Using wearable cameras to categorise type and context of accelerometer-identified episodes of physical activity

BACKGROUND

Accelerometers can identify certain physical activity behaviours, but not the context in which they take place. This study investigates the feasibility of wearable cameras to objectively categorise the behaviour type and context of participants' accelerometer-identified episodes of activity.

METHODS

Adults were given an Actical hip-mounted accelerometer and a SenseCam wearable camera (worn via lanyard). The onboard clocks on both devices were time-synchronised. Participants engaged in free-living activities for 3 days. Actical data were cleaned and episodes of sedentary, lifestyle-light, lifestyle-moderate, and moderate-to-vigorous physical activity (MVPA) were identified. Actical episodes were categorised according to their social and environmental context and Physical Activity (PA) compendium category as identified from time-matched SenseCam images.

RESULTS

There were 212 days considered from 49 participants from whom SenseCam images and associated Actical data were captured. Using SenseCam images, behaviour type and context attributes were annotated for 386 (out of 3017) randomly selected episodes (such as walking/transportation, social/not-social, domestic/leisure). Across the episodes, 12 categories that aligned with the PA Compendium were identified, and 114 subcategory types were identified. Nineteen percent of episodes could not have their behaviour type and context categorized; 59% were outdoors versus 39% indoors; 33% of episodes were recorded as leisure time activities, with 33% transport, 18% domestic, and 15% occupational. 33% of the randomly selected episodes contained direct social interaction and 22% were in social situations where the participant wasn't involved in direct engagement.

CONCLUSION

Wearable camera images offer an objective method to capture a spectrum of activity behaviour types and context across 81% of accelerometer-identified episodes of activity. Wearable cameras represent the best objective method currently available to categorise the social and environmental context of accelerometer-defined episodes of activity in free-living conditions.

Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence

BACKGROUND

Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand.

OBJECTIVE

To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years).

METHODS

Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012.

RESULTS

Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097).

CONCLUSION

Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.

The relationship between outdoor activity and health in older adults using GPS

Physical activity (PA) provides health benefits in older adults. Research suggests that exposure to nature and time spent outdoors may also have effects on health. Older adults are the least active segment of our population, and are likely to spend less time outdoors than other age groups. The relationship between time spent in PA, outdoor time, and various health outcomes was assessed for 117 older adults living in retirement communities. Participants wore an accelerometer and GPS device for 7 days. They also completed assessments of physical, cognitive, and emotional functioning. Analyses of variance were employed with a main and interaction effect tested for ±30 min PA and outdoor time. Significant differences were found for those who spent >30 min in PA or outdoors for depressive symptoms, fear of falling, and self-reported functioning. Time to complete a 400 m walk was significantly different by PA time only. QoL and cognitive functioning scores were not significantly different. The interactions were also not significant. This study is one of the first to demonstrate the feasibility of using accelerometer and GPS data concurrently to assess PA location in older adults. Future analyses will shed light on potential causal relationships and could inform guidelines for outdoor activity.

Validity of the Global Physical Activity Questionnaire (GPAQ) in adult Latinas

BACKGROUND

Valid and reliable self-report measures of physical activity (PA) are needed to evaluate the impact of interventions aimed at increasing the levels of PA. However, few valid measures for assessing PA in Latino populations exist.

OBJECTIVE

The purpose of this study is to determine whether the GPAQ is a valid measure of PA among Latinas and to examine its sensitivity to intervention change. Intervention attendance was also examined.

METHODS

Baseline and postintervention data were collected from 72 Latinas (mean age = 43.01; SD = 9.05) who participated in Caminando con Fe/Walking with Faith, a multilevel intervention promoting PA among church-going Latinas. Participants completed the GPAQ and were asked to wear the accelerometer for 7 consecutive days at baseline and again 6 months later. Accelerometer data were aggregated into 5 levels of activity intensity (sedentary, light, moderate, moderate-vigorous, and vigorous) and correlated to self-reported mean minutes of PA across several domains (leisure time, work, commute and household chores).

RESULTS

There were significant correlations at postintervention between self-reported minutes per week of vigorous LTPA and accelerometer measured vigorous PA (r = .404, P < .001) as well as significant correlations of sensitivity to intervention change (post intervention minus baseline) between self-reported vigorous LTPA and accelerometer-measured vigorous PA (r = .383, P < .003) and self-reported total vigorous PA and accelerometer measured vigorous PA (r = .363, P < .003).

CONCLUSIONS

The findings from this study suggest that the GPAQ may be useful for evaluating the effectiveness of programs aimed at increasing vigorous levels of PA among Latinas.

The first 3 years of national bowel cancer screening at a single UK tertiary centre

AIM

St Mark's Bowel Cancer Screening Centre commenced screening in October 2006 as a contributor to the national programme. The first 35 months' experience is reported.

METHOD

Individuals with a positive faecal occult blood test (FOBT) were offered colonoscopy or alternatives if they had significant comorbidity. All screening data were collected prospectively.

RESULTS

Of the 98 815 FOBT kits issued, 42 523 were returned (43% uptake; 20.79% men). In total, 1339/1488 (90%) FOBT-positive participants attended the nurse clinic (57% men). Of these, 1057 had an index colonoscopy, 115 had a computed tomography colonoscopy (CTC) and eight had a flexible sigmoidoscopy. Five hundred and seventeen (44%) procedures were 'normal' (no polyps/cancers). Eighty (6%) individuals had colorectal cancer. The polyp detection rate in index procedures, including colonoscopy, CTC and flexible sigmoidoscopy, was 50%. The adenoma detection rate of all colonoscopies was 62.8%. The median polyp size was 5 (1-80) mm. In total, 1200 colonoscopies were performed by five accredited colonoscopists (96% completion rate). There were 13 (1%) adverse events with < 1 in 500 patients undergoing polypectomy requiring a transfusion. There was one 30-day postsurgical mortality, one perforation and no colonoscopy-related mortality. Almost all 39/40 (97%) patients in the BCS programme felt that the findings were adequately explained compared with 21/32 (64%) elective patients (P < 0.001) within the same unit.

CONCLUSIONS

At this bowel cancer screening single centre, colonoscopy completion rates were high (unadjusted caecal intubation rate of 96%) and complication rates were low. In contrast to other published data, the uptake and cancer-detection rates were lower.

Cultural adaptation of physical activity self-report instruments

CONTEXT

The validity of physical activity (PA) self-report measures can be a problem when using these measures with target populations that differ from the population for which the measures were originally developed.

OBJECTIVES

Describe an approach to further tailor PA self-report measures to a target community, and report on focus group and cognitive interview findings.

PROCESS

Topics relevant to culturally tailoring measures are discussed, including translation, focus groups, and cognitive interviews. We describe examples from our own work, including focus groups and cognitive interviews conducted to assess Latinos' interpretations of PA questions derived from various epidemiological surveys that were developed in White communities.

FINDINGS

Findings from focus groups and cognitive interviews provide valuable information about the comprehension, interpretation, and cultural relevance of the PA questions to Latino communities.

CONCLUSIONS

It is recommended that investigators collect formative data to better assess the equivalence of items being applied to a different cultural group. Guidelines for cultural attunement of self-report instruments are described to promote more uniform and rigorous processes of adaptation and facilitate cross-cultural investigations.

Gender differences in the incidence and prevalence of patellofemoral pain syndrome

The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females were 2.23 times (95% CI: 1.19, 4.20) more likely to develop PFPS compared with males. While not statistically significant, the prevalence of PFPS at study enrollment tended to be higher in females (15%) than in males (12%) (P=0.09). Females at the USNA are significantly more likely to develop PFPS than males. Additionally, at the time of admission to the academy, the prevalence of PFPS was not significantly different between genders.

Effects on condom use of an HIV prevention programme 36 months postintervention: a cluster randomized controlled trial among Bahamian youth

Data are lacking on long-term effects of HIV behavioural intervention programmes. In this study, we report intervention effects 36 months postintervention on condom use and relevant outcome variables from the theory-based programme 'Focus on Youth in the Caribbean' (FOYC). Participants (1360 sixth-grade youth) were randomized by school into: (1) FOYC, plus one of two brief parent interventions or (2) the control condition 'Wondrous Wetlands', plus a brief parent intervention. Mixed effect analysis demonstrated significant programme effects, including enhanced HIV/AIDS knowledge (effect size D = 0.44, 95% confidence interval [CI]: 0.43, 0.46), increased self-efficacy of (D = 0.42, 95% CI: 0.30, 0.54), skills for (D = 0.62, 95% CI: 0.56, 0.64) and intention to use a condom (D = 0.20, 95% CI: 0.03, 0.37). Youth who received FOYC plus the parental monitoring intervention had higher condom use rates (odds ratio = 1.49, 95% CI: 0.97, 2.28). Feedback effects from key variables were also detected, supporting the sustained effect.