Where and for whom does the neighbourhood built environment matter for obesity and health? Examining sources of effect heterogeneity at multiple scales in the UK adult population

Context: Obesity and related non-communicable diseases represent a large and growing disease burden, and various aspects of contemporary urban environments may be important drivers of these health outcomes. Neighbourhood resources for physical activity, exposure to fast-food outlets and greenspace may play a role, but the evidence regarding these neighbourhood effects remains equivocal. A possible explanation is that neighbourhood effects may be heterogeneous; some people may be more sensitive than others to the built environment, and neighbourhoods may matter more in some places than in others. We know little about how neighbourhood characteristics interact with other factors at various scales to influence health. Methods: Using UK Biobank, a sample of >300,000 adults in mid-life, I conducted a multiscalar examination of heterogeneity in associations between neighbourhood built environments and adiposity, CVD and cancer. I examined cross-sectional associations between characteristics of the physical activity and food environments around people's home addresses, and multiple measures of adiposity, exploring potential effect modification by individual-, neighbourhood- and local authority-level variables. Using linked hospital data, I examined effect heterogeneity in longitudinal associations with CVD and cancer. Results: Population-wide associations obscured substantial effect heterogeneity. The magnitude of these associations varied with genetic risk, socioeconomic position, gender, and other environmental factors. Greater availability of formal physical activity facilities near home was associated with lower adiposity, particularly for people without public parks nearby, but less so for people also living near a fast-food outlet. Proximity to a fastfood outlet was associated with BMI, but this was modified by genetic risk of obesity: highrisk individuals appear to be more sensitive to their food environment. Associations between adiposity and neighbourhood characteristics varied across England, and potential drivers of this geographical heterogeneity were identified. Neighbourhood greenspace was not associated with any outcomes across the sample as a whole, but appeared protective against cancer in more deprived areas. Conclusions: This thesis contributes empirically and conceptually to our understanding of how, where and for whom neighbourhoods matter for health. The results highlight the role of individual and contextual factors operating at multiple scales to moderate people’s sensitivity to characteristics of their neighbourhood environment. A better understanding of effect modification relationships such as these may help to guide the development and evaluation of future interventions and policies involving the urban built environment

Thermoregulatory responses during competitive wheelchair rugby match play

The purpose of this study was to determine whether a player’s physical impairment or activity profile was related to the amount of thermal strain experienced during wheelchair rugby match play. 17 elite wheelchair rugby players played a competitive match, whilst activity profiles, measures of core and skin temperature, heart rate and perceptual responses were taken. Players were divided into 2 groups depending on their physical impairment: players with a cervical spinal cord injury, (n=10) or non-spinal related physical impairment (n=7). Total distance was lower (4 842±324 vs. 5 541±316 m, p<0.01, ES=2.2) and mean speed slower (1.13±0.11 vs. 1.27±0.11 m∙s−1, p<0.03, ES=1.3) in players with a spinal cord injury. Yet, the change in core temperature (1.6±0.4 vs. 0.7±0.3°C, p<0.01, ES=2.5) was significantly greater in players with a spinal cord injury. In conclusion, players with a spinal cord injury were under greater thermal strain during wheelchair rugby match play, as a result of their reduced heat loss capacity, due to their physical impairment and not because of their activity profile

Data from: Sleep duration is associated with vitamin D deficiency in older women living in Macao, China: A pilot cross-sectional study

Table 1.Characteristics of Macao population (n = 566) stratified by age. https://doi.org/10.1371/journal.pone.0229642.t001 Table 2. Sleep duration (h) and risk of serum 25OHD/L or 25OHD/L in older Macao residents (n = 204). https://doi.org/10.1371/journal.pone.0229642.t002 Table 3. Serum 25OHD/L or serum 25OHD/L risk stratified by duration of sleep (≤6h and \u3e6h) in older Macanese (n = 204). https://doi.org/10.1371/journal.pone.0229642.t003 Table 4. Studies investigating the association between sleep duration and vitamin D (serum 25OHD levels or dietary intake). https://doi.org/10.1371/journal.pone.0229642.t004 S1 Data. https://doi.org/10.1371/journal.pone.0229642.s00

Sleep duration is associated with vitamin D deficiency in older women living in Macao, China: A pilot cross-sectional study

© 2020 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Chinese women are known to have both a high prevalence of metabolic syndrome (MetS) and vitamin D deficiency (serum 25-hydroxyvitamin D (25OHD) /l). Associations between sleep duration and circulating 25OHD have recently been reported but, to our knowledge, these associations have not been studied in older Chinese populations. We thus investigated whether sleep duration was associated with vitamin D status in a population from Macao, China, and whether sleep duration modified the association between MetS and vitamin D deficiency. In 207 older (\u3e55 years) Macanese, anthropometry, blood samples and validated questionnaires, including sleep duration and cardiovascular risk factors, were simultaneously collected. On multivariable categorical analyses, those women, not men, who had short sleep duration (≤6 hours (h)) were at a 2-fold risk for vitamin D deficiency (both /L and /L; OR = 1.94, 95%CI 1.29-2.92; OR = 2.05, 95%CI 1.06-3.98, respectively) and those who had longer sleep duration (\u3e8 h) were 3-fold more likely to have vitamin D deficiency (OR = 3.07, 95%CI 1.47-6.39; OR = 2.75, 95%CI 1.08- 7.00, respectively) compared to those with normal sleep duration (6-8 h). Both women and men with MetS were 2-fold more likely to have vitamin D deficiency (women: OR = 2.04, 95%CI 1.31-3.17; OR = 2.15, 95%CI 1.11-4.17, respectively; men: OR = 2.01, 95%CI 1.23-3.28; OR = 2.04, 95%CI 1.00-4.29, respectively). Moreover, women with both short sleep duration and MetS had an increased risk of vitamin D deficiency (OR = 3.26, 95%CI 1.10-9.64). These associations were not found in those with longer sleep. Men with longer sleep and MetS had a 5-fold risk of vitamin D deficiency (OR = 5.22; 95%CI 2.70-10.12). This association was non-significant for men with shorter sleep. We conclude that both short and long sleep duration were associated with vitamin D deficiency in older Chinese women. Further research is needed in larger cohorts or with intervention studies to further examine the associations between reduced sleep, metabolic syndrome and vitamin D deficiency

Undergraduate students as co-producers in the creation of first-year practical class resources

Undergraduate students are increasingly working with academic staff to evaluate and design teaching materials in Higher Education, thereby moving from being passive consumers of knowledge to genuine partners in their education. Here we describe a student partnership project run at the University of Cambridge, which aimed to improve undergraduate biology practical class teaching. Student interns were recruited to act as researchers, pedagogical consultants and producers of teaching resources. Research by the interns revealed that students with limited practical experience at high-school level tended to have lower confidence and more negative responses to first-year university practical classes than peers with more experience. Interns and academics therefore redesigned the workflow for practicals to include online pre- and post-practical tutorials to support understanding and consolidation of laboratory-based material, which included student-produced quizzes and videos. We reflect on the process of building the partnership, and explore the value of partnership approaches in Higher Education.This work was supported by the University of Cambridge Teaching and Learning Innovation Fund [AHAV]

Inhibitory effects of Yangzheng Xiaoji on angiogenesis and the role of the focal adhesion kinase pathway

Angiogenesis is an essential event during the excessive growth and metastatic spread of solid tumours. Anti-angiogenic agents have become a new choice of therapy for patients with cancer. In the present study, we investigated the potential effect of Yangzheng Xiaoji, a traditional Chinese medicinal formula presently used in the treatment of several solid tumours including liver cancer and gastric cancer, on angiogenesis, in vitro. The human vascular endothelial cell line HECV was used. A Matrigel-based sandwich tubule formation assay was employed to assess in vitro angiogenesis, a colorimetric method for assessing in vitro cell growth. Electric cell-substrate impedance sensing (ECIS) was used to evaluate the adhesion and migration of endothelial cells. The effects on activation of focal adhesion kinase (FAK) were evaluated using western blotting and immunofluorescence methods. Yangzhen Xiaoji extract DME25 significantly inhibited tube formation (p=0.046 vs control). This was seen together with a concentration-dependent inhibition on cell-matrix adhesion and cellular migration. It was demonstrated that the focal adhesion kinase (FAK) inhibitor PF557328 had a significant synergistic effect on DME25-induced inhibition of cell adhesion, migration and tube formation. The study showed that DME25 inhibited the phosphorylation of FAK in endothelial cells. In conclusion, Yangzhen Xiaoji has a marked effect on angiogenesis, in vitro and that this effect is at least partly mediated by the focal adhesion kinase (FAK) pathway

Implication of metastasis suppressor gene, Kiss-1 and its receptor Kiss-1R in colorectal cancer

Background Kiss-1 and Kiss-1R have been suggested as a novel pair of metastasis suppressors for several human solid tumours, however, their role in colorectal cancer remains largely unknown. Therefore, the aim of this study was to investigate the role and signal transduction of Kiss-1 and Kiss-1R in colorectal cancer. Methods Ribozyme transgenes were used to knockdown high expression of Kiss-1 and Kiss-1R in HT115 and HRT18 cells. The stabilized transfected cells were then used to deduce the influence of Kiss-1 and Kiss-1R on the function of colorectal cancer cells by in vitro assays and ECIS assay. The effect of Kiss-1 on MMPs related to tumour metastasis was also deleted by zymography. The mRNA and protein expression of Kiss-1 and Kiss-1R, and their correlation to the clinical outcome in human colorectal cancer were investigated using real-time PCR and IHC respectively. Results Knocking down Kiss-1 resulted in increased invasion and migration of colorectal cancer cells. Kisspeptin-10 decreased cellular migration of colorectal cancer cells and required ERK signaling as shown during the ECIS based analyses. Reduction of MMP-9 was caused by Kisspeptin-10 and ERK inhibitor, shown by zymography. In human colorectal cancer tissues, the mRNA expression level of Kiss-1 had a negative correlation with Dukes staging, TNM staging, tumour size and lymph node involvement. Reduction of Kiss-1R was also linked to poor prognosis for the patients. Conclusions The present study has presented evidence that Kiss-1 may be a putative metastasis suppressor molecule in human colorectal cancer

Maternal psychological distress in primary care and association with child behavioural outcomes at age three

Observational studies indicate children whose mothers have poor mental health are at increased risk of socio-emotional behavioural difficulties, but it is unknown whether these outcomes vary by the mothers’ mental health recognition and treatment status. To examine this question, we analysed linked longitudinal primary care and research data from 1078 women enrolled in the Born in Bradford cohort. A latent class analysis of treatment status and self-reported distress broadly categorised women as (a) not having a common mental disorder (CMD) that persisted through pregnancy and the first 2 years after delivery (N = 756, 70.1 %), (b) treated for CMD (N = 67, 6.2 %), or (c) untreated (N = 255, 23.7 %). Compared to children of mothers without CMD, 3-year-old children with mothers classified as having untreated CMD had higher standardised factor scores on the Strengths and Difficulties Questionnaire (d = 0.32), as did children with mothers classified as having treated CMD (d = 0.27). Results were only slightly attenuated in adjusted analyses. Children of mothers with CMD may be at risk for socio-emotional and behavioural difficulties. The development of effective treatments for CMD needs to be balanced by greater attempts to identify and treat women. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00787-015-0777-2) contains supplementary material, which is available to authorized users

Who knows best? A Q methodology study to explore perspectives of professional stakeholders and community participants on health in low-income communities

Abstract Background Health inequalities in the UK have proved to be stubborn, and health gaps between best and worst-off are widening. While there is growing understanding of how the main causes of poor health are perceived among different stakeholders, similar insight is lacking regarding what solutions should be prioritised. Furthermore, we do not know the relationship between perceived causes and solutions to health inequalities, whether there is agreement between professional stakeholders and people living in low-income communities or agreement within these groups. Methods Q methodology was used to identify and describe the shared perspectives (‘subjectivities’) that exist on i) why health is worse in low-income communities (‘Causes’) and ii) the ways that health could be improved in these same communities (‘Solutions’). Purposively selected individuals (n = 53) from low-income communities (n = 25) and professional stakeholder groups (n = 28) ranked ordered sets of statements – 34 ‘Causes’ and 39 ‘Solutions’ – onto quasi-normal shaped grids according to their point of view. Factor analysis was used to identify shared points of view. ‘Causes’ and ‘Solutions’ were analysed independently, before examining correlations between perspectives on causes and perspectives on solutions. Results Analysis produced three factor solutions for both the ‘Causes’ and ‘Solutions’. Broadly summarised these accounts for ‘Causes’ are: i) ‘Unfair Society’, ii) ‘Dependent, workless and lazy’, iii) ‘Intergenerational hardships’ and for ‘Solutions’: i) ‘Empower communities’, ii) ‘Paternalism’, iii) ‘Redistribution’. No professionals defined (i.e. had a significant association with one factor only) the ‘Causes’ factor ‘Dependent, workless and lazy’ and the ‘Solutions’ factor ‘Paternalism’. No community participants defined the ‘Solutions’ factor ‘Redistribution’. The direction of correlations between the two sets of factor solutions – ‘Causes’ and ‘Solutions’ – appear to be intuitive, given the accounts identified. Conclusions Despite the plurality of views there was broad agreement across accounts about issues relating to money. This is important as it points a way forward for tackling health inequalities, highlighting areas for policy and future research to focus on