Perceived Built Environment and Physical Activity in U.S. Women by Sprawl and Region

Background A number of studies have demonstrated relationships between the perceived built environment and physical activity among adults. However, little is known about whether these associations differ by U.S. region and level of urban sprawl. Purpose To examine associations between the perceived built environment and physical activity in U.S. women by region and urban sprawl. Methods Nurses\u27 Health Study II participants (N=68,968) completed four perceived neighborhood environment survey items in 2005. Logistic regression was used to estimate associations with meeting physical activity recommendations, adjusting for demographic and weight-status variables, and stratifying by region and sprawl. Data analyses were completed in 2011. Results Perceived proximity to shops/stores was positively associated with physical activity across regions and levels of sprawl (ORs=1.21–1.46). Perceived access to recreation facilities was also a positive physical activity correlate in most region–sprawl strata, with strongest relationships found in the West (ORs=1.31–1.70). Perceived crime and presence of sidewalks did not show statistically significant associations with physical activity in most region–sprawl strata, although ORs for perceived crime showed a consistent pattern of negative associations (ORs=0.60–0.95). A higher number of positive environmental attributes was associated with a greater odds of meeting physical activity recommendations. Conclusions Findings indicate that perceived proximity to shops/stores and access to recreation facilities are important correlates of physical activity for women, irrespective of region or sprawl

Reliability of a Brief Intercept Survey for Trail Use Behaviors

Purpose: This study assessed test-retest reliability of an interviewer-administered trail survey. Methods: An intercept survey was conducted with adults using 2 paved trails in Indiana and South Carolina (N = 295; mean age = 46.9 ± 18 y). The survey included items on frequency and duration of trail use for recreation and transportation, other patterns of trail use, and sociodemographic characteristics. Fiftyfive adults completed the survey twice (2–16 d apart; mean = 7.4 ± 2.6 d). Test-retest reliability was assessed with Spearman rank correlation coefficients, Kappa coefficients, and percent agreement. Results: Kappa coefficients and percent agreement for 9 categorical items ranged from 0.65 to 0.96 and from 64.0% to 98.2%, respectively. Among these items, the lowest Kappas were found for perceived safety (0.65) and reported duration of visits for recreational purposes (0.67). Spearman rank correlation coefficients for travel distance to and on the trail and frequency of trail use during the past 7 days and past 4 weeks ranged from 0.62 to 0.93. Conclusion: Though further assessments of this survey with different populations and types of trails may be warranted, its overall high reliability indicates it can be used by researchers and practitioners in its current form

Creating Charisma Online: The Role of Digital Presence in the Formation of Religious Identity

This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Contemporary Religion on Publication Date 23-4-19, available online: https://doi.org/10.1080/13537903.2019.1585104This article investigates the construction and transmission of charisma through online channels, and its role in the formation of religious identities. Mindful of Max Weber’s observation that charisma inhabits the relationship between a leader and their followers, I argue for a critical reappraisal of the theoretical model in light of the ubiquity in the 21st century of new, virtual forms of social encounter. I focus my analysis on the Christian creationist movement in the USA, and particularly on an influential leader called Ken Ham. Using digital ethnographic methods, I show how Ham constructs charisma online, and how a virtual community forms itself around his charismatic claims. I illustrate how this virtual community intersects with offline worlds, and suggest that the theme park attractions that Ham’s organisation runs (Creation Museum, Ark Encounter) are imbued with deflected charisma by virtue of their association with his online avatar

Exploratory Study of Environmental Effects on Physical Activity and Overweight in Older Women: Research Update

Background: Physical inactivity and obesity are major public health issues. Recent studies have provided evidence that attributes of the built environment influence physical activity among adults and that factors such as greater urban sprawl are related to overweight and obesity. Few studies have developed objective individual-level measures of the built environment, a geographic scale that may be more relevant to certain types of physical activity, such as walking. In addition, further research is needed to assess the associations of both objective and perceived environmental factors with physical activity. In this 2-year exploratory study funded by the National Cancer Institute, we are addressing these research gaps. Purpose: The purpose of this poster presentation is to provide a brief overview of progress to date on a major component of this study, which is to develop objective measures of the built environment for approximately 30,000 women in the Nurses’ Health Study (NHS) using Geographic Information Systems (GIS) techniques and to examine associations with physical activity and weight-related outcomes. In particular, we will briefly summarize pilot work focused on development and testing of built environment variables. Methods: A sample of 300 NHS participants from six counties in Massachusetts, Pennsylvania, and California were selected for the pilot GIS work. Geocoded home addresses, U.S. Census population data, an InfoUSA facilities database, and street network files were loaded into ArcGIS 9.3. GIS methods were used to derive variables in three domains: 1) street connectivity, 2) land use mix, and 3) population density. For each domain at least two variables were created using different operational definitions. We also created variables using 400, 800, and 1200 m network buffers. We merged the built environment data with NHS survey data. Statistical analyses included calculating mean values for environmental variables, both overall and at the county level, and running correlations between environmental variables and physical activity outcomes. Next steps: A next step in the project is to create environmental variables for the full sample of NHS participants living in the three states (n≈30,000) and merge these data with NHS survey data. In addition, we are conducting a small validation study with the InfoUSA data. During November, we are also implementing a supplemental survey with a sub-sample (n≈3,800) of NHS participants to assess perceptions of the neighborhood environment and to collect detailed information on physical activity. In another component of the study, we are testing the use of available tools such as Google Map/Earth, Google Street View, and Microsoft Visual Oblique to develop micro-scale measures of the built environment, such as the presence of sidewalks availability and their condition

Validation of a Commercial Geographical Information Systems Database of Walking and Bicycling Destinations

Background: Recent interdisciplinary studies in public health, transportation, and urban planning have shown that stores and other destinations such as banks, post offices, and physical activity facilities within close proximity to residences are positively related to recreational and transportation physical activity. The built environment has been measured several different ways, including conducting field audits and by surveying individuals’ perceptions of their neighborhood. Increasingly researchers are also using geographic information systems (GIS) software and commercially available data sources to create objective measures of the built environment. The advantages of commercial data are that they are relatively easy to access and are regularly updated. Despite these advantages it is important to assess the validity of these databases for developing measures of accessibility and density of neighborhood destinations. Two recent studies have investigated the validity of GIS databases of physical activity facilities and food stores, but to our knowledge less research has been conducted to validate a broader range of facilities that may serve as important walking and bicycling destinations. Objective: The objective was to assess the validity of a commercially-available GIS database of facilities that may serve as walking and bicycling destinations for adults. Methods: Researchers conducted field audits to verify the presence of 402 facilities contained in a commercial database. A list of North American Industrial Classification System codes was reviewed to identify the types of commercial facilities in the database which could serve as walking or bicycling destinations for adults. These were further categorized into five domains; food and drink (n=139), social or cultural organizations (n=115), retail establishments (n=101), services (n=28), and physical activity resources (n=19). Two high, medium, and low population density tracts in both Hartford County, Connecticut and Tippecanoe County, Indiana were selected for the analysis (12 tracts in total). Three levels of agreement were defined; 1) facilities in the database were considered to be an “exact match” if they were located on the same street segment and had the same proprietary name, 2) “close to exact match” if the facility was located on the street segment and was of the same domain, but with a different proprietary name, and 3) an “adjacent street segment match” if the facility was found to be located on an adjacent street segment. The percentages of facilities in the database that were located in the field were calculated overall, and by county, population density, and domain. Chi-square analyses were used to examine differences in match rates by county, population density, and type of facility. Results: Overall, among the 402 facilities examined, field audits identified 67.7% were an exact match. When the ‘close to exact matches’ were included the percentage matched increased to 76.9%, and with the addition of adjacent street segments it increased to 85.8%. Percent agreement for exact matches was higher in Tippecanoe County than Hartford County (71.5% vs. 63.9%). However when all three levels of matches were included the percent agreements for the two counties were more similar (86.5% vs. 85.1%). Overall, match rates were higher in high population density census tracts than in low population density tracts (71.0% vs. 60.6%). Among the five facility domains, the exact match rates were 64.0% for food and drink establishments, 64.3% for services, 67.3% for retail establishments, 70.4% for social and cultural organizations, and 84.2% for physical activity facilities. Overall, chi-square analyses did not show statistically significant differences in match rates by county, population density, or by domain. Conclusions: The results of this validation study demonstrated moderate to good accuracy of the commercial GIS database with more than two-thirds of the facilities correctly located in the field overall. The estimates generated in this study were similar to those in two previous validation studies of physical activity facilities and food stores which found agreement was 71%-73%. The findings in this study suggest that the commercially available GIS database provided a valid alternative to conducting extensive field audits or resident surveys

Evaluation of SMAP Core Validation Site Representativeness Errors using Dense Networks of in situ Sensors and Random Forests

© 2008-2012 IEEE. In order to validate its soil moisture products, the NASA Soil Moisture Active Passive (SMAP) mission utilizes sites with permanent networks of in situ soil moisture sensors maintained by independent calibration and validation partners in a variety of ecosystems around the world. Measurements from each core validation site (CVS) are combined in a weighted average to produce an estimate of soil moisture at a 33-km scale that represents the SMAP's radiometer-based retrievals. Since upscaled estimates produced in this manner are dependent on the weighting scheme applied, an independent method of quantifying their biases is needed. Here, we present one such method that uses soil moisture measurements taken from a dense, but temporary, network of soil moisture sensors deployed at each CVS to train a random forests regression expressing soil moisture in terms of a set of spatial variables. The regression then serves as an independent source of upscaled estimates against which permanent network upscaled estimates can be compared in order to calculate bias statistics. This method, which offers a systematic and unified approach to estimate bias across a variety of validation sites, was applied to estimate biases at four CVSs. The results showed that the magnitude of the uncertainty in the permanent network upscaling bias can sometimes exceed 80% of the upper limit on SMAP's entire allowable unbiased root-mean-square error (ubRMSE). Such large CVS bias uncertainties could make it more difficult to assess biases in soil moisture estimates from SMAP

Critical care pharmacy practice advancement recommendations on direct patient care activities: An opinion of the American College of Clinical Pharmacy Critical Care Practice and Research Network

An updated position paper on critical care pharmacy services recommends the development of new clinical programs. However, proposed pragmatic strategies for critical care pharmacy practice advancement are lacking. The purpose of this position paper is to develop consensus recommendations aimed at direct patient care activities for the advancement of critical care pharmacy practice. A 24-member task force of critical care pharmacists, physicians, and nurses participated in a Recommendation Development Phase and Consensus-building Phase (using a Delphi method) to produce the final critical care practice advancement recommendations. Proposed recommendations of pragmatic medication management opportunities with an advanced scope of practice involving pharmacist prescriptive authority for initiating, modifying, or discontinuing drug therapy and medication monitoring were developed. Task force participants anonymously voted on each proposed recommendation using a fivepoint Likert scale (1 = strongly agree, 2 = agree, 3 = neutral, 4 = disagree, and 5 = strongly disagree). Recommendations failing to achieve consensus (≥70% agreement on “strongly agree”/“agree” votes) were revised for subsequent voting. Task force response rates during the first and second voting rounds were 71% (n = 17) and 79% (n = 19), respectively. A total of 57 (93.4%) of the 61 proposed practice advancement recommendations achieved consensus of which 88.5% (n = 54) met consensus after the first round. Consensus recommendations involved the critical care pharmacist initiating (n = 15), modifying (n = 22), or discontinuing (n = 9) drug therapy, and ordering relevant laboratory values or tests to optimize drug therapy (n = 11). One recommendation failing consensus was not revised for additional voting given the impracticality of achieving agreement. Fifty-seven of the proposed 61 recommendation statements (93%) achieved the consensus threshold after two rounds of voting by an interprofessional expert panel. These recommendations provide a conceptual framework for promoting novel critical care pharmacist prescriptive authority over specific aspects of direct patient care. Implementation challenges and barriers, further described in this paper, must be explored at the institutional level for acceptance