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

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

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

Interventions promoting active transport to school in children: A systematic review and meta-analysis

The systematic review investigated the effectiveness of active travel (AT) interventions on physical activity and fitness in primary school children. The review assessed intervention effectiveness, design, complexity, and study quality. Searches were conducted in five databases on 30/08/2018. Studies with an AT intervention compared to an inactive control, in 4 to 11 year olds, measuring AT or fitness outcomes were included. Two-stage screening identified relevant studies. Relevant data were extracted using Cochrane Extraction Form, Quality Assessment Tool for Quantitative Studies, Active Living by Design model, and intervention Complexity Assessment Tool for Systematic Reviews. Meta-analysis and Cohen's D effect size assessed effectiveness. Seventeen eligible studies were included. Effectiveness assessment found a statistically significant standardised mean difference (SMD) in AT outcomes in favour of the intervention (continuous AT - SMD 0.78 (CI 0.11–1.46); frequency AT - SMD 1.87 (CI 0.88–2.86)). Cohen's D calculation concurred with this finding. Fifteen studies had SMD favouring the intervention – two studies had SMD favouring the control. Sixteen studies received a weak quality rating - one study rated moderate. Active travel shows promise in increasing physical activity in primary school children. The review found walking school buses and educational strategies most effective for increasing relevant outcomes, although overall study quality was weak. Effect size did not associate with the complexity of an intervention, therefore supporting efforts to promote active travel through interventions may be easier to scale. Further intervention studies of greater methodological quality are necessary to confirm these findings due to the limited evidence available

Impact of Abamectin on Anagrus Nilaparvatae, an Egg Parasitoid of Nilaparvata Lugens

Anagrus nilaparvatae (Hymenoptera: Mymaridae) is an egg parasitoid potential for controlling the major pests on rice, the brown planthopper (Nilaparvata lugens [Hemiptera: Delphacidae]).Abamectin is one of insecticides registered for N. lugens. The research was aimed to investigate the impact of contact application of abamectin on the parasitism level of A. nilaparvatae under laboratory conditions. Adults of A. nilaparvatae and the first instars as well as adults of N. lugens were exposed to the residue of abamection inside the test tube. A. nilaparvatae was much more susceptible to abamectin compared to N. lugens. Application of abamectin at the recommended concentration (22.78 ppm) for 30 min caused 100% mortality, and it reduced to 85% when the concentration was decreased to 0.36 ppm. In contrast, the mortality for the first instar of N. lugens was only 15% at 22.78 and no mortality at 0.36 ppm. No N. lugens adults died even when they were exposed to 22.78 ppm. Furthermore, the parasitism test was conducted using 38 days after planting of IR-64 rice variety. Those plants were infested with 50 females of N. lugens for 2 days. A. nilaparvatae were exposed by contact to 0.02, 0.23, and 2.28 ppm of abamectin. The survivors were released to the rice plant containing eggs of N. lugens. Contact application of abamectin reduced parasitism level of A. nilaparvatae as much as 86.34, 70.01, and 28.43% with concentrations of 2.28 ppm, 0.23 and 0.02 ppm, respectively. In addition, the number of parasitoids emerged decreased with increasing concentration of abamectin. These results suggest that abamectin could be detrimental to A. nilaparvatae due to direct mortality, reduced the parasitism level, and decreased the number of progeny produced. IntisariAnagrus nilaparvatae (Hymenoptera: Mymaridae) merupakan salah satu parasitoid telur yang berpotensi untuk mengendalikan hama utama tanaman padi, wereng batang padi cokelat (Nilaparvata lugens [Hemiptera: Delphacidae]). Abamektin adalah salah satu insektisida yang terdaftar untuk pengendalian N. lugens. Penelitian ini bertujuan untuk mengetahui dampak aplikasi kontak abamektin terhadap suseptibilitas dan tingkat parasitasi A. nilaparvatae terhadap telur N. lugens pada kondisi laboratorium. Imago A. nilaparvatae serta instar satu dan imago N. lugens dipapar dengan residu abamektin di dalam tabung reaksi. A. nilaparvatae lebih peka terhadap abamektin dibandingkan N. lugens. Aplikasi abamektin pada konsentrasi anjuran (22,78 ppm) selama 30 menit menyebabkan mortalitas A. nilaparvatae 100%, dan mengurangi sampai dengan 85% pada konsentrasi yang lebih rendah 0,36 ppm. Sebaliknya, mortalitas instar satu N. lugens hanya sebesar 15% pada 22,78 ppm dan tidak menimbulkan kematian pada 0,36 ppm. Konsentrasi 22,78 ppm tidak menimbulkan kematian imago N. lugens. Selanjutnya, uji parasitasi dilakukan menggunakan media tanaman padi varietas IR-64 umur 38 hari setelah tanam. Tanaman diinfestasi dengan 50 ekor betina N. lugens selama dua hari. A. nilaparvatae dipapar abamektin dengan metode kontak pada konsentrasi 0.02, 0,23, dan 2,28 ppm. Parasitoid yang mampu bertahan hidup dilepaskan pada tanaman padi yang telah diinfestasi telur N. lugens. Aplikasi kontak abamektin mengurangi tingkat parasitasi A. nilaparvatae sebesar 86,34, 70.01, dan 28,43% pada konsentrasi 2,28; 0,23; dan 0,02 ppm. Selain itu, jumlah parasitoid yang muncul semakin menurun dengan peningkatan konsentrasi abamektin. Hasil ini menunjukkan bahwa abamektin dapat merugikan secara langsung terhadap mortalitas serta mengurangi tingkat parasitasi dan jumlah keturunan A. nilaparvatae