The cross-sectional associations of chronic conditions and disability with self-reported physical activity among adults in England

Objective: Using cross-sectional data from the 2018 Health Survey for England, this study describes the types of impairment reported by people with chronic conditions and the association of chronic conditions and impairments with physical activity(PA).   Methods: Participants self-reported the presence of seven chronic health conditions (diabetes; stroke/ischemic heart disease; hypertension; chronic obstructive pulmonary disease (COPD); asthma; arthritis/rheumatism/fibrositis; back problems), 11 types of impairment (vision, hearing, mobility, dexterity; learning; memory; mental health; stamina; social or behavioural; other; none); and their PA using the International Physical Activity Questionnaire. Multivariable Poisson regression was used to estimate the association of a)impairment type, b)number of impairments, and c)impairment type and chronic condition (mutually adjusted) with PA.   Results: In total, 2243 adults (55% female, 44% age > 55 yrs) reported having a chronic condition. PA volume (MET minutes per week: median (IQR)) was highest in participants with asthma (2093 (693–4479)), and lowest in those with COPD (454 (0–2079)). There was a negative association between number of impairments and levels of PA. After adjustment for age, sex, ethnicity and education, and mutually adjusting for all other conditions and impairments, diabetes (Incident rate ratio (95% confidence interval): 0.83 (0.73–0.94)), COPD (0.76 (0.59–0.99)), a mobility impairment (0.63 (0.56–0.72)), a dexterity impairment (0.86 (0.75–0.98)), or a memory impairment (0.84 (0.72–0.99)) was negatively associated with PA.   Conclusion: Future PA research requires consideration of the number and types of impairments that individuals experience, as well as assessing chronic conditions. This will improve understanding of the barriers to PA participation and inform interventions

A review of sedentary behavior assessment in national surveillance systems

Background: Temporal changes in sedentary behavior patterns reflect the evolving nature of our built and social environments, particularly the expanding availability of electronic media. It is important to understand what types of sedentary behavior are assessed in national surveillance to determine whether, and to what extent, they reflect contemporary patterns. The aims of this review were to describe the characteristics of questionnaires used for national surveillance of sedentary behavior and to identify the types of sedentary behaviors being measured. Method: We reviewed questionnaires from national surveillance systems listed on the Global Observatory for Physical Activity (GoPA!) country cards to locate items on sedentary behavior. Questionnaire characteristics were categorized using the Taxonomy of Self-reported Sedentary Behavior Tools (TASST). The purpose and type of sedentary behaviors captured were classified using the Sedentary Behavior International Taxonomy (SIT). Results: Overall, 346 surveillance systems were screened for eligibility, of which 93 were included in this review. Most questionnaires used a single-item direct measure of sitting time (n = 78, 84%). Work and domestic were the most frequently captured purposes of sedentary behavior, while television viewing and computer use were the most frequently captured types of behaviors. Conclusion: National surveillance systems should be periodically reviewed in response to evidence on contemporary behavior patterns in the population and the release of updated public health guidelines

A scoping review of disability assessment in prospective and cross-sectional studies that included device-based measurement of physical activity

Background: Evidence on the prevalence, determinants, and health outcomes of physical activity in disabled people is limited. It is possible that the limited availability of high-quality scientific evidence is due to the extent and nature of disability assessment in physical activity research. This scoping review explores how disability has been measured in epidemiological studies that included accelerometer-based measurement of physical activity. Methods: Data sources: MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus, and CINAHL. Eligibility criteria: Prospective and cross-sectional studies that included an accelerometer measurement of physical activity. Survey instruments used in these studies were obtained, and questions relating to the International Classification of Functioning, Disability and Health domains of (1) health conditions, (2) body functions and structures, and (3) activities and participation, were extracted for analysis. Results: Eighty-four studies met the inclusion criteria, from which complete information on the 3 domains was obtained for 68. Seventy-five percent of studies (n = 51) captured whether a person had at least one health condition, 63% (n = 43) had questions related to body functions and structures, and 75% (n = 51) included questions related to activities and participation. Conclusion: While most studies asked something about one of the 3 domains, there was substantial diversity in the focus and style of questions. This diversity indicates a lack of consensus on how these concepts should be assessed, with implications for the comparability of evidence across studies and subsequent understanding of the relationships between disability, physical activity, and health

Use of natural experimental studies to evaluate 20mph speed limits in two major UK cities.

INTRODUCTION: Reductions in traffic speed can potentially offer multiple health and public health benefits. In 2016, implementation of 20mph (30kph) speed limit interventions began in Edinburgh (city-wide) and Belfast (city centre). The aims of this paper are to describe 1) the broad theoretical approach and design of two natural experimental studies to evaluate the 20mph speed limits in Edinburgh and Belfast and 2) how these studies allowed us to test and explore theoretical mechanisms of 20mph speed limit interventions. METHODS: The evaluation consisted of several work packages, each with different research foci, including the political decision-making processes that led to the schemes, their implementation processes, outcomes (including traffic speed, perceptions of safety, and casualties) and cost effectiveness. We used a combination of routinely and locally collected quantitative data and primary quantitative and qualitative data. RESULTS: The evaluation identified many contextual factors influencing the likelihood of 20mph speed limits reaching the political agenda. There were substantial differences between the two sites in several aspects related to implementation. Reductions in speed resulted in significant reductions in collisions and casualties, particularly in Edinburgh, which had higher average speed at baseline. The monetary value of collisions and casualties prevented are likely to exceed the costs of the intervention and thus the overall balance of costs and benefits is likely to be favourable. CONCLUSIONS: Innovative study designs, including natural experiments, are important for assessing the impact of 'real world' public health interventions. Using multiple methods, this project enabled a deeper understanding of not only the effects of the intervention but the factors that explain how and why the intervention and the effects did or did not occur. Importantly it has shown that 20mph speed limits can lead to reductions in speed, collisions and casualties, and are therefore an effective public health intervention

Microfoundations

The paper argues that the microfoundations programme can be understood as an implementation of an underlying methodological principle, methodological individualism, and that it therefore shares a fundamental ambiguity with that principle, viz, whether the macro must be derived from and therefore reducible to, or rather consistent with micro-level behaviours. The pluralist conclusion of the paper is not that research guided by the principle of microfoundations is necessarily wrong, but that the exclusion of approaches not guided by that principle is indeed necessarily wrong. The argument is made via an examination of the advantages claimed for dynamic stochastic general equilibrium models, the relationship between parts and wholes in social science, and the concepts of reduction, substrate neutrality, the intentional stance, and hypostatisation

Microfoundations

This paper argues that the microfoundations programme can be understood as an implementation of an underlying methodological principle—methodological individualism—and that it therefore shares a fundamental ambiguity with that principle, viz, whether the macro must be derived from and therefore reducible to, or rather consistent with, micro-level behaviours. The pluralist conclusion of the paper is not that research guided by the principle of microfoundations is necessarily wrong, but that the exclusion of approaches not guided by that principle is indeed necessarily wrong. The argument is made via an examination of the advantages claimed for dynamic stochastic general equilibrium models, the relationship between parts and wholes in social science, and the concepts of reduction, substrate neutrality, the intentional stance, and hypostatisation

Can 20mph speed limit interventions influence liveability? A natural experiment using the Microscale Audit of Pedestrian Streetscapes Liveability (MAPS-Liveability) and Google Street View

Background: A recent meta-narrative review investigating 20mph speed limits on public health outcomes reported inconclusive findings and the limited scope of liveability investigations. Consequently, we investigated the impact of 20mph speed limit interventions on liveability using the Microscale Audit of Pedestrian Streetscapes Liveability (MAPS-Liveability) via Google Street View (GSV). Methods: MAPS-Liveability provides a quantitative assessment of liveability and its constructs (i.e., safety, health, sustainability, inclusivity, places, education, traffic/transport, roads, and pavements) at the micro-level (i.e., street). Google Street View enabled pre- and post-implementation data collection for Belfast (n = 68 streets) and Edinburgh (n = 76 streets) by two independent raters, with scores calculated for total liveability and nine liveability constructs. Wilcoxon signed-rank tests (changes pre-to post-implementation), cluster analysis (identification of discrete street clusters), analysis of variance (differences within clusters) and analysis of covariance (differences between clusters) were undertaken. Clusters were mapped, street types identified, and clusters named by determining the predominant street type. Results: In Belfast and Edinburgh, there were significant increases post-intervention for total liveability, with 57.4% (n = 39) of streets in Belfast and 75% (n = 57) in Edinburgh seeing positive changes. Both cities also saw significant positive increases in the liveability constructs of traffic/transport (e.g., speed signage) and places (e.g., presence of shops); with Edinburgh also seeing a significant positive increase post-intervention for pavements (e.g., quality). Cluster analysis identified three clusters “Mixed land use”, “Central Business District” and “Residential” with each showing positive changes for total liveability and the construct of traffic/transport. Conclusion: 20mph speed limit interventions were found to positively contribute to total liveability and the specific liveability construct of traffic/transport. This was particularly the case when 20mph speed limits were implemented on streets with dense mixed land use

Free classification of large sets of everyday objects is more thematic than taxonomic

Traditionally it has been thought that the overall organisation of categories in the brain is taxonomic. To examine this assumption, we had adults sort 140–150 diverse, familiar objects from different basic-level categories. Almost all the participants (80/81) sorted the objects more thematically than taxonomically. Sorting was only weakly modulated by taxonomic priming, and people still produced many thematically structured clusters when explicitly instructed to sort taxonomically. The first clusters that people produced were rated as having equal taxonomic and thematic structure. However, later clusters were rated as being increasingly thematically organised. A minority of items were consistently clustered taxonomically, but the overall dominance of thematically structured clusters suggests that people know more thematic than taxonomic relations among everyday objects. A final study showed that the semantic relations used to sort a given item in the initial studies predicted the proportion of thematic to taxonomic word associates generated to that item. However, unlike the results of the sorting task, most of these single word associates were related taxonomically. This latter difference between the results of large-scale, free sorting tasks versus single word association tasks suggests that thematic relations may be more numerous, but weaker, than taxonomic associations in our stored conceptual network. Novel statistical and numerical methods for objectively measuring sorting consistency were developed during the course of this investigation, and have been made publicly available

The varved succession of Crawford Lake, Milton, Ontario, Canada as a candidate Global boundary Stratotype Section and Point for the Anthropocene series

An annually laminated succession in Crawford Lake, Ontario, Canada is proposed as the Global boundary Stratotype Section and Point (GSSP) for the Anthropocene as a series/epoch with a base dated at 1950 CE. Varve couplets of organic matter capped by calcite precipitated each summer in alkaline surface waters reflect environmental change at global to local scales. Spheroidal carbonaceous particles and nitrogen isotopes record an increase in fossil fuel combustion in the early 1950s, coinciding with fallout from nuclear and thermonuclear testing—239+240Pu and 14C:12C, the latter more than compensating for the effects of old carbon in this dolomitic basin. Rapid industrial expansion in the North American Great Lakes region led to enhanced leaching of terrigenous elements by acid precipitation during the Great Acceleration, and calcite precipitation was reduced, producing thin calcite laminae around the GSSP that is marked by a sharp decline in elm pollen (Dutch Elm disease). The lack of bioturbation in well-oxygenated bottom waters, supported by the absence of fossil pigments from obligately anaerobic purple sulfur bacteria, is attributed to elevated salinities and high alkalinity below the chemocline. This aerobic depositional environment, unusual in a meromictic lake, inhibits the mobilization of 239Pu, the proposed primary stratigraphic guide for the Anthropocene