The Association Between Neighbourhood Walkability And Adult Body Mass Index In Urban Canada: A Cross-sectional Analysis.

This study sets out to examine whether there was a cross-sectional association between neighbourhood walkability and obesity in adults aged 18 to 64 years. The data source was the 2010/11 cycle of the National Population Health Survey merged with the 2011 Census and DMTI built environment data. A mediation analysis was undertaken to investigate whether physical activity was a mediator in the pathway between a measure of neighbourhood walkability and obesity. Multivariable regression results revealed no statistically significant associations between any of the neighbourhood walkability measures and adult BMI. Similar results were found for males and females. This study did not find that physical activity mediated an association between neighbourhood walkability and adult obesity

Clinical characteristics and outcomes of atrial fibrillation and flutter at the Aga Khan University Hospital, Nairobi

Introduction: Scant data exist on the epidemiology and clinical characteristics of atrial fibrillation in Kenya. Traditionally, atrial fibrillation (AF) in sub-Saharan Africa is as a result of rheumatic valve disease. However, with the economic transition in sub-Saharan Africa, risk factors and associated complications of this arrhythmia are likely to change. Methods: A retrospective observational survey was carried out between January 2008 and December 2010. Patients with a discharge diagnosis of either atrial fibrillation or flutter were included for analysis. The data-collection tool included clinical presentation, risk factors and management strategy. Follow-up data were obtained from the patients\u27 medical records six months after the index presentation. Results: One hundred and sixty-two patients were recruited (mean age 67 ± 17 years, males 56%). The distribution was paroxysmal (40%), persistent (20%) and permanent AF (40%). Associated co-morbidities included hypertension (68%), heart failure (38%) diabetes mellitus (33%) and valvular abnormalities (12%). One-third presented with palpitations, dizziness or syncope and 15% with a thromboembolic complication as the index AF presentation. Ratecontrol strategies were administered to 78% of the patients, with beta-blockers and digoxin more commonly prescribed. Seventy-seven per cent had a CHA2DS2VASC score ≥ 2, but one-quarter did not receive any form of oral anticoagulation. At the six-month follow up, 6% had died and 12% had been re-admitted at least once. Of the high-stroke risk patients on anticoagulation, just over one-half were adequately anticoagulated. Conclusion: Hypertension and diabetes mellitus, not rheumatic valve disease were the more common co-morbidities. Stroke risk stratification and prevention needs to be emphasised and appropriately managed