Young people's views on accelerometer use in physical activity research : findings from a user involvement investigation

The use of accelerometers to objectively measure physical activity is important in understanding young people's behaviours, as physical activity plays a key part in obesity prevention and treatment. A user-involvement qualitative study with young people aged 7–18years (n = 35) was carried out to investigate views on accelerometer use to inform an obesity treatment research study. First impressions were often negative, with issues related to size and comfort reported. Unwanted attention from wearing an accelerometer and bullying risk were also noted. Other disadvantages included feeling embarrassed and not being able to wear the device for certain activities. Positive aspects included feeling "special" and having increased attention from friends. Views on the best time to wear accelerometers were mixed. Advice was offered on how to make accelerometers more appealing, including presenting them in a positive way, using a clip rather than elastic belt to attach, personalising the device, and having feedback on activity levels. Judgements over the way in which accelerometers are used should be made at the study development stage and based on the individual population. In particular, introducing accelerometers in a clear and positive way is important. Including a trial wearing period, considering practical issues, and providing incentives may help increase compliance

Time spent in sedentary posture is associated with waist circumference and cardiovascular risk

Background The relationship between metabolic risk and time spent sitting, standing and stepping has not been well established. The present study aimed to determine associations of objectively measured time spent siting, standing and stepping, with coronary heart disease (CHD) risk. Methods A cross-sectional study of healthy non-smoking Glasgow postal workers, n=111 (55 office-workers, 5 women, and 56 walking/delivery-workers, 10 women), who wore activPAL physical activity monitors for seven days. Cardiovascular risks were assessed by metabolic syndrome categorisation and 10-y PROCAM risk. Results Mean(SD) age was 40(8) years, BMI 26.9(3.9)kg/m-2 and waist circumference 95.4(11.9)cm. Mean(SD) HDL-cholesterol 1.33(0.31), LDL-cholesterol 3.11(0.87), triglycerides 1.23(0.64)mmol/l and 10-y PROCAM risk 1.8(1.7)%. Participants spent mean(SD) 9.1(1.8)h/d sedentary, 7.6(1.2)h/d sleeping, 3.9(1.1)h/d standing and 3.3(0.9)h/d stepping, accumulating 14,708(4,984)steps/d in 61(25) sit-to-stand transitions per day. In univariate regressions - adjusting for age, sex, family history of CHD, shift worked, job type and socio-economic status - waist circumference (p=0.005), fasting triglycerides (p=0.002), HDL-cholesterol (p=0.001) and PROCAM-risk (p=0.047) were detrimentally associated with sedentary time. These associations remained significant after further adjustment for sleep, standing and stepping in stepwise regression models. However, after further adjustment for waist circumference, the associations were not significant. Compared to those without the metabolic syndrome, participants with the metabolic syndrome were significantly less active – fewer steps, shorter stepping duration and longer time sitting. Those with no metabolic syndrome features walked >15,000 steps/day, or spent >7h/day upright. Conclusion Longer time spent in sedentary posture is significantly associated with higher CHD risk and larger waist circumference

Cost-effectiveness of obesity treatment

Limitations in epidemiological data means that most health economic analyses have provided incomplete estimates of the total financial burden of obesity on healthcare: more complete data are needed on multiple disease risks and costs attributable to overweight and obesity, stratified by age, sex and BMI, particularly for severe and complicated obesity. UK primary care data indicate that the annual healthcare costs of patients with BMI 20–21 kg/m2 (ideal body weight) are about half those at BMI 40 kg/m2, for both men and women. Cost-effectiveness of structured weight management is high over patients' lifetimes (potentially cost-saving). Drug treatments and bariatric surgery are also highly cost-effective, but have greater unit costs and so afford less net benefit at a population level. Before these interventions can reduce the spiralling healthcare costs associated with obesity, short-term spending is necessary to establish services that will become cost-effective over a longer period

The parent–infant interaction observation scale : reliability and validity of a screening tool

Background: Sensitive responsiveness in parent-infant interaction is a significant predictor of infant attachment security, but frontline practitioners do not currently have the tools to identify 'high-risk' dyads. There is an urgent need for a brief screening tool that can be used by practitioners to screen new parents. Aims: To assess the reliability and validity of the Parent-Infant Interaction Observation Scale (PIIOS) in screening parent-infant interaction at 2-7 months. Method: Twenty-three professionals trained in parent-infant observation rated 14 3-minute videotapes of parent-infant interaction using the PIIOS in two studies. Inter-rater reliability was assessed using intraclass correlation coefficients, and validity was assessed by comparing the CARE-Index Maternal Sensitivity scale with the new scale, with inter-item correlation expressed as mean difference and 95% confidence intervals (CI). Results: The inter-rater reliability was excellent - study 1 0.94 (95% CI 0.92-0.95) and study 2 0.94 (95% CI 0.93-0.95). Higher correlation coefficients were obtained for scores in the lower range. A strong overall correlation coefficient was obtained with the CARE-Index Sensitivity scale - study 1: -0.88, and study 2: -0.86 (p < 0.001), ranging from 0.60 to 0.94 (study 1) and 0.59 to 0.89 (study 2) for individual coders. There was also strong internal consistency with positive correlations between each item score and the total score (range: 0.55-0.87). Conclusion: The PIIOS comprises a brief and easily administered method of screening parent-infant interaction, which could be used by primary care practitioners to identify parents in need of further support

Saudi female school teachers’ knowledge and opinion related to physical exercise for school children

The study explores possible barriers behind physical inactivity in female students. The method of the research is cross-sectional quantitative study. The findings based on assessing female teachers’ level of knowledge about physical exercise for girls through distributing a questionnaire to female teachers of Al-Abna’a Schools in Riyadh, Saudi Arabia. The results show that the majority of the participants believe that physical exercise is important for children and girls should attend physical exercise classes in school. However, teachers’ levels of knowledge regarding physical exercise recommendation for children are low. Some of the barriers of regular physical exercise in children are lack of social and parental support, children’s low interest in physical exercise, and lack of sports facilities suitable for young girls

The validity and reliability of a novel activity monitor as a measure of walking

Background: The accurate measurement of physical activity is crucial to understanding the relationship between physical activity and disease prevention and treatment. Objective: The primary purpose of this study was to investigate the validity and reliability of the activPAL physical activity monitor in measuring step number and cadence. Methods: The ability of the activPAL monitor to measure step number and cadence in 20 healthy adults (age 34.5±6.9 years; BMI 26.8±4.8 (mean±SD)) was evaluated against video observation. Concurrently, the accuracy of two commonly used pedometers, the Yamax Digi-Walker SW-200 and the Omron HJ-109-E, was compared to observation for measuring step number. Participants walked on a treadmill at five different speeds (0.90, 1.12, 1.33, 1.56, and 1.78 m/s) and outdoors at three self selected speeds (slow, normal, and fast). Results: At all speeds, inter device reliability was excellent for the activPAL (ICC (2,1)⩾0.99) for both step number and cadence. The absolute percentage error for the activPAL was <1.11% for step number and cadence regardless of walking speed. The accuracy of the pedometers was adversely affected by slow walking speeds. Conclusion: The activPAL monitor is a valid and reliable measure of walking in healthy adults. Its accuracy is not influenced by walking speed. The activPAL may be a useful device in sports medicine

The validation of a novel activity monitor in the measurement of posture and motion during everyday activities

Background: Accurate measurement of physical activity patterns can be used to identify sedentary behaviour and may facilitate interventions aimed at reducing inactivity. Objective: To evaluate the activPAL physical activity monitor as a measure of posture and motion in everyday activities using observational analysis as the criterion standard. Methods: Wearing three activPAL monitors, 10 healthy participants performed a range of randomly assigned everyday tasks incorporating walking, standing and sitting. Each trial was captured on a digital camera and the recordings were synchronised with the activPAL. The time spent in different postures was visually classified and this was compared with the activPAL output. Results: Intraclass correlation coefficients (ICC 2,1) for interdevice reliability ranged from 0.79 to 0.99. Using the Bland and Altman method, the mean percentage difference between the activPAL monitor and observation for total time spent sitting was 0.19% (limits of agreement −0.68% to 1.06%) and for total time spent upright was −0.27% (limits of agreement −1.38% to 0.84%). The mean difference for total time spent standing was 1.4% (limits of agreement −6.2% to 9.1%) and for total time spent walking was −2.0% (limits of agreement −16.1% to 12.1%). A second-by-second analysis between observer and monitor found an overall agreement of 95.9%. Conclusion: The activPAL activity monitor is a valid and reliable measure of posture and motion during everyday physical activities

Assessing geographic co-morbidity associated with vascular diseases in South Africa : a joint Bayesian Modeling approach

The growing incidence of chronic conditions associated with changing lifestyles is creating new challenges for African countries; most of which are struggling with widespread infectious diseases. The dangers of infectious diseases such as malaria, HIV/AIDS and tuberculosis in Africa are well-known. However, the growing public health problems associated with lifestyle and chronic diseases such as heart disease, stroke, obesity, diabetes, cancer, as well as those associated with smoking, alcohol and drug abuse are not widely recognised. Changing lifestyles and dietary patterns, declining levels of physical activity and an increasingly long-lived population all play a role as African countries move through stages of nutritional and epidemiologic transitions (Mensah 2008). The shift from infectious to chronic diseases is accelerating: it’s projected that by 2020, chronic diseases will account for almost three-quarters of all deaths worldwide and that 60 % of the burden of chronic diseases will occur in developing countries (WHO 2011)

A physically active occupation does not result in compensatory inactivity during out-of-work hours

To examine differences in non-occupational physical activity behaviour in workers who engage in high and low occupational physical activity. Design Cross-sectional survey of 112 otherwise comparable volunteers in active (56 walking postal delivery workers) or inactive (56 administrative postal workers) occupations in Glasgow (Scotland) in 2007. Methods Twenty four-hour physical activity (steps and time standing, walking and sedentary) patterns were measured using activPAL™ for seven days. Comparisons were made during 8-hour work-shifts, during non-work hours on work-days and during the 2 non-work days. Results Age and body mass index of delivery and office staff, respectively, were (means (SD)) 38 (9) years versus 40 (7) years and 26.3 (3) kg m− 2 versus 27.4 (4) kg m− 2. Delivery staff spent substantially longer time than office staff upright (6.0 (1.1) h versus 3.9 (1.5) h) and walking (3.1 (0.7) h versus 1.6 (0.7) h) and amassed more steps (16,035 (4264) versus 6709 (2808)) during 8-hour work-shifts and over 24 h on work days. During non-work hours of work-days and during non-work days, there were no significant differences in physical activity between the groups. The results were unchanged when the 15 women were excluded. Conclusion Having a more active occupation is not associated with more inactivity during non-work hours

A patient-centred approach to estimate total annual healthcare cost by body mass index in the UK Counterweight programme

Background: Previous studies, based on relative risks for certain secondary diseases, have shown greater healthcare costs in higher body mass index (BMI) categories. The present study quantifies the relationship between BMI and total healthcare expenditure, with the patient as the unit of analysis. Methods: Analyses of cross-sectional data, collected over 18-months in 2002–2003, from 3324 randomly selected patients, in 65 general practices across UK. Healthcare costs estimated from primary care, outpatient, accident/emergency and hospitalisation attendances, weighted by unit costs taken from standard sources. Results: In univariate analyses, significant associations (Pmen, drinkernon-smokers, and increasing with greater physical activity, age and BMI. In multivariate analysis, age, sex, BMI, smoking and alcohol consumption remained significantly associated with healthcare cost, and together explained just 9% of the variance in healthcare expenditure. Adjusted total annual healthcare cost was £16 (95% CI £11–£21) higher per unit BMI. All cost categories were significantly (P40 compared with BMI <20 kg m−2: prescription drugs (men: £390 versus £16; women: £211 versus £73), hospitalisation (men: £72 versus £0; women: £243 versus £107), primary care (men: £191 versus £69; women: £268 versus £153) and outpatient care (£234 versus £107 women only). Conclusions: Annual healthcare expenditure rose a mean of £16 per unit greater BMI, doubling between BMI 20–40 kg m−2. This gradient may be an underestimate if the lower-BMI patients with heights and weights recorded had other costly diseases