of electroluminescence

International audienceConjugated oligomers based on two different heterocycles are typically prepared by step growth polycondensation cross-coupling methods from two monomers X-Cycle1-X and M-Cycle2-M with no control of the regioselectivity. In this work, we used a new synthetic strategy that involves an extremely chemoselective reaction of a dielectrophilic compound, X1 Cycle1 X2, with a dinucleophilic component, M1-Cycle2-M2, under Stille conditions. The resulting monomers, X1 Cycle1 Cycle2-M2 are di-heterocyclic push pull monomers that still contain a nucleophilic site (boronic acid) and electrophilic site (bromide) and are set up for a controlled polymerization under Suzuki conditions. In this way, two semiconducting oligomers, based on thiophene / benzene and thiophene / pyridine motifs were synthesized. Both oligomers were characterized in terms of their, thermal, electrochemical, absorption, emission and electroluminescence properties

Changes in Waist Circumference and the Incidence of Acute Myocardial Infarction in Middle-Aged Men and Women

BACKGROUND: Waist circumference (WC) measured at one point in time is positively associated with the risk of acute myocardial infarction (MI), but the association with changes in WC (DWC) is not clear. We investigated the association between DWC and the risk of MI in middle-aged men and women, and evaluated the influence from concurrent changes in BMI (DBMI). METHODOLOGY/PRINCIPAL FINDINGS: Data on 38,593 participants from the Danish Diet, Cancer and Health study was analysed. Anthropometry was assessed in 1993-97 and 1999-02. Information on fatal and non-fatal MI was obtained from National Registers. Cases were validated by review of the medical records. Hazard ratios (HR) were calculated from Cox proportional hazard models with individuals considered at risk from 1999-02 until December 30 2009. During 8.4 years of follow-up, 1,041 incident cases of MI occurred. WC was positively associated with the risk of MI, but weakly after adjustment for BMI. DWC was not associated with the risk of MI (HR per 5 cm change = 1.01 (0.95, 1.09) with adjustment for covariates, baseline WC, BMI and DBMI). Associations with DWC were not notably different in sub-groups stratified according to baseline WC or DBMI, or when individuals with MI occurring within the first years of follow-up were excluded. CONCLUSIONS/SIGNIFICANCE: WC was positively associated with the risk of MI in middle-aged men and women, but changes in WC were not. These findings suggest that a reduction in WC may be an insufficient target for prevention of MI in middle-aged men and women

Obesity prevalence from a European perspective: a systematic review

<p>Abstract</p> <p>Background</p> <p>Obesity has been recognised as an important contributing factor in the development of various diseases, but comparative data on this condition are limited. We therefore aimed to identify and discuss current epidemiological data on the prevalence of obesity in European countries.</p> <p>Methods</p> <p>We identified relevant published studies by means of a MEDLINE search (1990–2008) supplemented by information obtained from regulatory agencies. We only included surveys that used direct measures of weight and height and were representative of each country's overall population.</p> <p>Results</p> <p>In Europe, the prevalence of obesity (body mass index ≥ 30 kg/m²) in men ranged from 4.0% to 28.3% and in women from 6.2% to 36.5%. We observed considerable geographic variation, with prevalence rates in Central, Eastern, and Southern Europe being higher than those in Western and Northern Europe.</p> <p>Conclusion</p> <p>In Europe, obesity has reached epidemic proportions. The data presented in our review emphasise the need for effective therapeutic and preventive strategies.</p

Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS &gt;5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p&lt;0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

Predictors of disease worsening defined by progression of organ damage in diffuse systemic sclerosis: a European Scleroderma Trials and Research (EUSTAR) analysis.

Objectives Mortality and worsening of organ function are desirable endpoints for clinical trials in systemic sclerosis (SSc). The aim of this study was to identify factors that allow enrichment of patients with these endpoints, in a population of patients from the European Scleroderma Trials and Research group database. Methods Inclusion criteria were diagnosis of diffuse SSc and follow-up over 12\ub13 months. Disease worsening/organ progression was fulfilled if any of the following events occurred: new renal crisis; decrease of lung or heart function; new echocardiography-suspected pulmonary hypertension or death. In total, 42 clinical parameters were chosen as predictors for the analysis by using (1) imputation of missing data on the basis of multivariate imputation and (2) least absolute shrinkage and selection operator regression. Results Of 1451 patients meeting the inclusion criteria, 706 had complete data on outcome parameters and were included in the analysis. Of the 42 outcome predictors, eight remained in the final regression model. There was substantial evidence for a strong association between disease progression and age, active digital ulcer (DU), lung fibrosis, muscle weakness and elevated C-reactive protein (CRP) level. Active DU, CRP elevation, lung fibrosis and muscle weakness were also associated with a significantly shorter time to disease progression. A bootstrap validation step with 10 000 repetitions successfully validated the model. Conclusions The use of the predictive factors presented here could enable cohort enrichment with patients at risk for overall disease worsening in SSc clinical trial