Physical activity and energy expenditure in rheumatoid arthritis patients and matched controls

Objectives. To compare daily energy expenditure between RA patients and matched controls, and to explore the relationship between daily energy expenditure or sedentariness and disease-related scores. Methods. One hundred and ten patients with RA and 440 age- and sex-matched controls were included in this study. Energy expenditure was assessed using the validated physical activity (PA) frequency questionnaire. Disease-related scores included disease activity (DAS-28), functional status (HAQ), pain visual analogue scale (VAS) and fatigue VAS. Total energy expenditure (TEE) and the amount of energy spent in low- (TEE-low), moderate- (TEE-mod) and high-intensity (TEE-high) PAs were calculated. Sedentariness was defined as expending <10% of TEE in TEE-mod or TEE-high activities. Between-group comparisons were computed using conditional logistic regression. The effect of disease-related scores on TEE was investigated using linear regression. Results. TEE was significantly lower for RA patients compared with controls [2392 kcal/day (95% CI 2295, 2490) and 2494 kcal/day (2446, 2543), respectively, P = 0.003]. A significant difference was found between groups in TEE-mod (P = 0.015), but not TEE-low (P = 0.242) and TEE-high (P = 0.146). All disease-related scores were significantly poorer in sedentary compared with active patients. TEE was inversely associated with age (P < 0.001), DAS-28 (P = 0.032) and fatigue VAS (P = 0.029), but not with HAQ and pain VAS. Conclusion. Daily energy expenditure is significantly lower in RA patients compared with matched controls, mainly due to less moderate-intensity PAs performed. Disease activity and fatigue are important contributing factors. These points need to be addressed if promoting PA in RA patients is a health goal. Trial registration. ClinicalTrials.gov, http://clinicaltrials.gov, NCT0122881

Spatial Dependence of Body Mass Index: Geneva, Switzerland

Urban health (UH) is an emerging field, which explores the effect of urban environment and urbanization on health. Evidence suggests that urban environment can either positively influence health behaviors or be a health stressor. One key approach in UH is the use of georeferenced data and geographic information system (GIS). Mapping disease prevalence and trends provide insight into disease mechanisms and etiologies. An important limitation of GIS is that data sets have likely been collected separately by different agencies, often over different time periods.The Canton of Geneva deviates from this limitation as it has been collecting geographic and health-related information continuously since 1998 through the Unit of Population Epidemiology (UEP) of the Geneva University Hospitals and its Bus Santé study. Combining health-related data from the Bus Santé study and GIS, using Local Indicators of Spatial Association (LISA), the investigators detected significant spatial dependance with respect to BMI. The results clearly indicate that BMI levels are not distributed at random in the Canton of Geneva. Moreover, performing preliminary exploratory analyses on blood pressure, investigators have identified cluster of individuals with higher blood pressure than the average, lifting up possible influences of environmental/urban factors (e.g., sidewalks, traffic, socioeconomic status)

Evaluasi Penyusunan Anggaran sebagai Alat Pengendalian Manajemen Blu Rsup Prof.dr. R.d. Kandou Manado

Rumah sakit adalah salah satu fasilitas yang diberikan oleh pemerintah dalam bidang kesehatan. Dlaam rangka meningkatkan kualitas pelayanan, rumah sakit membutuhkan dana investasi yang cukup besar. Dengan adanya penyusunan anggaran manajemen rumah sakit dapat membandingkan dan menganalisa biaya yang sesungguhnya dengan biaya yang dianggarkan. Penelitian dilakukan pada penyusunan anggaran di BLU RSUP Prof. Dr. R. D. Kandou Manado (Rumah Sakit Malalayang). Tujuannya untuk mengetahui penyusunan anggaran sabagai alat pengendalian manajemendi rumah sakit. Metode yang digunakan adalah analisis deskriptif, yaitu menggambarkan penyusunan anggaran yang ada pada Rumah Sakit Malalayang. Hasil penelitian menunjukan bahwa penyusunan anggaran di Rumah Sakit Malalayang sebagai alat pengendalian manajemen sudah cukup efektif. Penyusunan anggaran yang digunakan menggunakan pendekatan sistem perencanaan, program, dan anggaran terpadu (PBBS). PBBS tidak seperti penganggaran tradisional, dimana pengambilan keputusan anggaran dilakukan dari atas kebawah melainkan kombinasi antara pengambilankeputusan dari atas kebawah dan bawah keatas. Hal ini terlihat dari bagaimana proses penyusunan anggaran sampai dengan tahap pelaporannya sesuai dengan karakteristik PBBS yaitu pendekatan ini dirumuskan dalam bentuk program atau aktivitas dari visi, misi, dan tujuan yang terdapat dalam dokumen perencanaan di Rumah Sakit Malalayang. Kata kunci: penyusunan anggaran, alat pengendalian manajeme

Biodiversity dynamics and the effect of urban environment on the distribution of genetic variation in the Geneva cross-border area

Population growth, urbanization and agriculture lead to degradation and loss of natural environment. This has an adverse effect on the diversity of habitats, species and genes and might cause decline in the quality of life of the resident population. In this context and in the densely populated Geneva cross-border area, we study biodiversity dynamics and the effect of the environment on the distribution of genetic variation (URBANGENE project). We use genetic information of three model species (a plant, an insect and an amphibian) in combination with environmental and landscape data to evaluate their potential to disperse and adapt to urban environments. Based on a representative population survey, we further investigate how urban residents perceive their quality of life with a local biodiversity perspective, compared with health data measured in the same areas. Using genome-wide SNP data, we assessed genome-environment associations for Plantago major, a synanthropic plant, in order to obtain information on its ability to disperse among habitats and to adapt to the urban environment. Butterfly (Pieris rapae) and amphibian model species (Bufo bufo) will be sampled in 2015. As regards the amphibians, we developed a WebGIS participatory platform, making it possible for Geneva residents to indicate the geographic location of amphibian habitats on an interactive map, and to transmit information on the species they observed in this area. The integration of results from this interdisciplinary project should allow for a more sustainable urban development and a better conservation and management of biodiversity in urban areas

Persistent spatial clusters of high body mass index in a Swiss urban population as revealed by the 5-year GeoCoLaus longitudinal study

OBJECTIVE Body mass index (BMI) may cluster in space among adults and be spatially dependent. Whether and how BMI clusters evolve over time in a population is currently unknown. We aimed to determine the spatial dependence of BMI and its 5-year evolution in a Swiss general adult urban population, taking into account the neighborhood- and individual-level characteristics. DESIGN Cohort study SETTING Swiss general urban population PARTICIPANTS 6,481 geo-referenced individuals from the CoLaus cohort at baseline (age range 35–74 years, period=2003-2006) and 4,460 at follow-up (period=2009-2012). OUTCOME MEASURES Body weight and height were measured by trained health care professionals with participants standing without shoes in light indoor clothing. BMI was calculated as weight (kg) divided by height squared (m2). Participants were geocoded using their postal address (geographic coordinates of the place of residence). Getis-Ord Gi statistic was used to measure the spatial dependence of BMI values at baseline and its evolution at follow-up. RESULTS BMI was not randomly distributed across the city. At baseline and at follow-up, significant clusters of high versus low BMIs were identified and remained stable during the two periods. These clusters were meaningfully attenuated after adjustment for neighborhood-level income but not individual-level characteristics. Similar results were observed among participants who developed obesity. CONCLUSIONS To our knowledge, this is the first study to report longitudinal changes in BMI clusters in adults from a general population. Spatial clusters of high BMI persisted over a 5-year period and were mainly influenced by neighborhood-level income. ARTICLE SUMMARY STRENGTHS AND LIMITATIONS OF THE STUDY • As far as we know, this is the first study to report the persistence of spatial clusters of high BMI values over a 5-year period in adults from a general population • The observed east to west pattern of BMI clustering fits known socio-economic and ethno-cultural differences distinguishing these opposite regions of the city of Lausanne, Switzerland • A consequence of the social policy applied by the city is likely to fix populations with modest income in subsidized housing located in specific areas • While recruitment methods of the CoLaus study aimed at collecting information on a representative sample of the general population, adult participants and non-participants to the CoLaus study may differ and participation bias cannot be excluded • We considered several individual-level covariates but data on individual income was missing. We used instead the median income of the including city statistical sector

Relationship between land cover type and Body Mass Index in Geneva

Past studies conducted in urban areas analyzed the impact of the presence of green spaces on public health, and highlighted in particular the psychological benefits of interacting with nature. To investigate a supposed relationship between overweight and dense built environment, we focused on the State of Geneva, Switzerland, and calculated the correlation between Body Mass Index (BMI) in a representative sample of 6663 adults and the percentage of natural areas at the locations where these individuals were living. To this end, we used populationbased health data from the “Bus Sante” study (Geneva University Hospitals) and multi-scale land cover maps obtained by means of satellite images and LiDAR data classification. We found little correlation between BMI (as a proxy for health) and land cover data and were not able to verify the working hypothesis at local and regional scales. However, an important phenomenon highlighted here is the difference in the results obtained between the city center and the whole State

Twenty-year trends in dietary patterns in French-speaking Switzerland: toward healthier eating

Background: Dietary patterns provide a summary of dietary intake, but to our knowledge, few studies have assessed trends in dietary patterns in the population. Objective: The aim was to assess 20-y trends in dietary patterns in a representative sample of the Geneva, Switzerland, population with the consideration of age, sex, education, and generation. Design: Repeated, independent cross-sectional studies were conducted between 1993 and 2014. Dietary intake was assessed by using a validated food-frequency questionnaire. Dietary patterns were assessed by using principal components analyses. Results: Among 18,763 adults, 1 healthy ("fish and vegetables”) and 2 unhealthy ("meat and chips” and "chocolate and sweets”) patterns were identified. Scores for the "fish and vegetables” pattern increased, whereas the "meat and chips” and "chocolate and sweets” pattern scores decreased in both sexes and across all age groups. The stronger increase in the "fish and vegetables” pattern score among the less well-educated participants led to a narrowing of educational differences (mean ± SD scores in 1993: −0.56 ± 1.39 compared with −0.05 ± 1.58 in low- compared with highly educated groups, respectively; P < 0.001; scores in 2014: 0.28 ± 1.64 compared with 0.24 ± 1.83, respectively; P = 0.772). Generational analysis showed that older age groups tended to show smaller changes than younger age groups: the yearly score change in "chocolate and sweets” was −0.021 (95% CI: −0.027, −0.014; P < 0.001) for the 35- to 44-y cohort compared with −0.002 (95% CI: −0.009, 0.005; P = 0.546) for the 45- to 54-y cohort. Conclusions: Three dietary patterns were identified; scores for the "fish and vegetables” pattern increased, whereas the "meat and chips” and the "chocolate and sweets” pattern scores decreased. The stronger increases in the "fish and vegetables” pattern score among the less well-educated participants led to a smaller difference in dietary intake across the different educational levels

1999-2009 Trends in prevalence, unawareness, treatment and control of hypertension in Geneva, Switzerland

There are no time trends in prevalence, unawareness, treatment, and control of hypertension in Switzerland. The objective of this study was to analyze these trends and to determine the associated factors

Developing Attitude Measures Based on Respondents’ Representations of Unfamiliar Objects: An Application to Attitudes Towards Biodiversity

A key challenge in the design of effective survey questionnaires is to write questions that respondents can understand consistently. Recommendations in the questionnaire design literature propose the use of respondents’ own terminology to facilitate comprehension and the response process. In this paper, we propose an innovative questionnaire development method to construct items using respondents’ own terminology. On the basis of statistical analyses of answers to an open-ended question asked in a survey measuring attitudes to biodiversity (N = 351), we first identified the words that respondents associate most frequently with the concept of ‘biodiversity’. We then designed new attitude measures composed of the words identified as being central to representations about biodiversity. These items were tested in another survey using a different sample (N = 467). The results show that the attitude items designed on the basis of a social representation method satisfied validity and reliability quality criteria