Working from home, health and wellbeing consequences of a pandemic

Drawing from a survey of 1,165 Sydney (Australia) workers conducted in late 2020, when restrictions from the first COVID-19 wave were easing across Australia, we explore the impact of the pandemic on perceived changes to working from home (WfH) and other travel behaviours. Based on this analysis, we identify three distinct segments of the population with differing physical activity (PA) and quality of life (QoL) outcomes: (1) ‘Active but Anxious’ (22%) – younger, higher income, largest increase in WfH, sitting most of the day, sufficient PA; (2) ‘Less Change, Less Worries’ (38%) – older and male, least change in WfH, sitting relatively less, largely sufficient PA; (3) ‘Stressed and Sedentary’ (40%) – average age, lower income, largest loss of paid work, highest levels of sedentary behaviour, lowest PA and QoL. In a probable future of greater opportunities for WfH, understanding these heterogenous outcomes has implications for individuals, employers and policy-makers

Koinonia

Conference SpotlightA Life Calling Conceptual and Developmental Model, Bill Millard Community ConsiderationsThinking Theologically: Considering Community, Todd Ream Women\u27s IssuesWomen, Work, and Family, Cara Copeland & Melanie Hulbert Calling and CareerVocational Realization Through the Discovery of Human Assets, Tony Marchese Human SexualityCreating an Effective Human Sexuality Statement, Canaan Crane Book ReviewBono: In Conversation with Michka Assayas, reviewed by David Johnstone FeaturesThe President\u27s Corner; Editor\u27s Diskhttps://pillars.taylor.edu/acsd_koinonia/1003/thumbnail.jp

Development of an online diary for longitudinal travel / activity surveys

Motivated by the continued search for methods to reduce participant burden and non-response, and improve the quality of travel data, this paper details the development of a new online travel/activity diary to support a major longitudinal investigation of travel in Sydney, Australia. The diary employs several innovative features designed to simplify the process of data entry, and improve participant recall and completeness of travel, including auto-fills, prompts, trip editing capabilities, favourite trips and a dragand- drop technique for capturing travel mode. An additional innovation is the ability to view a GPS-based Google map of daily travel while completing the diary to assist with recall. The diary is tested on 37 participants, with a range of diagnostics provided to assess their comprehension and interaction with the diary, reaction and burden, and completeness of data provided. Overall, 89% of participants complete all seven days of the diary with 75% indicating no issues once they become accustomed to how it works. Trip entry times average around two minutes/trip with three-quarters of trips entered within 24 hours of being made and 96% of trips provided with complete details. In terms of the GPS component, while the data itself is of variable quality and the optional viewing of trips is lower than anticipated, those carrying a GPS report more trips/day and segments/day, fewer missing days, and provide more complete trip data

Mindfulness-based cognitive therapy (MBCT) reduces the association between depressive symptoms and suicidal cognitions in patients with a history of suicidal depression.

Objective: In patients with a history of suicidal depression, recurrence of depressive symptoms can easily reactivate suicidal thinking. In this study, we investigated whether training in mindfulness, which is aimed at helping patients “decenter” from negative thinking, could help weaken the link between depressive symptoms and suicidal cognitions. Method: Analyses were based on data from a recent randomized controlled trial, in which previously suicidal patients were allocated to mindfulness-based cognitive therapy (MBCT), an active control treatment, cognitive psychoeducation (CPE), which did not include any meditation practice, or treatment as usual (TAU). After the end of the treatment phase, we compared the associations between depressive symptoms, as assessed through self-reports on the Beck Depression Inventory–II (Beck, Steer, & Brown, 1996), and suicidal thinking, as assessed through the Suicidal Cognitions Scale (Rudd et al., 2001). Results: In patients with minimal to moderate symptoms at the time of assessment, comparisons of the correlations between depressive symptoms and suicidal cognitions showed significant differences between the groups. Although suicidal cognitions were significantly related to levels of symptoms in the 2 control groups, there was no such relation in the MBCT group. Conclusion: The findings suggest that, in patients with a history of suicidal depression, training in mindfulness can help to weaken the association between depressive symptoms and suicidal thinking, and thus reduce an important vulnerability for relapse to suicidal depression

A multi-scalar perspective on health and urban housing: an umbrella review

With more than half the world’s population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth’s natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research

Search strategies for: "Climate action for health and wellbeing in cities: a protocol for the systematic development of a database of peer-reviewed studies using machine learning methods"

The search strategies were constructed for the development of a database of peer-reviewed studies on climate change mitigation and adaptation actions implemented in cities for human health and wellbeing. The development of the database followed a systematic process assisted by the use of machine learning methods for article classification to allow capturing a broad landscape of relevant literature across many disciplines and sectors. The search strategies are tailored to this purpose, and therefore, cover both explicit and implicit terms of relevance to climate change mitigation and adaptation. There are two separate sets of search terms, one capturing climate change mitigation actions and one climate change adaptation actions. Each set is comprised of three blocks of search terms. For mitigation the blocks of terms are: (climate terms OR energy terms) AND (explicit mitigation and mitigation policy terms OR sector-specific mitigation terms) AND (health terms OR wellbeing terms). For adaptation the terms are: (climate terms) AND (explicit adaptation terms including resilience OR action-specific adaptation terms) AND (health terms OR wellbeing terms). Here we present the search strategies for Medline (accessed via Web of Science). These was also translated for the Web of Science Core Collections (consisting of SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, and ESCI) and Scopus. The bibliographic databases were searched in January/February 2021. Further details on the development of the search strategy are available in the study protocol (see the associated papers)

Staying well after depression: trial design and protocol

<p>Abstract</p> <p>Background</p> <p>Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.</p> <p>Methods/Design</p> <p>This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter.</p> <p>Discussion</p> <p>This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression - that in people who become suicidal when depressed.</p> <p>Trial Registration</p> <p>Current Controlled Trials: ISRCTN97185214.</p

Transforming cities for sustainability: A health perspective.

Transformational change is urgently needed to address planetary health challenges in cities. Through an interdisciplinary overview of the literature, we consider how to frame and unpack city-level transformation towards synergistic benefits for urban health and environmental sustainability. By describing the characteristics of a 'healthy sustainable city' and by bringing together the ideas underlying frameworks for health and sustainability, we develop a conceptual understanding of how cities may progress towards achieving significant improvements in health and the environment. We investigate how urban change works, and build a theoretical understanding of how urban change may be directed to integrate health and sustainability. We conclude that urban transformation needs to be a multi-scalar process across city sectors to meet the scale, speed and form of change required. We propose that this can best be achieved in practice through a composition of mechanisms, including strengthening city governance, enabling technological and social innovations, applying sustainable urban planning and infrastructure development, and impelling social behaviour change; supported by systems-driven policy and practice-focused scientific evidence

Effectiveness of integrating a pragmatic pathway for prescribing liraglutide 3.0mg in weight management services (STRIVE study): a multicentre, open-label, parallel-group, randomized controlled trial

Summary. Background: An effective prescribing pathway for liraglutide 3 mg, an approved obesity pharmacotherapy, may improve treatment access. This trial compared a targeted prescribing pathway for liraglutide 3 mg with multiple stopping rules in specialist weight management services (SWMS) to standard SWMS care. Methods: This phase four, two-year, multicentre, open-label, parallel-group, real-world randomized clinical trial (ClinicalTrials.gov: NCT03036800) enrolled adults with BMI ≥35 kg/m2 plus prediabetes, type 2 diabetes, hypertension or sleep apnoea from five SWMS in Ireland and UK. Participants were randomly allocated (2:1, stratified by centre and BMI) to SWMS care plus a targeted prescribing pathway for once daily subcutaneous liraglutide 3 mg (intervention) with stopping rules at 16 (≥5% weight loss, WL), 32 (≥10% WL) and 52 weeks (≥15% WL) or to SWMS care alone (control) through an online randomization service. The primary outcome was WL ≥15% at 52 weeks, assessed by complete cases analysis. All randomized participants were included in safety analysis. Findings From November 28, 2017 to February 28, 2020, 434 participants were screened, and 392 randomized (260 intervention; 132 control), while 294 (201 intervention; 93 control) included in the 52 weeks complete case analysis. More intervention than control participants achieved WL ≥15% at 52 weeks [51/201 (25.4%) vs 6/93 (6.5%); odds ratio 5.18; 95% CI 2.09, 12.88; p &lt; 0.0001]. More adverse events occurred in the intervention (238/260, 91.5%; two deaths) than control (89/132, 67.4%; no deaths) group. Interpretation: A targeted prescribing pathway for liraglutide 3 mg helps more people achieve ≥15% WL at 52 weeks than standard care alone