Canadian children's and youth's pedometer-determined steps/day, parent-reported TV watching time, and overweight/obesity: The CANPLAY Surveillance Study

<p>Abstract</p> <p>Background</p> <p>This study examines associations between pedometer-determined steps/day and parent-reported child's Body Mass Index (BMI) and time typically spent watching television between school and dinner.</p> <p>Methods</p> <p>Young people (aged 5-19 years) were recruited through their parents by random digit dialling and mailed a data collection package. Information on height and weight and time spent watching television between school and dinner on a typical school day was collected from parents. In total, 5949 boys and 5709 girls reported daily steps. BMI was categorized as overweight or obese using Cole's cut points. Participants wore pedometers for 7 days and logged daily steps. The odds of being overweight and obese by steps/day and parent-reported time spent television watching were estimated using logistic regression for complex samples.</p> <p>Results</p> <p>Girls had a lower median steps/day (10682 versus 11059 for boys) and also a narrower variation in steps/day (interquartile range, 4410 versus 5309 for boys). 11% of children aged 5-19 years were classified as obese; 17% of boys and girls were overweight. Both boys and girls watched, on average, < 40 minutes of television between school and dinner on school days. Adjusting for child's age and sex and parental education, the odds of a child being obese decreased by 20% for every extra 3000 steps/day and increased by 21% for every 30 minutes of television watching. There was no association of being overweight with steps/day, however the odds of being overweight increased by 8% for every 30 minutes of additional time spent watching television between school and dinner on a typical school day.</p> <p>Discussion</p> <p>Television viewing is the more prominent factor in terms of predicting overweight, and it contributes to obesity, but steps/day attenuates the association between television viewing and obesity, and therefore can be considered protective against obesity. In addition to replacing opportunities for active alternative behaviours, exposure to television might also impact body weight by promoting excess energy intake.</p> <p>Conclusions</p> <p>In this large nationally representative sample, pedometer-determined steps/day was associated with reduced odds of being obese (but not overweight) whereas each parent-reported hour spent watching television between school and dinner increased the odds of both overweight and obesity.</p

Patterns of impact resulting from a 'sit less, move more' web-based program in sedentary office employees.

PURPOSE: Encouraging office workers to 'sit less and move more' encompasses two public health priorities. However, there is little evidence on the effectiveness of workplace interventions for reducing sitting, even less about the longer term effects of such interventions and still less on dual-focused interventions. This study assessed the short and mid-term impacts of a workplace web-based intervention (Walk@WorkSpain, W@WS; 2010-11) on self-reported sitting time, step counts and physical risk factors (waist circumference, BMI, blood pressure) for chronic disease. METHODS: Employees at six Spanish university campuses (n=264; 42±10 years; 171 female) were randomly assigned by worksite and campus to an Intervention (used W@WS; n=129; 87 female) or a Comparison group (maintained normal behavior; n=135; 84 female). This phased, 19-week program aimed to decrease occupational sitting time through increased incidental movement and short walks. A linear mixed model assessed changes in outcome measures between the baseline, ramping (8 weeks), maintenance (11 weeks) and follow-up (two months) phases for Intervention versus Comparison groups. RESULTS: A significant 2 (group) × 2 (program phases) interaction was found for self-reported occupational sitting (F[3]=7.97, p=0.046), daily step counts (F[3]=15.68, p=0.0013) and waist circumference (F[3]=11.67, p=0.0086). The Intervention group decreased minutes of daily occupational sitting while also increasing step counts from baseline (446±126; 8,862±2,475) through ramping (+425±120; 9,345±2,435), maintenance (+422±123; 9,638±3,131) and follow-up (+414±129; 9,786±3,205). In the Comparison group, compared to baseline (404±106), sitting time remained unchanged through ramping and maintenance, but decreased at follow-up (-388±120), while step counts diminished across all phases. The Intervention group significantly reduced waist circumference by 2.1cms from baseline to follow-up while the Comparison group reduced waist circumference by 1.3cms over the same period. CONCLUSIONS: W@WS is a feasible and effective evidence-based intervention that can be successfully deployed with sedentary employees to elicit sustained changes on "sitting less and moving more"

Frequency of Injuries from Line Entanglements, Killer Whales, and Ship Strikes on Bering-Chukchi-Beaufort Seas Bowhead Whales

We analyzed scarring data for Bering-Chukchi-Beaufort (BCB) Seas bowhead whales (Balaena mysticetus) harvested by Alaska Native hunters to quantify the frequency of line entanglement, ship strikes, and killer whale-inflicted injuries. We had 904 records in our database for whales landed between 1990 and 2012, and after data quality screening, we found 521 records containing information on scarring. Logistic regression was used to evaluate different combinations of explanatory variables (i.e., body length, sex, year, year-group) to develop a prediction model for each scar type. We also list bowhead whales that were harvested, found dead, or observed alive entangled in commercial line/fishing gear. Our findings suggest that about 12% of harvested bowheads show entanglement scars. Their frequency is highly correlated with body length and sex: about 50% of very large bowheads (&gt; 17 m) show such scars, while whales under 9 m rarely do, and males show a significantly higher rate than females. Scars associated with ship strikes are infrequent and occur on ~2% of all harvested whales; body length, sex, and year were not significant factors. Scarring from attempted killer whale predation was evident on ~8% of landed whales. As with entanglement injuries, the frequency of killer whale scars was much higher (&gt; 40%) on whales more than 16 m in length and statistically more frequent in the second half of the study (2002 – 12). Increased killer whale injuries in the recent decade are consistent with studies conducted on bowheads of the Eastern Canada-West Greenland population. The findings presented here reflect the most thorough analysis of injury rates from entanglement, ships, and killer whales for the BCB bowheads conducted to date. They indicate that (1) entanglement rates primarily from pot fishing gear (crab or cod or both) are relatively high for very large and presumably older bowheads, (2) collisions with ships are infrequent at present, and (3) scarring from killer whales is frequent on very large adult whales (&gt; 17 m). Considering that bowhead habitat is changing rapidly (e.g., sea ice reduction), industrial ship traffic in the Arctic is increasing, and commercial fishing operations are expanding to the north, we strongly recommend that monitoring of scarring and injuries on harvested bowheads continue into the future as a means of documenting change.Nous avons analysé les données sur les cicatrices que portent les baleines boréales (Balaena mysticetus) des mers de Béring, des Tchouktches et de Beaufort capturées par des chasseurs autochtones de l’Alaska afin de quantifier la fréquence d’emmêlements dans des filets de pêche, de collisions avec des navires et de blessures infligées par des épaulards. Notre base de données contenait 904 enregistrements portant sur des baleines prises entre 1990 et 2012 et, après une sélection des données selon leur qualité, nous avons trouvé 521 enregistrements comptant de l’information sur des cicatrices. Une méthode de régression logistique a été utilisée pour évaluer différentes combinaisons de variables explicatives (longueur corporelle, sexe, année et année-groupe, par exemple) afin de concevoir un modèle prédictif pour chaque type de cicatrice. Nous énumérons également les baleines boréales retrouvées emmêlées dans des engins ou des filets de pêche commerciale qui ont été capturées, trouvées mortes ou observées vivantes. Nos découvertes suggèrent qu’environ 12 % des baleines boréales capturées portent des cicatrices causées par l’emmêlement. La fréquence des cicatrices est étroitement liée à la longueur corporelle et au sexe : environ 50 % des baleines boréales de très grande taille (&gt; 17 m) montrent de telles cicatrices, tandis que les baleines mesurant moins de 9 m portent rarement de telles cicatrices. Par ailleurs, les mâles affichent beaucoup plus de cicatrices que les femelles. Les cicatrices reliées à des collisions avec des navires sont rares et n’apparaissent que sur environ 2 % de toutes les baleines capturées; la longueur corporelle, le sexe et l’année n’étaient pas des facteurs importants. Les cicatrices causées par des tentatives de prédation par les épaulards étaient apparentes sur environ 8 % des baleines prises. Comme pour les blessures causées par l’emmêlement, la fréquence des cicatrices causées par des épaulards était beaucoup plus élevée(&gt; 40 %) sur les baleines mesurant plus de 16 m de longueur et statistiquement plus fréquente dans la deuxième partie de l’étude (2002–2012). L’augmentation des blessures causées par des épaulards au cours de la dernière décennie concorde avec les études réalisées sur la population des baleines boréales de l’est du Canada et de l’ouest du Groenland. Les résultats présentés dans cette étude reflètent l’analyse la plus profonde du taux de blessures causées par l’emmêlement, les navires et les épaulards sur les baleines boréales des mers de Béring, des Tchouktches et de Beaufort à avoir été réalisée jusqu’à présent. Les observations indiquent que : 1) le taux d’emmêlement découlant principalement des engins ou casiers de pêche (crabe ou morue ou les deux) est relativement élevé chez les baleines boréales de très grande taille et probablement plus vieilles, 2) les collisions avec les navires sont rares en ce moment, et 3) les cicatrices causées par des épaulards sont fréquentes chez les baleines adultes de très grande taille (&gt; 17 m). Étant donné le changement rapide de l’habitat de la baleine boréale (diminution des glaces marines, par exemple), l’augmentation de la circulation maritime industrielle dans l’Arctique et l’intensification des opérations de pêche commerciale au nord, nous recommandons fortement de continuer de surveiller les cicatrices et les blessures des baleines boréales capturées afin de documenter les changements

Does physical activity counselling enhance the effects of a pedometer-based intervention over the long-term : 12-month findings from the Walking for Wellbeing in the West study

Peer reviewedPublisher PD

Powered mobility interventions for very young children with mobility limitations to aid participation and positive development:the EMPoWER evidence synthesis

Background One-fifth of all disabled children have mobility limitations. Early provision of powered mobility for very young children (aged < 5 years) is hypothesised to trigger positive developmental changes. However, the optimum age at which to introduce powered mobility is unknown. Objective The aim of this project was to synthesise existing evidence regarding the effectiveness and cost-effectiveness of powered mobility for very young children, compared with the more common practice of powered mobility provision from the age of 5 years. Review methods The study was planned as a mixed-methods evidence synthesis and economic modelling study. First, evidence relating to the effectiveness, cost-effectiveness, acceptability, feasibility and anticipated outcomes of paediatric powered mobility interventions was reviewed. A convergent mixed-methods evidence synthesis was undertaken using framework synthesis, and a separate qualitative evidence synthesis was undertaken using thematic synthesis. The two syntheses were subsequently compared and contrasted to develop a logic model for evaluating the outcomes of powered mobility interventions for children. Because there were insufficient published data, it was not possible to develop a robust economic model. Instead, a budget impact analysis was conducted to estimate the cost of increased powered mobility provision for very young children, using cost data from publicly available sources. Data sources A range of bibliographic databases [Cumulative Index to Nursing and Allied Health Literature (CINHAL), MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), Physiotherapy Evidence Database (PEDro), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), Applied Social Sciences Index and Abstracts (ASSIA), PsycINFO, Science Citation Index (SCI; Clarivate Analytics, Philadelphia, PA, USA), Social Sciences Citation Index™ (SSCI; Clarivate Analytics), Conference Proceedings Citation Index – Science (CPCI-S; Clarivate Analytics), Conference Proceedings Citation Index – Social Science & Humanities (CPCI-SSH; Clarivate Analytics), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA) Database and OpenGrey] was systematically searched and the included studies were quality appraised. Searches were carried out in June 2018 and updated in October 2019. The date ranges searched covered from 1946 to September 2019. Results In total, 89 studies were included in the review. Only two randomised controlled trials were identified. The overall quality of the evidence was low. No conclusive evidence was found about the effectiveness or cost-effectiveness of powered mobility in children aged either < 5 or ≥ 5 years. However, strong support was found that powered mobility interventions have a positive impact on children’s movement and mobility, and moderate support was found for the impact on children’s participation, play and social interactions and on the safety outcome of accidents and pain. ‘Fit’ between the child, the equipment and the environment was found to be important, as were the outcomes related to a child’s independence, freedom and self-expression. The evidence supported two distinct conceptualisations of the primary powered mobility outcome, movement and mobility: the former is ‘movement for movement’s sake’ and the latter destination-focused mobility. Powered mobility should be focused on ‘movement for movement’s sake’ in the first instance. From the budget impact analysis, it was estimated that, annually, the NHS spends £1.89M on the provision of powered mobility for very young children, which is < 2% of total wheelchair service expenditure. Limitations The original research question could not be answered because there was a lack of appropriately powered published research. Conclusions Early powered mobility is likely to have multiple benefits for very young children, despite the lack of robust evidence to demonstrate this. Age is not the key factor; instead, the focus should be on providing developmentally appropriate interventions and focusing on ‘movement for movement’s sake’. Future work Future research should focus on developing, implementing, evaluating and comparing different approaches to early powered mobility. Study registration This study is registered as PROSPERO CRD42018096449. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology programme and will be published in full in Health Technology Assessment; Vol. 24, No. 50. See the NIHR Journals Library website for further project information

Non-response bias in physical activity trend estimates

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