The impact of behavioural screening on intervention outcomes in a randomised, controlled multiple behaviour intervention trial

Background: With an increasing research focus on multiple health behaviour change interventions, a methodological issue requiring further investigation is whether or not to employ pre-trial behavioural screening to exclude participants who are achieving a pre-specified level of one or more behaviours. Behavioural screening can be used to direct limited resources to participants most in need of a behaviour change intervention; but may reduce the representativeness of the sample and limit comparability with trials that do not employ pre-trial behavioural screening. Furthermore, the impact of this type of screening on intervention participation and intervention effects is unknown

Cardio-metabolic impact of changing sitting, standing, and stepping in the workplace

According to cross-sectional and acute experimental evidence, reducing sitting time should improve cardio-metabolic health risk biomarkers. Furthermore, the improvements obtained may depend on whether sitting is replaced with standing or ambulatory activities. Based on data from the Stand Up Victoria multi-component workplace intervention, we examined this issue using compositional data analysis - a method that can examine and compare all activity changes simultaneously.Participants receiving the intervention (n=136 ≥0.6 full-time equivalent desk-based workers, 65% women, mean±SD age=44.6 ±9.1 years from seven worksites) were asked to improve whole-of-day activity by standing up, sitting less and moving more. Their changes in the composition of daily waking hours (activPAL-assessed sitting, standing, stepping) were quantified, then tested for associations with concurrent changes in cardio-metabolic risk (CMR) scores and 14 biomarkers concerning body composition, glucose, insulin and lipid metabolism. Analyses were by mixed models, accounting for clustering (3 months, n=105-120; 12 months, n=80-97).Sitting reduction was significantly (

Validity of self-reported measures of workplace sitting time and breaks in sitting time

CLARK, B. K., A. A. THORP, E. A. H. WINKLER, P. A. GARDINER, G. N. HEALY, N. OWEN, and D. W. DUNSTAN. Validity of Self-Reported Measures of Workplace Sitting Time and Breaks in Sitting Time. Med. Sci. Sports Exerc., Vol. 43, No. 10, pp. 1907-1912, 2011. Purpose: To understand the prevalence and potential health effect of prolonged workplace sedentary (sitting) time, valid measures are required. Here, we examined the criterion validity of a brief self-reported measure of workplace sitting time and breaks in sitting time. Methods: An interviewer-administered questionnaire was used to assess workplace sitting time (h.d(-1)) and breaks from sitting per hour at work in a convenience sample of 121 full-time workers (36% men, mean age = 37 yr, 53% office based). These self-reported measures were compared with accelerometer-derived sedentary time (hours per day, = 100 counts per minute) during work hours. Results: Self-reported sitting time was significantly correlated with accelerometer-derived sedentary time (Pearson r = 0.39, 95% confidence interval = 0.22-0.53), with an average sitting time 0.45 h.d(-1) higher than average sedentary time. Bland-Altman plots and regression analysis showed positive associations between the difference in sitting and sedentary time and the average of sitting and sedentary time (mean difference = -2.75 h + 0.47 x average sitting and sedentary time; limits of agreement = +/- 2.25 h.d(-1)). The correlation of self-reported breaks per sitting hour with accelerometer-derived breaks per sedentary hour was also statistically significant (Spearman r(s) = 0.26, 95% confidence interval = 0.11-0.44). Conclusions: This study is the first to examine the criterion validity of an interviewer-administered questionnaire measure of workplace sitting time and breaks in sitting time using objective criterion measures. The workplace sitting measure has acceptable properties for use in observational studies concerned with sedentary behavior in groups of workers; however, the wide limits of agreement suggest caution in estimating individuals' sitting time with high precision. Using self-reported measures to capture patterns of workplace sitting (such as breaks in sitting time) requires further development

Device-measured sedentary behavior and physical activity in older adults differ by demographic and health-related factors

Background: Our aim was to describe and explore older adults' device-measured sedentary behavior and physical activity (PA) pattern by sex, age, education, marital status, body mass index, and physical function; and to assess agreement regarding fulfillment of PA recommendations, i.e. 150 min/week of moderate-to-vigorous intensity PA (MVPA), between device-measured and self-reported PA. Method: We included 656 older adults (64% women), aged 66, 81-87 or ≥ 90 years from a Swedish population-based cohort study. The activPAL3 accelerometer provided information on sedentary behavior (sedentary time, sedentary bouts, sit-to-stand transitions) and PA. Stepping ≥100 steps/min was considered MVPA; standing and stepping < 100 steps/min were considered light-intensity PA (LPA). Self-reported PA was compared with min/week in MVPA and steps/day. Results: On average, 60% of wear time was spent sedentary, 36% in LPA, and 4% in MVPA. Relative to men, women, had significantly (p < 0.05) more sit-to-stand transitions, spent 33 min/day less sedentary and 27 min/day more in LPA, and were more likely to report meeting PA recommendations, but showed no difference in steps/day, MVPA, or sedentary bout duration. Older age was associated with more sedentary time, lower MVPA and fewer steps/day. The prevalence of meeting PA recommendations was 59% device-measured and 88% by self-report with limited agreement between methods (Cohen's Kappa = 0.21, Spearman's rho = 0.28). Age differences were much more pronounced with objective measures than by self-report. Conclusions: We found significant sex differences in sedentary behavior and time in LPA in older adults, but not in MVPA, in contrast to previous findings. Sedentary time increased with age, with small differences in accumulation pattern. MVPA time was lower with older age, obesity, and poor physical function. A majority of the participants > 80 years did not meet the PA recommendations. Given the strong relationships between sedentary behavior, PA and health in older adults, programs are needed to address these behaviors. Agreement between device-measured and self-reported fulfillment of PA recommendations was limited. Device-based measurement adds value to PA studies, providing richer and different data than self-report. © 2020 The Author(s)

Reducing office workers' sitting time: rationale and study design for the Stand Up Victoria cluster randomized trial

Background: Excessive time spent in sedentary behaviours (sitting or lying with low energy expenditure) is associated with an increased risk for type 2 diabetes, cardiovascular disease and some cancers. Desk-based office workers typically accumulate high amounts of daily sitting time, often in prolonged unbroken bouts. The Stand Up Victoria study aims to determine whether a 3-month multi-component intervention in the office setting reduces workplace sitting, particularly prolonged, unbroken sitting time, and results in improvements in cardio-metabolic biomarkers and work-related outcomes, compared to usual practice

Prefrontal gamma oscillations reflect ongoing pain intensity in chronic back pain patients

Chronic pain is a major health care issue characterized by ongoing pain and a variety of sensory, cognitive, and affective abnormalities. The neural basis of chronic pain is still not completely understood. Previous work has implicated prefrontal brain areas in chronic pain. Furthermore, prefrontal neuronal oscillations at gamma frequencies (60–90 Hz) have been shown to reflect the perceived intensity of longer lasting experimental pain in healthy human participants. In contrast, noxious stimulus intensity has been related to alpha (8–13 Hz) and beta (14–29 Hz) oscillations in sensorimotor areas. However, it is not fully understood how the intensity of ongoing pain as the key symptom of chronic pain is represented in the human brain. Here, we asked 31 chronic back pain patients to continuously rate their ongoing pain while simultaneously recording electroencephalography (EEG). Time–frequency analyses revealed a positive association between ongoing pain intensity and prefrontal beta and gamma oscillations. No association was found between pain and alpha or beta oscillations in sensorimotor areas. These findings indicate that ongoing pain as the key symptom of chronic pain is reflected by neuronal oscillations implicated in the subjective perception of longer lasting pain rather than by neuronal oscillations related to the processing of objective nociceptive input. The findings, thus, support a dissociation of pain intensity from nociceptive processing in chronic back pain patients. Furthermore, although possible confounds by muscle activity have to be taken into account, they might be useful for defining a neurophysiological marker of ongoing pain in the human brain

Associations of sitting accumulation patterns with cardio-metabolic risk biomarkers in Australian adults

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Relationship of television time with accelerometer-derived sedentary time: NHANES

CLARK, B. K., G. N. HEALY, E. A. H. WINKLER, P. A. GARDINER, T. SUGIYAMA, D. W. DUNSTAN, C. E. MATTHEWS, and N. OWEN. Relationship of Television Time with Accelerometer-Derived Sedentary Time: NHANES. Med. Sci. Sports Exerc., Vol. 43, No. 5, pp. 822-828, 2011. Purpose: To examine the relationship of self-reported television (TV) viewing time with accelerometer-derived total sedentary time and to determine whether it differs by subgroup. Methods: Using data for adults (>= 20 yr) from the 2003-2004 and 2005-2006 nationally representative US National Health and Nutrition Examination Surveys (NHANES; n = 5738), linear regression models examined the associations of categories of self-reported TV viewing time (< 1, 1, 2, 3, 4, and 95 h.d(-1)) with accelerometer-derived sedentary time (< 100 counts per minute; h.d(-1)). Spearman rho assessed the correlation between participants' rankings on the two measures. Analyses were stratified by gender, age, race/ethnicity, and, in the 2003-2004 NHANES cycle, by work status among working-aged adults (20-65 yr, n = 2069). Results: TV viewing time was significantly associated with sedentary time, with positive associations for all gender, age, race/ethnicity groups, and for those not working or working part-time, but not for those in full-time work. However, correlations between rankings of the measures were only "fair" overall (rho = 0.22) and were similar for all gender and racial/ethnic groups and for those of mid- and older age but not for those of younger age (20-39 yr, rho = 0.05). In the working-aged subgroup, there was also a fair correlation between the measures for those not working (rho = 0.22) but no significant correlation for those in part-time (rho = 0.14) or full-time work (rho = 0.03). Conclusions: Associations of TV viewing time with accelerometer-derived total sedentary time were statistically significant, but correlations were of only fair magnitude, and the strength of the relationship was not consistent across all population subgroups. These findings suggest that TV viewing time has an influence on overall sedentary time at a population level; however, measurement of sedentary time in other domains is also important

Measuring older adults' sedentary time: Reliability, validity, and responsiveness

GARDINER, P. A., B. K. CLARK, G. N. HEALY, E. G. EAKIN, E. A. H. WINKLER, and N. OWEN. Measuring Older Adults' Sedentary Time: Reliability, Validity, and Responsiveness. Med. Sci. Sports Exerc., Vol. 43, No. 11, pp. 2127-2133, 2011. Purpose: With evidence that prolonged sitting has deleterious health consequences, decreasing sedentary time is a potentially important preventive health target. High-quality measures, particularly for use with older adults, who are the most sedentary population group, are needed to evaluate the effect of sedentary behavior interventions. We examined the reliability, validity, and responsiveness to change of a self-report sedentary behavior questionnaire that assessed time spent in behaviors common among older adults: watching television, computer use, reading, socializing, transport and hobbies, and a summary measure (total sedentary time). Methods: In the context of a sedentary behavior intervention, nonworking older adults (n = 48, age = 73 +/- 8 yr (mean +/- SD)) completed the questionnaire on three occasions during a 2-wk period (7 d between administrations) and wore an accelerometer (ActiGraph model GT1M) for two periods of 6 d. Test-retest reliability (for the individual items and the summary measure) and validity (self-reported total sedentary time compared with accelerometer-derived sedentary time) were assessed during the 1-wk preintervention period, using Spearman (rho) correlations and 95% confidence intervals (CI). Responsiveness to change after the intervention was assessed using the responsiveness statistic (RS). Results: Test-retest reliability was excellent for television viewing time (rho (95% CI) = 0.78 (0.63-0.89)), computer use (rho (95% CI) = 0.90 (0.83-0.94)), and reading (rho (95% CI) = 0.77 (0.62-0.86)); acceptable for hobbies (rho (95% CI) = 0.61 (0.39-0.76)); and poor for socializing and transport (rho < 0.45). Total sedentary time had acceptable test-retest reliability (rho (95% CI) = 0.52 (0.27-0.70)) and validity (rho (95% CI) = 0.30 (0.02-0.54)). Self-report total sedentary time was similarly responsive to change (RS = 0.47) as accelerometer-derived sedentary time (RS = 0.39). Conclusions: The summary measure of total sedentary time has good repeatability and modest validity and is sufficiently responsive to change suggesting that it is suitable for use in interventions with older adults

Genome-wide association and HLA fine-mapping studies identify risk loci and genetic pathways underlying allergic rhinitis

Allergic rhinitis is the most common clinical presentation of allergy, affecting 400 million people worldwide, with increasing incidence in westernized countries1,2. To elucidate the genetic architecture and understand the underlying disease mechanisms, we carried out a meta-analysis of allergic rhinitis in 59,762 cases and 152,358 controls of European ancestry and identified a total of 41 risk loci for allergic rhinitis, including 20 loci not previously associated with allergic rhinitis, which were confirmed in a replication phase of 60,720 cases and 618,527 controls. Functional annotation implicated genes involved in various immune pathways, and fine mapping of the HLA region suggested amino acid variants important for antigen binding. We further performed genome-wide association study (GWAS) analyses of allergic sensitization against inhalant allergens and nonallergic rhinitis, which suggested shared genetic mechanisms across rhinitis-related traits. Future studies of the identified loci and genes might identify novel targets for treatment and prevention of allergic rhinitis