It's A-bout Time: Detailed Patterns of Physical Activity in Obese Adolescents Participating in a Lifestyle Intervention.

BACKGROUND: The detailed patterns of physical activity and sedentary behaviors of overweight and obese adolescents are unknown, but may be important for health outcomes and targeted intervention design. METHODS: Participants completed Curtin University's Activity, Food and Attitudes Program (CAFAP), an 8-week intervention with 12 months of maintenance intervention. Physical activity and sedentary time were assessed at 6 time periods with accelerometers and were analysed by 1) time and type of day 2) intensity bout patterns using exposure variation analysis, and 3) individual case analysis. RESULTS: Participants (n=56) spent a lower percentage of time at baseline in light activity during school days compared to weekend days (24.4% vs 29.0%, p=.004). The majority of time was in long uninterrupted sedentary bouts of greater than 30 minutes (26.7% of total time, 36.8% of sedentary time at baseline). Moderate activity was accumulated in short bouts of less than 5 minutes (3.1% of total time, 76.0% moderate time). Changes varied by individuals. CONCLUSIONS: Exposure variation analysis revealed specific changes in activity patterns in overweight and obese adolescents who participated in a lifestyle intervention. A better understanding of these patterns can help to design interventions that meaningfully affect specific behaviors, with unique health consequences

Effects of muscle strength and endurance on blood pressure and related cardiometabolic risk factors from childhood to adolescence

Objective: This study aimed to examine the evolution of relationships between measures of muscle strength and endurance with individual cardiometabolic risk factors from childhood to late adolescence in a prospective population-based cohort. Methods: Participants from the Western Australian Pregnancy Cohort (Raine) Study at ages 10, 14 and 17 were analysed, using longitudinal linear mixed model analyses. Results: Handgrip strength after adjusting for the confounding effects of BMI was positively associated with SBP, but not DBP. The association between handgrip strength and SBP was stronger in men than women at all time points [coefficient (women): 0.18, P < 0.001; sex × handgrip strength coefficient: 0.09, P = 0.002]. The association was strongest at 10 years and significantly attenuated over time (year × handgrip coefficient from 10 to 14 years: −0.11, P = 0.003; year × handgrip coefficient from 10 to 17 years: −0.19, P ≤ 0.001). After the inclusion of BMI as a confounder, handgrip strength was significantly negatively associated with homeostatic model assessment of insulin resistance and high-sensitivity C-reactive protein over time in both sexes. Back muscle endurance was positively associated with SBP, but not DBP, after adjustment for the confounding effects of BMI (coefficient: 0.01, P = 0.002). There were small, albeit significant, inverse associations between back muscle endurance and log homeostatic model assessment of insulin resistance and log high-sensitivity C-reactive protein. Conclusion: The positive association between handgrip strength and back muscle endurance with SBP throughout childhood and adolescence contrasts with beneficial effects on other related traditional cardiometabolic risk factors. Mechanisms underlying these paradoxical effects on SBP warrant further investigation

How many trafficked people are there in Greater New Orleans? lessons in measurement

In an effort to develop a model for estimating prevalence in a city or region of the United States, this study employed Multiple Systems Estimation, a statistical approach that uses data on known cases collected from individual agencies to estimate the number not known, with the ultimate aim of estimating the prevalence of trafficking in a region. Utilizing de-identified data provided by local non-profits and law enforcement agencies, the researchers estimated the prevalence of trafficking in the New Orleans-Metairie metropolitan statistical area. This represents one of the first attempts to use Multiple Systems Estimation to quantify human trafficking in a United States context. The article provides an account of the impediments to and limitations of conducting such an estimate, given the definitional variance and political dynamics that are endemic to anti-trafficking efforts in the United States. The authors provide recommendations for data collection and prevalence analysis that could be applied in other cities or regions of the United States as well as in other similarly-resourced environments

The impact of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion interventions on office worker productivity: A cluster-randomized trial

Objectives: Using an employer’s perspective, this study aimed to compare the immediate and longer-term impact of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion information on health-related productivity among a general population of office workers and those with neck pain. Methods: A prospective one-year cluster randomized trial was conducted. Participants received an individualized workstation ergonomics intervention, combined with 12 weeks of either workplace neck-specific exercises or health promotion information. Health-related productivity at baseline, post-intervention and 12-months was measured with the Health and Work Performance Questionnaire. Intention-to-treat analysis was performed using multilevel mixed models. Results: We recruited 763 office workers from 14 organizations and allocated them to 100 clusters. For the general population of office workers, monetized productivity loss at 12 months [AU$1464 (standard deviation [SD] 1318) versus AU$1563 (SD=1039); P=0.023]; and presenteeism at 12 months [2.0 (SD 1.2) versus 2.4 (SD 1.4); P=0.007] was lower in the exercise group compared to those in the health promotion information group. For office workers with neck pain, exercise participants had lower sickness absenteeism at 12 months compared to health promotion information participants [0.7 days (SD 1.0) versus 1.4 days (SD 3.1); P=0.012], despite a short-term increase in sickness absenteeism post-intervention compared to baseline for the exercise group [1.2 days (SD 2.2) versus 0.6 days (SD 0.9); P&lt;0.001]. Conclusion: A workplace intervention combining ergonomics and neck-specific exercise offers possible benefits for sickness presenteeism and health-related productivity loss among a general population of office workers and sickness absenteeism for office workers with neck pain in the longer-term

Australia and Other Nations are Failing to Meet Sedentary Behaviour Guidelines for Children: Implications and a Way Forward

BACKGROUND: Australia has joined a growing number of nations which have evaluated the physical activity and sedentary behaviour status of their children. Australia received a 'D minus' in the first Active Healthy Kids Australia Physical Activity Report Card. METHODS: An expert subgroup of the Australian Report Card Research Working Group iteratively reviewed available evidence to answer three questions: 1) What are the main sedentary behaviours of children?, 2) What are the potential mechanisms for sedentary behaviour to impact on child health and development? and, 3) What are the effects of different types of sedentary behaviours on child health and development? RESULTS: Neither sedentary time nor screen time are homogeneous activities likely to result in homogenous effects. There are several mechanisms by which various sedentary behaviours may positively or negatively affect cardiometabolic, neuro-musculoskeletal, and psycho-social health, though the strength of evidence varies. National surveillance systems, and mechanistic, longitudinal and experimental studies are needed for Australia and other nations to improve their grade. CONCLUSIONS: Despite limitations, available evidence is sufficiently convincing that the total exposure and pattern of exposure to sedentary behaviours are critical to the healthy growth, development and wellbeing of children. Nations therefore need strategies to address these common behaviours

Screen-based media use clusters are related to other activity behaviours and health indicators in adolescents

Background: Screen-based media (SBM) occupy a considerable portion of young peoples’ discretionary leisure time. The aim of this paper was to investigate whether distinct clusters of SBM use exist, and if so, to examine the relationship of any identified clusters with other activity/sedentary behaviours and physical and mental health indicators.Methods: The data for this study come from 643 adolescents, aged 14 years, who were participating in the longitudinal Western Australian Pregnancy Cohort (Raine) Study through May 2003 to June 2006. Time spent on SBM, phone use and reading was assessed using the Multimedia Activity Recall for Children and Adults. Height, weight, muscle strength were measured at a clinic visit and the adolescents also completed questionnaires on their physical activity and psychosocial health. Latent class analysis (LCA) was used to analyse groupings of SBM use.Results: Three clusters of SBM use were found; C1 ‘instrumental computer users’ (high email use, general computer use), C2 ‘multi-modal e-gamers’ (both high console and computer game use) and C3 ‘computer e-gamers’ (high computer game use only). Television viewing was moderately high amongst all the clusters. C2 males took fewer steps than their male peers in C1 and C3 (-13,787/week, 95% CI: -4619 to -22957, p = 0.003 and -14,806, 95% CI: -5,306 to -24,305, p = 0.002) and recorded less MVPA than the C1 males (-3.5 h, 95% CI: -1.0 to -5.9, p = 0.005). There was no difference in activity levels between females in clusters C1 and C3.Conclusion: SBM use by adolescents did cluster and these clusters related differently to activity/sedentary behaviours and both physical and psychosocial health indicators. It is clear that SBM use is not a single construct and future research needs to take consideration of this if it intends to understand the impact SBM has on health

The dichotomy of the application of a systems approach in UK healthcare: the challenges and priorities for implementation

There is increasing demand for a systems approach within national healthcare guidelines to provide a systematic and sustainable framework for improvements in patient safety. Supported by this is the growing body of evidence within Human Factors/Ergonomics (HFE) healthcare literature for the inclusion of this approach in health service design, provision and evaluation. This paper considers the current interpretation of this within UK healthcare systems and the dichotomy which exists in the challenge to implement a systems approach. Three case studies, from primary and secondary care, present a systems approach, offering a novel perspective of primary care and blood sampling. These provide practical illustrations of how HFE methods have been used in collaboration with healthcare staff to understand the system for the purpose of professional education, design and safety of clinical activities. The paper concludes with the challenge for implementation and proposes five roles for systems HFE to support patient safety

The impact of Curtin University's Activity, Food and Attitudes Program on physical activity, sedentary time and fruit, vegetable and junk food consumption among overweight and obese adolescents: A waitlist controlled trial

Background: To determine the effects of participation in Curtin University's Activity, Food and Attitudes Program (CAFAP), a community-based, family-centered behavioural intervention, on the physical activity, sedentary time, and healthy eating behaviours of overweight and obese adolescents. Methods: In this waitlist controlled clinical trial in Western Australia, adolescents (n = 69, 71% female, mean age 14.1 (SD 1.6) years) and parents completed an 8-week intervention followed by 12 months of telephone and text message support. Assessments were completed at baseline, before beginning the intervention, immediately following the intervention, and at 3-, 6-, and 12- months follow-up. The primary outcomes were physical activity and sedentary time assessed by accelerometers and servings of fruit, vegetables and junk food assessed by 3-day food records. Results: During the intensive 8-week intervention sedentary time decreased by −5.1 min/day/month (95% CI: −11.0, 0.8) which was significantly greater than the rate of change during the waitlist period (p = .014). Moderate physical activity increased by 1.8 min/day/month (95% CI: −0.04, 3.6) during the intervention period, which was significantly greater than the rate of change during the waitlist period (p = .041). Fruit consumption increased during the intervention period (monthly incidence rate ratio (IRR) 1.3, 95% CI: 1.10, 1.56) and junk food consumption decreased (monthly IRR 0.8, 95% CI: 0.74, 0.94) and these changes were different to those seen during the waitlist period (p = .004 and p = .020 respectively). Conclusions: Participating in CAFAP appeared to have a positive influence on the physical activity, sedentary and healthy eating behaviours of overweight and obese adolescents and many of these changes were maintained for one year following the intensive intervention. Trial Registration: Australia and New Zealand Clinical Trials Registry ACTRN12611001187932

Rationale, design and methods for a randomised and controlled trial to investigate whether home access to electronic games decreases children's physical activity

Background. Many children are reported to have insufficient physical activity (PA) placing them at greater risk of poor health outcomes. Participating in sedentary activities such as playing electronic games is widely believed to contribute to less PA. However there is no experimental evidence that playing electronic games reduces PA. There is also no evidence regarding the effect of different types of electronic games (traditional sedentary electronic games versus new active input electronic games) on PA. Further, there is a poor understanding about how characteristics of children may moderate the impact of electronic game access on PA and about what leisure activities are displaced when children play electronic games. Given that many children play electronic games, a better understanding of the effect of electronic game use on PA is critical to inform child health policy and intervention. Methods. This randomised and controlled trial will examine whether PA is decreased by access to electronic games and whether any effect is dependent on the type of game input or the child's characteristics. Children aged 1012 years (N = 72, 36 females) will be recruited and randomised to a balanced ordering of 'no electronic games', 'traditional' electronic games and 'active' electronic games. Each child will participate in each condition for 8 weeks, and be assessed prior to participation and at the end of each condition. The primary outcome is PA, assessed by Actical accelerometers worn for 7 days on the wrist and hip. Energy expenditure will be assessed by the doubly labelled water technique and motor coordination, adiposity, self-confidence, attitudes to technology and PA and leisure activities will also be assessed. A sample of 72 will provide a power of > 0.9 for detecting a 15 mins difference in PA (sd = 30 mins). Discussion. This is the first such trial and will provide critical information to understand whether access to electronic games affects children's PA. Given the vital importance of adequate PA to a healthy start to life and establishing patterns which may track into adulthood, this project can inform interventions which could have a profound impact on the long term health of children. Trial registration. This trial is registered in the Australia and New Zealand Clinical Trials Registry (ACTRN 12609000279224)

Objectively measured patterns of sedentary time and physical activity in young adults of the Raine study cohort

Background: To provide a detailed description of young adults' sedentary time and physical activity. Methods: 384 young women and 389 young men aged 22.1±0.6 years, all participants in the 22 year old follow-up of the Raine Study pregnancy cohort, wore Actigraph GT3X+ monitors on the hip for 24 h/day over a one-week period for at least one 'valid' day (=10 h of waking wear time). Each minute epoch was classified as sedentary, light, moderate or vigorous intensity using 100 count and Freedson cut-points. Mixed models assessed hourly and daily variation; t-tests assessed gender differences. Results: The average (mean±SD) waking wear time was 15.0±1.6 h/day, of which 61.4±10.1 % was spent sedentary, 34.6±9.1 % in light-, 3.7±5.3 % in moderate- and, 0.3±0.6 % in vigorous-intensity activity. Average time spent in moderate to vigorous activity (MVPA) was 36.2±27.5 min/day. Relative to men, women had higher sedentary time, but also higher vigorous activity time. The 'usual' bout duration of sedentary time was 11.8±4.5 min in women and 11.7±5.2 min in men. By contrast, other activities were accumulated in shorter bout durations. There was large variation by hour of the day and by day of the week in both sedentary time and MVPA. Evenings and Sundays through Wednesdays tended to be particularly sedentary and/or inactive. Conclusion: For these young adults, much of the waking day was spent sedentary and many participants were physically inactive (low levels of MVPA). We provide novel evidence on the time for which activities were performed and on the time periods when young adults were more sedentary and/or less active. With high sedentary time and low MVPA, young adults may be at risk for the life-course sequelae of these behaviours