An informational stair climbing intervention with greater effects in overweight pedestrians

Previous interventions have successfully increased levels of stair climbing in public-access settings (e.g. malls). This study used robust methods to establish the magnitude of intervention effects among a specific target group—the overweight. Ascending stair/escalator users (N = 20 807) were observed in a mall. A 2-week baseline was followed by a 5-week intervention in which message banners, promoting stair climbing, were attached to the stair risers. Standardized silhouettes were used to code individuals as normal/overweight. Logistic regression analyses were conducted with stair/escalator choice as the outcome variable and weight status entered as a moderator alongside condition, gender, ethnicity and ‘pedestrian traffic volume’. Overall, the intervention significantly increased the rate of stair climbing [odds ratio (OR) = 1.28, 95% confidence intervals (CI) = 1.08–1.53], with the effects sustained over 5 weeks. There were differential effects between weight categories, with greater increases in overweight (OR = 1.95, CI = 1.34–2.83) versus normal weight individuals (OR = 1.29, CI = 1.09–1.53). In conclusion, message prompts produced larger effects among overweight individuals, who could benefit most from stair climbing. The public health value of these interventions may, therefore, be greater than realized. The heightened effects among the overweight were likely due to the salience of the current message, which linked stair climbing with the target of weight control

Promoting stair climbing in public-access settings: an audit of intervention opportunities in England

Objective: Introducing message prompts at the ‘point-of-choice’ (POC) between stairs and escalators increases stair choice in ‘public-access’ settings (e.g. malls). For nationwide campaigns, plentiful POCs appear needed. We audited the availability of POCs in public-access settings across England. Methods: Boundaries for 25 urban areas (population=6,829,874) were verified using Ordinance Survey maps, which showed all airports and train/tram stations. Malls and bus stations were identified from commercial listings and local authority web-pages. From September 2010-March 2011 two investigators visually inspected all venues (N=410), counting ‘true’ POCs and ‘quasi’ POCs (i.e. instances where stairs were visible from, but not adjacent to, escalators). Results: 5% of venues had ≥1 true POC (quasi POC=3%). Aggregating across areas, there was a true and quasi POC for every 243,924 and 379,437 people, respectively. There were regional variations; one area had 10 true/quasi POCs, whilst 10/24 remaining areas had none. POCs were more common in airports (4/6 venues) than malls (11/85) and train stations (4/215). Conclusion: Although public-access POCs reach sizeable audiences, their availability in England is sporadic, precluding nationwide campaigns. Interventions should be considered locally, based on available POCs. Work/community venues (e.g. offices, hospitals), where pedestrians choose between stairs and elevators, may provide greater intervention opportunities

Promoting stair climbing: effects of message specificity and validation

Current exercise guidelines encourage the daily accumulation of lifestyle activities, such as stair climbing. Although several studies show that visual prompts can increase stair usage, there has been little systematic assessment of the messages employed. Some of the messages used in previous interventions represent general descriptions of stair climbing (e.g. ‘free exercise’), while others emphasize specific consequences of stair use (e.g. ‘keeps you fit’). Twelve hundred structured interviews were conducted in order to establish which type of message is more persuasive. In addition, half of the interviewees were told that the messages were true, in order to assess how validating messages may influence their persuasive appeal. Results suggest that messages focussing on specific consequences are more persuasive than those providing general descriptions and that validating the information presented in stair-climbing interventions may increase their efficacy. Previous messages may not, therefore, have demonstrated the full potential of stair climbing as a model for increasing population activity levels

The acceptability of homebased exercise snacking and Tai-chi snacking amongst high and low function UK and Taiwanese older adults

Introduction: Exercise “snacking” and Tai-chi ‘snacking’ protocols are designed to overcome typical barriers to older adults’ participation in muscle strength and balance exercise, using short bouts of home-based exercise. This study aimed to investigate the acceptability of homebred exercise- and Tai-chi snacking in British and Taiwanese older adults of high and low physical function. Methods: Thirty-three British and Thirty Taiwanese older adults took part in semi-structured interviews, after trying 1-week of exercise- and Tai-chi snacking. The interview schedule and deductive framework analysis was based on the seven components of the Theoretical Framework of Acceptability (TFA). Differences between the Taiwanese and United Kingdom participants and those considered high versus low physical function were also analysed. Results: Both snacking regimes were found to be convenient and easy to implement. Participants reported that no activity had to be given up, and considered the programmes would be beneficial to their physical and mental health. Interestingly, more UK-based participants preferred the elegant and relaxing movements of Tai-chi snacking, yet participants with low physical function experienced difficulties when mastering Tai-chi movements. A few high physical function participants perceived exercise snacking to be tedious. Discussion: Overall, the snacking exercise was found to be acceptable and useful. Personal affective attitude and different cultural backgrounds may affect exercise participation. Nevertheless, it is important to consider individuals’ physical function when designing exercise regime. The findings indicate that making Tai-chi snacking easier to master initially, building in progression and adding some upper body movements in the exercise snacking may further enhance acceptability.</p

A multi-component stair climbing promotional campaign targeting calorific expenditure for worksites; a quasi-experimental study testing effects on behaviour, attitude and intention

BACKGROUND: Accumulation of lifestyle physical activity is a current aim of health promotion, with increased stair climbing one public health target. While the workplace provides an opportunity for regular stair climbing, evidence for effectiveness of point-of-choice interventions is equivocal. This paper reports a new approach to worksite interventions, aimed at changing attitudes and, hence, behaviour. METHODS: Pre-testing of calorific expenditure messages used structured interviews with members of the public (n = 300). Effects of multi-component campaigns on stair climbing were tested with quasi-experimental, interrupted time-series designs. In one worksite, a main campaign poster outlining the amount of calorific expenditure obtainable from stair climbing and a conventional point-of-choice prompt were used (Poster alone site). In a second worksite, additional messages in the stairwell about calorific expenditure reinforced the main campaign (Poster + Stairwell messages site). The outcome variables were automated observations of stair and lift ascent (28,854) and descent (29,352) at baseline and for three weeks after the intervention was installed. Post-intervention questionnaires for employees at the worksites assessed responses to the campaign (n = 253). Analyses employed Analysis of Variance with follow-up Bonferroni t-tests (message pre-testing), logistic regression of stair ascent and descent (campaign testing), and Bonferroni t-tests and multiple regression (follow-up questionnaire). RESULTS: Pre-testing of messages based on calorific expenditure suggested they could motivate stair climbing if believed. The new campaign increased stair climbing, with greater effects at the Poster + Stairwell messages site (OR = 1.52, 95% CI = 1.40-1.66) than Posters alone (OR = 1.24, 95% CI = 1.15-1.34). Follow-up revealed higher agreement with two statements about calorific outcomes of stair climbing in the site where they were installed in the stairwell, suggesting more positive attitudes resulted from the intervention. Future intentions for stair use were predicted by motivation by the campaign and beliefs that stair climbing would help weight control. CONCLUSIONS: Multi-component campaigns that target attitudes and intentions may substantially increase stair climbing at work

The ocean's gravitational potential energy budget in a coupled climate model

This study examines, in a unified fashion, the budgets of ocean gravitational potential energy (GPE) and available gravitational potential energy (AGPE) in the control simulation of the coupled atmosphere–ocean general circulation model HadCM3. Only AGPE can be converted into kinetic energy by adiabatic processes. Diapycnal mixing supplies GPE, but not AGPE, whereas the reverse is true of the combined effect of surface buoyancy forcing and convection. Mixing and buoyancy forcing, thus, play complementary roles in sustaining the large scale circulation. However, the largest globally integrated source of GPE is resolved advection (+0.57 TW) and the largest sink is through parameterized eddy transports (-0.82 TW). The effect of these adiabatic processes on AGPE is identical to their effect on GPE, except for perturbations to both budgets due to numerical leakage exacerbated by non-linearities in the equation of state

Interpretation and application of carbon isotope ratios in freshwater diatom silica

Carbon incorporated into diatom frustule walls is protected from degradation enabling analysis for carbon isotope composition (δ13Cdiatom). This presents potential for tracing carbon cycles via a single photosynthetic host with well-constrained ecophysiology. Improved understanding of environmental processes controlling carbon delivery and assimilation is essential to interpret changes in freshwater δ13Cdiatom. Here relationships between water chemistry and δ13Cdiatom from contemporary regional data sets are investigated. Modern diatom and water samples were collected from river catchments within England and lake sediments from across Europe. The data suggest dissolved, biogenically produced carbon supplied proportionately to catchment productivity was critical in the rivers and soft water lakes. However, dissolved carbon from calcareous geology overwhelmed the carbon signature in hard water catchments. Both results demonstrate carbon source characteristics were the most important control on δ13Cdiatom, with a greater impact than productivity. Application of these principles was made to a sediment record from Lake Tanganyika. δ13Cdiatom co-varied with δ13Cbulk through the last glacial and Holocene. This suggests carbon supply was again dominant and exceeded authigenic demand. This first systematic evaluation of contemporary δ13Cdiatom controls demonstrates that diatoms have the potential to supply a record of carbon cycling through lake catchments from sediment records over millennial timescales

A decomposition of the Atlantic meridional overturning

A decomposition of meridional overturning circulation (MOC) cells into geostrophic vertical shears, Ekman, and bottom pressure–dependent (or external mode) circulation components is presented. The decomposition requires the following information: 1) a density profile wherever bathymetry changes to construct the vertical shears component, 2) the zonal-mean zonal wind stress for the Ekman component, and 3) the mean depth-independent velocity information over each isobath to construct the external mode. The decomposition is applied to the third-generation Hadley Centre Coupled Ocean–Atmosphere General Circulation Model (HadCM3) to determine the meridional variability of these individual components within the Atlantic Ocean. The external mode component is shown to be extremely important where western boundary currents impinge on topography, and also in the area of the overflows. The Sverdrup balance explains the shape of the external mode MOC component to first order, but the time variability of the external mode exhibits only a very weak dependence on the wind stress curl. Thus, the Sverdrup balance cannot be used to determine the external mode changes when examining temporal change in the MOC. The vertical shears component allows the time-mean and the time-variable upper North Atlantic MOC cell to be deduced at 25°S and 50°N. A stronger dependency on the external mode and Ekman components between 8° and 35°N and in the regions of the overflows means that hydrographic sections need to be supplemented by bottom pressure and wind stress information at these latitudes. At the decadal time scale, variability in Ekman transport is less important than that in geostrophic shears. In the Southern Hemisphere the vertical shears component is dominant at all time scales, suggesting that hydrographic sections alone may be suitable for deducing change in the MOC at these latitudes

Transcutaneous vagus nerve stimulation (t-VNS): A novel effective treatment for temper outbursts in adults with Prader-Willi Syndrome indicated by results from a non-blind study.

Temper outbursts are a severe problem for people with Prader-Willi Syndrome (PWS). Previous reports indicate that vagus nerve stimulation (VNS) may reduce maladaptive behaviour in neurodevelopmental disorders, including PWS. We systematically investigated the effectiveness of transcutaneous VNS (t-VNS) in PWS. Using a non-blind single case repeat measures modified ABA design, with participants as their own controls, t-VNS was evaluated in five individuals with PWS [three males; age 22-41 (M = 26.8)]. After a baseline phase, participants received four-hours of t-VNS daily for 12 months, followed by one month of daily t-VNS for two-hours. The primary outcome measure was the mean number of behavioural outbursts per day. Secondary outcomes included findings from behavioural questionnaires and both qualitative and goal attainment interviews. Four of the five participants who completed the study exhibited a statistically significant reduction in number and severity of temper outbursts after approximately nine months of daily four-hour t-VNS. Subsequent two-hour daily t-VNS was associated with increased outbursts for all participants, two reaching significance. Questionnaire and interview data supported these findings, the latter indicating potential mechanisms of action. No serious safety issues were reported. t-VNS is an effective, novel and safe intervention for chronic temper outbursts in PWS. We propose these changes are mediated through vagal projections and their effects both centrally and on the functioning of the parasympathetic nervous system. These findings challenge our present biopsychosocial understanding of such behaviours suggesting that there is a single major mechanism that is modifiable using t-VNS. This intervention is potentially generalizable across other clinical groups. Future research should address the lack of a sham condition in this study along with the prevalence of high drop out rates, and the potential effects of different stimulation intensities, frequencies and pulse widths