Relation of modifiable neighborhood attributes to walking

Abstract Background There is a paucity of research examining associations between walking and environmental attributes that are more modifiable in the short term, such as car parking availability, access to transit, neighborhood traffic, walkways and trails, and sidewalks. Methods Adults were recruited between April 2004 and September 2006 in the Minneapolis-St Paul metropolitan area and in Montgomery County, Maryland using similar research designs in the two locations. Self-reported and objective environmental measures were calculated for participants\u27 neighborhoods. Self-reported physical activity was collected through the long form of the International Physical Activity Questionnaire (IPAQ-LF). Generalized estimating equations were used to examine adjusted associations between environmental measures and transport and overall walking. Results Participants (n = 887) averaged 47 years of age (SD = 13.65) and reported 67 min/week (SD = 121.21) of transport walking and 159 min/week (SD = 187.85) of non-occupational walking. Perceived car parking difficulty was positively related to higher levels of transport walking (OR 1.41, 95%CI: 1.18, 1.69) and overall walking (OR 1.18, 95%CI: 1.02, 1.37). Self-reported ease of walking to a transit stop was negatively associated with transport walking (OR 0.86, 95%CI: 0.76, 0.97), but this relationship was moderated by perceived access to destinations. Walking to transit also was related to non-occupational walking (OR 0.85, 95%CI: 0.73, 0.99). Conclusions Parking difficulty and perceived ease of access to transit are modifiable neighborhood characteristics associated with self-reported walking

The effects of neighborhood density and street connectivity on walking behavior: the Twin Cities walking study

A growing body of health and policy research suggests residential neighborhood density and street connectivity affect walking and total physical activity, both of which are important risk factors for obesity and related chronic diseases. The authors report results from their methodologically novel Twin Cities Walking Study; a multilevel study which examined the relationship between built environments, walking behavior and total physical activity. In order to maximize neighborhood-level variation while maintaining the exchangeability of resident-subjects, investigators sampled 716 adult persons nested in 36 randomly selected neighborhoods across four strata defined on density and street-connectivity – a matched sampling design. Outcome measures include two types of self-reported walking (from surveys and diaries) and so-called objective 7-day accelerometry measures. While crude differences are evident across all outcomes, adjusted effects show increased odds of travel walking in higher-density areas and increased odds of leisure walking in low-connectivity areas, but neither density nor street connectivity are meaningfully related to overall mean miles walked per day or increased total physical activity. Contrary to prior research, the authors conclude that the effects of density and block size on total walking and physical activity are modest to non-existent, if not contrapositive to hypotheses. Divergent findings are attributed to this study's sampling design, which tends to mitigate residual confounding by socioeconomic status

Understanding the Effects of the Neighbourhood Built Environment on Public Health with Open Data

The investigation of the effect of the built environment in a neighbourhood and how it impacts residents' health is of value to researchers from public health policy to social science. The traditional methods to assess this impact is through surveys which lead to temporally and spatially coarse grained data and are often not cost effective. Here we propose an approach to link the effects of neighbourhood services over citizen health using a technique that attempts to highlight the cause-effect aspects of these relationships. The method is based on the theory of {\em propensity score matching with multiple `doses'} and it leverages existing fine grained open web data. To demonstrate the method, we study the effect of sport venue presence on the prevalence of antidepressant prescriptions in over 600 neighbourhoods in London over a period of three years. We find the distribution of effects is approximately normal, centred on a small negative effect on prescriptions with increases in the availability of sporting facilities, on average. We assess the procedure through some standard quantitative metrics as well as matching on synthetic data generated by modelling the real data. This approach opens the door to fast and inexpensive alternatives to quantify and continuously monitor effects of the neighborhood built environment on population health.Cambridge Trust and King's Colleg

How Long Do Endoprosthetic Reconstructions for Proximal Femoral Tumors Last?

As the life expectancy of patients with musculoskeletal tumors improves, long-term studies of endoprosthetic reconstructions are necessary to establish realistic expectations for the implants and compare them to other reconstruction approaches. (1) What is the long-term survival of cemented bipolar proximal femoral replacements? (2) How does prosthesis survival compare to patient survival among patients with Stage I, II, and III disease? (3) Do modular implants outperform custom-built prostheses? (4) Do some proximal femoral replacements require conversion to THA? We retrospectively reviewed all 86 proximal femoral replacements used for tumor reconstruction from 1982 to 2008. Primary diagnoses were 43 high-grade tumors (IIA/IIB), 20 low-grade tumors (IA/IB or benign), and 23 with metastatic disease. We reviewed prosthesis survival, patient survival, complication rates, functional outcomes, and rates of conversion to THA. Five of 86 patients (5.8%) required revision of the femoral component. Five-, 10-and 20-year implant survivorships were 93%, 84%, and 56%, respectively. All patients with low-grade disease survived; the 5-year survival rate for patients with metastatic disease was 16%; the 5-, 10-, and 20-year survival for IIA/IIB patients was 54%, 50%, and 44%, respectively. Five of 86 patients (5.8%) underwent conversion to THA for groin pain. Cemented bipolar proximal femoral replacements after tumor resection proved a durable reconstruction technique. The implants outlived patients with metastatic disease and high-grade localized disease while patients with low-grade disease outlived their implants. The survival of modular prostheses was comparable to that of older, one-piece custom designs. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence

Differentiated State of Initiating Tumor Cells Is Key to Distinctive Immune Responses Seen in H-Ras

Heterogeneity in tumor immune responses is a poorly understood yet critical parameter for successful immunotherapy. In two doxycycline-inducible models where oncogenic H-RasG12V is targeted either to the epidermal basal/stem cell layer with a Keratin14-rtTA transgene (K14Ras), or committed progenitor/suprabasal cells with an Involucrin-tTA transgene (InvRas), we observed strikingly distinct tumor immune responses. On threshold doxycycline levels yielding similar Ras expression, tumor latency, and numbers, tumors from K14Ras mice had an immunosuppressed microenvironment, whereas InvRas tumors had a proinflammatory microenvironment. On a Rag1-/- background, InvRas mice developed fewer and smaller tumors that regressed over time, whereas K14Ras mice developed more tumors with shorter latency than Rag1+/+ controls. Adoptive transfer and depletion studies revealed that B-cell and CD4 T-cell cooperation was critical for tumor yield, lymphocyte polarization, and tumor immune phenotype in Rag1+/+ mice of both models. Coculture of tumor-conditioned B cells with CD4 T cells implicated direct contact for Th1 and regulatory T cell (Treg) polarization, and CD40-CD40L for Th1, Th2, and Treg generation, a response not observed from splenic B cells. Anti-CD40L caused regression of InvRas tumors but enhanced growth in K14Ras, whereas a CD40 agonist mAb had opposite effects in each tumor model. These data show that position of tumor-initiating cells within a stratified squamous epithelial tissue provokes distinct B- and CD4 T-cell interactions, which establish unique tumor microenvironments that regulate tumor development and response to immunotherap

Ngrams and Engrams: the use of structural and conceptual features to discriminate between English translations of religious texts

In this paper, we present experiments using the Linguistic Inquiry and Word Count (LIWC) program, a ‘closed-class keyword’ (CCK) analysis and a ‘correspondence analysis’ (CA) to examine whether the Scientology texts of L. Ron Hubbard are linguistically and conceptually like those of other religions. A Kruskal–Wallis test comparing the frequencies of LIWC category words in the Scientology texts and the English translations of the texts of five other religions showed that there were eighteen categories for which the Scientology texts differed from the others, and between one and seventeen for the other religions. In the CCK experiment, keywords typical of each religion were found, both by comparing the religious texts with one another and with the Brown corpus of general English. The most typical keywords were looked up in a concordancer and were manually coded with conceptual tags. The set of categories found for the Scientology texts showed little overlap with those found for the others. Our CA experiments produced fairly clear clusters of texts by religion. Scientology texts were seen at one pole on the first factor, with Christian and Islamic texts at the other. It appears that, in several ways, the Scientology texts are dissimilar to the texts of some of the world's major religions

Social group membership before treatment for substance dependence predicts early identification and engagement with treatment communities

Social relationships play a major role in recovery from substance dependence. To date, greater attention has been paid to the role of important individuals in a person’s life and their contribution to recovery following treatment. This study is the first to examine both individual and wider group-based social connections in the lead up to residential treatment for substance misuse in a therapeutic community (TC), and their influence both on a person’s readiness to engage with the treatment community and with a recovery pathway. Participants were 307 adults interviewed early in treatment about their individual- and group-based social relationships prior to treatment entry, their social identification with the TC, as ‘a user’ and a person ‘in recovery’, their current recovery capital and quality of life. Correlational analysis showed that only pre-treatment group-based, and not individual, relationships, were significantly associated with developing social identification with the TC early in treatment. Moreover, results of hierarchical regression analyses indicated that identification with the TC was best predicted by the extent to which people saw themselves as being in recovery. Finally, mediation analysis indicated that TC identification was the mechanism through which social group memberships prior to treatment commencement protected quality of life in the early phases of treatment. These findings highlight the protective role that group memberships play in building early identification with the TC and supporting well-being in a critical period of transitioning to treatment

Can a Flexibility/Support Initiative Reduce Turnover Intentions and Exits? Results from the Work, Family, and Health Network

We draw on panel data from a randomized field experiment to assess the effects of a flexibility/supervisor support initiative called STAR on turnover intentions and voluntary turnover among professional technical workers in a large firm. An unanticipated exogenous shock-the announcement of an impending merger-occurred in the middle of data collection. Both organizational changes reflect an emerging employment contract characterized by increasing employee temporal flexibility even as employers wield greater flexibility in reorganizing their workforces. We theorized STAR would reduce turnover intentions and actual turnover by making it more attractive to stay with the current employer. We found being in a STAR team (versus a usual practice team) lowered turnover intentions 12 months later and reduced the risk of voluntary turnover over almost three years. We also examined potential mechanisms accounting for the effects of these two organizational changes; STAR effects on reducing turnover intentions are partially mediated by reducing work-to-family conflict, family-to-work conflict, burnout, psychological distress, perceived stress, and increasing job satisfaction. The effect of learning about the merger on increasing turnover intentions is fully mediated by increased job insecurity. STAR also moderates the negative effects of learning about the merger on turnover intentions for different subgroups. Findings provide insights into the effectiveness of an organizational intervention, the dynamics of organizations, and how competing logics of two organizational changes affect employees' labor market expectations and behavior