Associations of adult physical activity with perceived safety and police-recorded crime: the Multi-ethnic Study of Atherosclerosis

Abstract Background Due to the inconsistent findings of prior studies, we explored the association of perceived safety and police-recorded crime measures with physical activity. Methods The study included 818 Chicago participants of the Multiethnic Study of Atherosclerosis 45 to 84 years of age. Questionnaire-assessed physical activity included a) transport walking; b) leisure walking; and c) non-walking leisure activities. Perceived safety was assessed through an interviewer-administered questionnaire. Police-recorded crime was assessed through 2-year counts of selected crimes (total and outdoor incivilities, criminal offenses, homicides) per 1000 population. Associations were examined using generalized estimating equation logistic regression models. Results Perceiving a safer neighborhood was positively associated with transport walking and perceiving lower violence was associated with leisure walking. Those in the lowest tertile of total or outdoor incivilities were more likely to report transport walking. Models with both perceived safety and police-recorded measures of crime as independent variables had superior fit for both transport walking and leisure walking outcomes. Neither perceived safety nor police-recorded measures of crime were associated with non-walking leisure activity. Conclusions Perceived and police-recorded measures had independent associations with walking and both should be considered in assessing the impact of neighborhood crime on physical activity.http://deepblue.lib.umich.edu/bitstream/2027.42/112746/1/12966_2012_Article_681.pd

Rationale, design, and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR) randomized trial in primary care

<p>Abstract</p> <p>Background</p> <p>Clinical prediction rules (CPRs) represent well-validated but underutilized evidence-based medicine tools at the point-of-care. To date, an inability to integrate these rules into an electronic health record (EHR) has been a major limitation and we are not aware of a study demonstrating the use of CPR's in an ambulatory EHR setting. The integrated clinical prediction rule (iCPR) trial integrates two CPR's in an EHR and assesses both the usability and the effect on evidence-based practice in the primary care setting.</p> <p>Methods</p> <p>A multi-disciplinary design team was assembled to develop a prototype iCPR for validated streptococcal pharyngitis and bacterial pneumonia CPRs. The iCPR tool was built as an active Clinical Decision Support (CDS) tool that can be triggered by user action during typical workflow. Using the EHR CDS toolkit, the iCPR risk score calculator was linked to tailored ordered sets, documentation, and patient instructions. The team subsequently conducted two levels of 'real world' usability testing with eight providers per group. Usability data were used to refine and create a production tool. Participating primary care providers (n = 149) were randomized and intervention providers were trained in the use of the new iCPR tool. Rates of iCPR tool triggering in the intervention and control (simulated) groups are monitored and subsequent use of the various components of the iCPR tool among intervention encounters is also tracked. The primary outcome is the difference in antibiotic prescribing rates (strep and pneumonia iCPR's encounters) and chest x-rays (pneumonia iCPR only) between intervention and control providers.</p> <p>Discussion</p> <p>Using iterative usability testing and development paired with provider training, the iCPR CDS tool leverages user-centered design principles to overcome pervasive underutilization of EBM and support evidence-based practice at the point-of-care. The ongoing trial will determine if this collaborative process will lead to higher rates of utilization and EBM guided use of antibiotics and chest x-ray's in primary care.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier <a href="http://www.clinicaltrials.gov/ct2/show/NCT01386047">NCT01386047</a></p

Associations of adult physical activity with perceived safety and police-recorded crime: the Multi-ethnic Study of Atherosclerosis

Abstract Background Due to the inconsistent findings of prior studies, we explored the association of perceived safety and police-recorded crime measures with physical activity. Methods The study included 818 Chicago participants of the Multiethnic Study of Atherosclerosis 45 to 84 years of age. Questionnaire-assessed physical activity included a) transport walking; b) leisure walking; and c) non-walking leisure activities. Perceived safety was assessed through an interviewer-administered questionnaire. Police-recorded crime was assessed through 2-year counts of selected crimes (total and outdoor incivilities, criminal offenses, homicides) per 1000 population. Associations were examined using generalized estimating equation logistic regression models. Results Perceiving a safer neighborhood was positively associated with transport walking and perceiving lower violence was associated with leisure walking. Those in the lowest tertile of total or outdoor incivilities were more likely to report transport walking. Models with both perceived safety and police-recorded measures of crime as independent variables had superior fit for both transport walking and leisure walking outcomes. Neither perceived safety nor police-recorded measures of crime were associated with non-walking leisure activity. Conclusions Perceived and police-recorded measures had independent associations with walking and both should be considered in assessing the impact of neighborhood crime on physical activity

The Association of Perceived and Objectively Measured Crime with Physical Activity: A Cross-Sectional Analysis

Crime is one aspect of the environment that can act as a barrier to physical activity. The goals of this study were to (1) compare measures of perceived crime with observed crime and (2) examine the association between the independent and combined effects of objective and perceived crime on physical activity

Assessing the Effects of Weather Conditions on Physical Activity Participation Using Objective Measures

Habitual physical activity is an important determinant of health, yet many people are considered to be inactive. Identification of the obstacles to greater participation is necessary for the development of strategies to overcome those obstacles. The weather has been identified as a perceived barrier to participation in physical activity, but exactly which adverse weather conditions are most important, and the extent to which they contribute to decreases in physical activity have rarely been quantified in populations. In the past decade, a small number of studies have used publicly available databases to examine the quantitative effects of weather (e.g., temperature, precipitation, wind) on physical activity in children, adolescents and adults. This review examines our historical, qualitative versus emerging, quantitative understanding of how specific weather conditions affect a population’s activity

Genomic and Genic Deletions of the FOX Gene Cluster on 16q24.1 and Inactivating Mutations of FOXF1 Cause Alveolar Capillary Dysplasia and Other Malformations

Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare, neonatally lethal developmental disorder of the lung with defining histologic abnormalities typically associated with multiple congenital anomalies (MCA). Using array CGH analysis, we have identified six overlapping microdeletions encompassing the FOX transcription factor gene cluster in chromosome 16q24.1q24.2 in patients with ACD/MPV and MCA. Subsequently, we have identified four different heterozygous mutations (frameshift, nonsense, and no-stop) in the candidate FOXF1 gene in unrelated patients with sporadic ACD/MPV and MCA. Custom-designed, high-resolution microarray analysis of additional ACD/MPV samples revealed one microdeletion harboring FOXF1 and two distinct microdeletions upstream of FOXF1, implicating a position effect. DNA sequence analysis revealed that in six of nine deletions, both breakpoints occurred in the portions of Alu elements showing eight to 43 base pairs of perfect microhomology, suggesting replication error Microhomology-Mediated Break-Induced Replication (MMBIR)/Fork Stalling and Template Switching (FoSTeS) as a mechanism of their formation. In contrast to the association of point mutations in FOXF1 with bowel malrotation, microdeletions of FOXF1 were associated with hypoplastic left heart syndrome and gastrointestinal atresias, probably due to haploinsufficiency for the neighboring FOXC2 and FOXL1 genes. These differences reveal the phenotypic consequences of gene alterations in cis

Search for Pair-Produced Resonances Decaying to Quark Pairs in Proton-Proton Collisions at √s = 13 TeV

A general search for the pair production of resonances, each decaying to two quarks, is reported. The search is conducted separately for heavier resonances (masses above 400 GeV), where each of the four final-state quarks generates a hadronic jet resulting in a four-jet signature, and for lighter resonances (masses between 80 and 400 GeV), where the pair of quarks from each resonance is collimated and reconstructed as a single jet resulting in a two-jet signature. In addition, a b-tagged selection is applied to target resonances with a bottom quark in the final state. The analysis uses data collected with the CMS detector at the CERN LHC, corresponding to an integrated luminosity of 35.9  fb⁻¹, from proton-proton collisions at a center-of-mass energy of 13 TeV. The mass spectra are analyzed for the presence of new resonances, and are found to be consistent with standard model expectations. The results are interpreted in the framework of R-parity-violating supersymmetry assuming the pair production of scalar top quarks decaying via the hadronic coupling λ′′312 or λ′′323 and upper limits on the cross section as a function of the top squark mass are set. These results probe a wider range of masses than previously explored at the LHC, and extend the top squark mass limits in the ˜t→qq′ scenario

Search for electroweak production of charginos and neutralinos in multilepton final states in proton-proton collisions at √s = 13 TeV

Results are presented from a search for the direct electroweak production of charginos and neutralinos in signatures with either two or more leptons (electrons or muons) of the same electric charge, or with three or more leptons, which can include up to two hadronically decaying tau leptons. The results are based on a sample of proton-proton collision data collected at s√=13 TeV, recorded with the CMS detector at the LHC, corresponding to an integrated luminosity of 35.9 fb⁻¹. The observed event yields are consistent with the expectations based on the standard model. The results are interpreted in simplified models of supersymmetry describing various scenarios for the production and decay of charginos and neutralinos. Depending on the model parameters chosen, mass values between 180 GeV and 1150 GeV are excluded at 95% CL. These results significantly extend the parameter space probed for these particles in searches at the LHC. In addition, results are presented in a form suitable for alternative theoretical interpretations