Inpatient care utilisation and expenditure associated with objective physical activity:econometric analysis of the UK Biobank

BACKGROUND Physical inactivity increases the risk of chronic disease and mortality. The high prevalence of physical inactivity in the UK is likely to increase financial pressure on the National Health Service. The UK Biobank Study offered an opportunity to assess the impact of physical inactivity on healthcare use and spending using individual-level data and objective measures of physical activity. The objective of this study was to assess the associations between objectively measured physical activity levels and future inpatient days and costs in adults in the UK Biobank study. METHODS We conducted an econometric analysis of the UK Biobank study, a large prospective cohort study. The participants (n = 86,066) were UK adults aged 43-79 who had provided sufficient valid accelerometer data. Hospital inpatient days and costs were discounted and standardised to mean monthly values per person to adjust for the variation in follow-up times. Econometric models adjusted for BMI, long-standing illness, and other sociodemographic factors. RESULTS Mean follow-up time for the sample was 28.11 (SD 7.65) months. Adults in the most active group experienced 0.037 fewer days per month (0.059-0.016) and 14.1% lower inpatient costs ( - £3.81 [ - £6.71 to  - £0.91] monthly inpatient costs) compared to adults in the least active group. The relationship between physical activity and inpatient costs was stronger in women compared to men and amongst those in the lowest income group compared to others. The findings remained significant across various sensitivity analyses. CONCLUSIONS Increasing physical activity levels in the UK may reduce inpatient hospitalisations and costs, especially in women and lower-income groups

The Calibration of the WISE W1 and W2 Tully-Fisher Relation

In order to explore local large-scale structures and velocity fields, accurate galaxy distance measures are needed. We now extend the well-tested recipe for calibrating the correlation between galaxy rotation rates and luminosities -- capable of providing such distance measures -- to the all-sky, space-based imaging data from the Wide-field Infrared Survey Explorer (WISE) W1 ($3.4\mu$m) and W2 ($4.6\mu$m) filters. We find a linewidth to absolute magnitude correlation (known as the Tully-Fisher Relation, TFR) of $\mathcal{M}^{b,i,k,a}_{W1} = -20.35 - 9.56 (\log W^i_{mx} - 2.5)$ (0.54 magnitudes rms) and $\mathcal{M}^{b,i,k,a}_{W2} = -19.76 - 9.74 (\log W^i_{mx} - 2.5)$ (0.56 magnitudes rms) from 310 galaxies in 13 clusters. We update the I-band TFR using a sample 9% larger than in Tully & Courtois (2012). We derive $\mathcal{M}^{b,i,k}_I = -21.34 - 8.95 (\log W^i_{mx} - 2.5)$ (0.46 magnitudes rms). The WISE TFRs show evidence of curvature. Quadratic fits give $\mathcal{M}^{b,i,k,a}_{W1} = -20.48 - 8.36 (\log W^i_{mx} - 2.5) + 3.60 (\log W^i_{mx} - 2.5)^2$ (0.52 magnitudes rms) and $\mathcal{M}^{b,i,k,a}_{W2} = -19.91 - 8.40 (\log W^i_{mx} - 2.5) + 4.32 (\log W^i_{mx} - 2.5)^2$ (0.55 magnitudes rms). We apply an I-band -- WISE color correction to lower the scatter and derive $\mathcal{M}_{C_{W1}} = -20.22 - 9.12 (\log W^i_{mx} - 2.5)$ and $\mathcal{M}_{C_{W2}} = -19.63 - 9.11 (\log W^i_{mx} - 2.5)$ (both 0.46 magnitudes rms). Using our three independent TFRs (W1 curved, W2 curved and I-band), we calibrate the UNION2 supernova Type Ia sample distance scale and derive $H_0 = 74.4 \pm 1.4$(stat) $\pm\ 2.4$(sys) kms$^{-1}$ Mpc$^{-1}$ with 4% total error.Comment: 22 page, 21 figures, accepted to ApJ, Table 1 data at http://spartan.srl.caltech.edu/~neill/tfwisecal/table1.tx

Time to 're-think' physical activity promotion for young people? Results from a repeated cross-sectional study

Abstract Background The aim of this study was to investigate the relationship between knowledge of the current UK physical activity (PA) guidelines and amount of daily PA using a sample population of 11–16 year olds in Northern Ireland. Methods Cross-sectional survey data from the 2010 and 2013 Young Persons’ Behaviour and Attitudes Survey of 10,790 young people provided information on PA, knowledge of guidelines and socio-demographic characteristics. Multinomial logistic regression was used to investigate the associations between knowledge and amount of daily PA. Results Results from 2013 showed 67.0% of respondents were aware of PA guidelines with 15.4% reporting meeting them. Males were more likely to meet PA guidelines than females (OR 3.36, 95% CI 2.47, 4.59). Males who were active for 60 min or more, 7 days per week were less likely to be aware of guidelines (OR = 1.51, 95% CI 1.02, 2.24). For females, knowledge of PA guidelines had no significant association with amount of daily PA (OR = 1.74, 95% CI 0.99, 3.07). Those who did not enjoy being active were less likely to meet the guidelines (OR = 0.05, 95% CI 0.02, 0.12). Conclusions Knowledge did not appear to be an important predictor of PA in young people. Consequently, threshold based messaging containing recommended minimum PA guideline information may not be appropriate for this age group. Re-branding PA promotion to include the use of humour may offer a new direction for public health messaging based around fun and enjoyment

First Year Students\u27 Experience in a Cyber World Course - An Evaluation

Although cybersecurity is a major present concern, it is not a required subject in University. In response, we developed Cyber World which introduces students to eight highly important cybersecurity topics (primarily taught by none cybersecurity experts). We embedded it into our critical thinking Common Course (core curriculum) which is a team-taught first-year experience required for all students. Cyber World was first taught in Fall 2018 to a cohort of over 150 students from various majors at the University of New Haven. This article presents the evaluation of our Fall taught course. In detail, we compare the performance of Cyber World students to other Common Course sections that ran in parallel and conclude that despite the higher workload students performed equally well. Furthermore, we assess the students’ development throughout the course with respect to their cybersecurity knowledge where our results indicate a significant gain of knowledge. Note, this article also presents the idea and topics of Cyber World; however a detailed explanation has been released previously

Individual Characteristics Associated with Active Travel in Low and High Income Groups in the UK.

Active travel (AT) has gained increasing attention as a way of addressing low levels of physical activity. However, little is known regarding the relationship between income and AT. The aim of this study was to investigate characteristics associated with undertaking AT in an adult population and by low- and high-income groups. Data collected from the Physical Activity and the Rejuvenation of Connswater (PARC) study in 2017 were used. Participants were categorised into socio-economic groups according to their weekly household income, and were categorised as participating in 'no' AT or 'some' AT and 'sufficient' AT. Multivariable logistic regression explored characteristics associated with AT in the full cohort, and the low- and high-income groups separately. Variables associated with AT in the low-income group were body mass index (BMI), physical activity self-efficacy, marital status, long term illness, difficulty walking and housing tenure. For the high-income group, BMI, marital status, housing tenure and education were associated with AT. For both income groups, there were consistent positive associations with the action/maintenance phase of the stage of change model across all AT categories. The findings suggest that population sub-groups may benefit from targeted initiatives to support engagement in AT and prevent further widening of inequalities

Secondary prevention lifestyle interventions initiated within 90 days after TIA or 'minor' stroke: a systematic review and meta-analysis of rehabilitation programmes

Background Strokes are often preceded by a transient ischaemic attack (TIA) or ‘minor’ stroke. The immediate period after a TIA/minor stroke is a crucial time to initiate secondary prevention. However, the optimal approach to prevention, including non-pharmacological measures, after TIA is not clear. Aim To systematically review evidence about the effectiveness of delivering secondary prevention, with lifestyle interventions, in comprehensive rehabilitation programmes, initiated within 90 days of a TIA/minor stroke. Also, to categorise the specific behaviour change techniques used. Design and setting The review identified randomised controlled trials by searching the Cochrane Library, Ovid MEDLINE, Ovid EMBASE, Web of Science, EBSCO CINAHL and Ovid PsycINFO. Method Two review authors independently screened titles and abstracts for eligibility (programmes initiated within 90 days of event; outcomes reported for TIA/minor stroke) and extracted relevant data from appraised studies; a meta-analysis was used to synthesise the results. Results A total of 31 potentially eligible papers were identified and four studies, comprising 774 patients post-TIA or minor stroke, met the inclusion criteria; two had poor methodological quality. Individual studies reported increased aerobic capacity but meta-analysis found no significant change in resting and peak systolic blood pressure, resting heart rate, aerobic capacity, falls, or mortality. The main behaviour change techniques were goal setting and instructions about how to perform given behaviours. Conclusion There is limited evidence of the effectiveness of early post-TIA rehabilitation programmes with preventive lifestyle interventions. Further robust randomised controlled trials of comprehensive rehabilitation programmes that promote secondary prevention and lifestyle modification immediately after a TIA are needed

Stroke Prevention Rehabilitation Intervention Trial of Exercise (SPRITE) - a randomised feasibility study.

Background The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, ‘The Healthy Brain Rehabilitation Manual’, for patients following a TIA/minor stroke, participants’ views on the intervention and, to identify the behaviour change techniques (BCTs) used. Methods Clinicians were asked to identify patients attending the Ulster Hospital, Belfast within 4 weeks of a first TIA or minor stroke. Those who agreed to participate underwent assessments of physical fitness, cardiovascular risk, quality of life and mental health, before random allocation to: Group (1) standard/usual care; (2) rehabilitation manual or (3) manual plus pedometer. All participants received telephone support at 1 and 4 weeks, reassessment at 6 weeks and an invitation to a focus group exploring views regarding the study. Two trained review authors independently assessed the manual to identify the BCTs used. Results Twenty-eight patients were invited to participate, with 15 (10 men, 5 women; 9 TIA, 6 minor stroke; mean age 69 years) consenting and completing the study. Mean time to enrolment from the TIA/stroke was 20.5 days. Participants completed all assessment measures except VO2max testing, which all declined. The manual and telephone contact were viewed positively, as credible sources of advice. Pedometers were valued highly, particularly for goal-setting. Overall, 36 individual BCTs were used, the commonest being centred around setting goals and planning as well as social support. Conclusion Recruitment and retention rates suggest that a trial to evaluate the effectiveness of a novel home-based CR programme, implemented within 4 weeks of a first TIA/minor stroke is feasible. The commonest BCTs used within the manual revolve around goals, planning and social support, in keeping with UK national guidelines. The findings from this feasibility work have been used to further refine the next stage of the intervention’s development, a pilot study

Scaling Relations of Spiral Galaxies

We construct a large data set of global structural parameters for 1300 field and cluster spiral galaxies and explore the joint distribution of luminosity L, optical rotation velocity V, and disk size R at I- and 2MASS K-bands. The I- and K-band velocity-luminosity (VL) relations have log-slopes of 0.29 and 0.27, respectively with sigma_ln(VL)~0.13, and show a small dependence on color and morphological type in the sense that redder, early-type disk galaxies rotate faster than bluer, later-type disk galaxies for most luminosities. The VL relation at I- and K-bands is independent of surface brightness, size and light concentration. The log-slope of the I- and K-band RL relations is a strong function of morphology and varies from 0.25 to 0.5. The average dispersion sigma_ln(RL) decreases from 0.33 at I-band to 0.29 at K, likely due to the 2MASS selection bias against lower surface brightness galaxies. Measurement uncertainties are sigma_ln(V)~0.09, sigma_ln(L)~0.14 and somewhat larger and harder to estimate for ln(R). The color dependence of the VL relation is consistent with expectations from stellar population synthesis models. The VL and RL residuals are largely uncorrelated with each other; the RV-RL residuals show only a weak positive correlation. These correlations suggest that scatter in luminosity is not a significant source of the scatter in the VL and RL relations. The observed scaling relations can be understood in the context of a model of disk galaxies embedded in dark matter halos that invokes low mean spin parameters and dark halo expansion, as we describe in our companion paper (Dutton et al. 2007). We discuss in two appendices various pitfalls of standard analytical derivations of galaxy scaling relations, including the Tully-Fisher relation with different slopes. (Abridged).Comment: Accepted for publication at ApJ. The full document, with high-resolution B&W and colour figures, is available at http://www.astro.queensu.ca/~courteau/papers/VRL2007ApJ.pdf . Our data base for 1303 spiral galaxies is also available at http://www.astro.queensu.ca/~courteau/data/VRL2007.da

A Revised Model for the Formation of Disk Galaxies: Low Spin and Dark-Halo Expansion

We use observed rotation velocity-luminosity (VL) and size-luminosity (RL) relations to single out a specific scenario for disk galaxy formation in the LCDM cosmology. Our model involves four independent log-normal random variables: dark-halo concentration c, disk spin lam_gal, disk mass fraction m_gal, and stellar mass-to-light ratio M/L_I. A simultaneous match of the VL and RL zero points with adiabatic contraction requires low-c halos, but this model has V_2.2~1.8 V_vir (where V_2.2 and V_vir are the circular velocity at 2.2 disk scale lengths and the virial radius, respectively) which will be unable to match the luminosity function (LF). Similarly models without adiabatic contraction but standard c also predict high values of V_2.2/V_vir. Models in which disk formation induces an expansion rather than the commonly assumed contraction of the dark-matter halos have V_2.2~1.2 V_vir which allows a simultaneous fit of the LF. This may result from non-spherical, clumpy gas accretion, where dynamical friction transfers energy from the gas to the dark matter. This model requires low lam_gal and m_gal values, contrary to naive expectations. However, the low lam_gal is consistent with the notion that disk galaxies predominantly survive in halos with a quiet merger history, while a low m_gal is also indicated by galaxy-galaxy lensing. The smaller than expected scatter in the RL relation, and the lack of correlation between the residuals of the VL and RL relations, respectively, imply that the scatter in lam_gal and in c need to be smaller than predicted for LCDM halos, again consistent with the idea that disk galaxies preferentially reside in halos with a quiet merger history.Comment: 28 pages, 16 figures, ApJ accepted, minor changes from unpublished version, uses emulateapj.cls, high-resolution version available at http://www.ucolick.org/~dutton/65200/hi-res-version/ms.dutton.v2_hr.p