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Frehlich L, Turin TC, Doyle-Baker PK, Lang JJ, McCormack GR. Mediation analysis of the associations between neighbourhood walkability and greenness, accelerometer-measured physical activity, and health-related fitness in urban dwelling Canadians. Prev Med 2024; 178:107792. [PMID: 38052331 DOI: 10.1016/j.ypmed.2023.107792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To estimate sex-specific associations (total, direct, and indirect effects) between objectively measured neighbourhood walkability and greenness and objectively measured physical activity and health-related fitness including cardiorespiratory and muscular fitness in Canadian adults. METHODS Neighbourhood walkability (Canadian Active Living Environment) and greenness (Normalized Difference Vegetation Index; NDVI) data were linked to cardiorespiratory (i.e., submaximal step test estimated V̇O2 max) and muscular fitness (i.e., handgrip strength) and accelerometer measured physical activity; Canadian Health Measures Survey). Covariate-adjusted sex-stratified path analyses was conducted to assess if physical activity (light: LPA; moderate: MPA, and; vigorous: VPA) mediated the associations between neighbourhood walkability, NDVI and health-related fitness. Model sample sizes ranged from 987 to 2796 for males and 989 to 2835 for females. RESULTS Among males, we found indirect effects between neighbourhood walkability and cardiorespiratory fitness via LPA (negative) and VPA (positive). We also found a total effect (negative) between neighbourhood walkability and grip strength and indirect effects between neighbourhood walkability and handgrip strength via LPA (negative) and MPA (negative). Among females, we found a total effect (positive) and direct effect (positive) between neighbourhood walkability and cardiorespiratory fitness, and an indirect effect for neighbourhood walkability and cardiorespiratory fitness via LPA. We found no significant effects related to neighbourhood greenness. CONCLUSIONS Residing in a neighbourhood with higher walkability may positively affect cardiorespiratory fitness but negatively affect muscular strength. The negative associations between neighbourhood walkability and LPA may offset potential positive associations between neighbourhood walkability and MPA and VPA and their subsequent influence on health-related fitness.
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Affiliation(s)
- Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Tanvir C Turin
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Family Medicine, Cumming School of Medicine, University of Calgary, Canada
| | - Patricia K Doyle-Baker
- Faculty of Kinesiology, University of Calgary, Canada; School of Architecture, Landscape and Planning, University of Calgary, Canada
| | - Justin J Lang
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Canada; Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Faculty of Kinesiology, University of Calgary, Canada; School of Architecture, Landscape and Planning, University of Calgary, Canada; Faculty of Sports Science, Waseda University, Japan
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Kaufman M, Frehlich L, Fredericson M. Reply to Wakolbinger-Habel, R.; Muschitz, C. Comment on "Kaufman et al. Popular Dietary Trends' Impact on Athletic Performance: A Critical Analysis Review. Nutrients 2023, 15, 3511". Nutrients 2023; 15:4710. [PMID: 38004104 PMCID: PMC10675748 DOI: 10.3390/nu15224710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
We appreciate Wakolbinger-Habel and Muschitz's comment [...].
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Affiliation(s)
- Matthew Kaufman
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA 94063, USA;
- Stanford Lifestyle Medicine, Stanford University, Redwood City, CA 94063, USA;
| | - Levi Frehlich
- Stanford Lifestyle Medicine, Stanford University, Redwood City, CA 94063, USA;
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AL T2N 4N1, Canada
| | - Michael Fredericson
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA 94063, USA;
- Stanford Lifestyle Medicine, Stanford University, Redwood City, CA 94063, USA;
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Chawla V, Bansal N, Spelber D, Desai A, Frehlich L, Ballon JS, Kalinowski A, Noordsy DL. Inspire self report scale (ISRS): A feasibility study of a Novel self report scale for people with schizophrenia spectrum disorders. J Psychiatr Res 2023; 165:248-253. [PMID: 37531843 DOI: 10.1016/j.jpsychires.2023.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/08/2023] [Accepted: 05/15/2023] [Indexed: 08/04/2023]
Abstract
Clinician-rated symptom scales are the current standard for outcome measures in Schizophrenia Spectrum Disorders (SSD) research. There has been growing interest in the development of self-report measures for people with SSD to support measurement-based care and inclusive research. We developed the Inspire Self Report Scale (ISRS), which measures the current magnitude of well-being, mood symptoms, psychosis, negative symptoms and cognition using 10 questions on a Likert or Visual analogue scale (VAS). The main aim of this report was to investigate the correlation and concordance between patient self-report and clinician ratings on the ISRS during a clinical encounter. When ratings were discordant, we sought to identify whether the participant's or psychiatrist's rating was more accurate. The results indicated a moderately strong statistically significant correlation between participant and clinician ratings. There was a moderate concordance between participant and clinician ratings on the ISRS. When the results were discordant, the participant ratings were assessed to be more accurate than the clinician rating over 70% of the time. The ISRS has distinct utility compared to existing scales due to the measurement of present symptom severity, capturing multiple clinical domains, and time efficiency and ease of use. Thus, it may be useful in clinical and research settings.
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Affiliation(s)
- Vanika Chawla
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Nandini Bansal
- McMaster University, 90 Main St W, Hamilton, ON, L8P 1H6, Canada.
| | - David Spelber
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Aakash Desai
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Levi Frehlich
- Department of Community Health Sciences Cumming School of Medicine, University of Calgary, Canada.
| | - Jacob S Ballon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Agnieszka Kalinowski
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Douglas L Noordsy
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA.
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Frehlich L, Amson A, Doyle-Baker P, Black T, Boustead D, Cameron E, Crowshoe LL, McBrien K, Ji YJ, McGuire A, Oliver A, Tuttauk L, Zhang J, Checholik C, Wicklum S. Spread of Makoyoh'sokoi (Wolf Trail): a community led, physical activity-based, holistic wellness program for Indigenous women in Canada. J Health Popul Nutr 2023; 42:80. [PMID: 37573348 PMCID: PMC10422705 DOI: 10.1186/s41043-023-00427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 08/07/2023] [Indexed: 08/14/2023]
Abstract
Globally, Indigenous populations have been impacted by colonization. Populations who have endured colonization are at higher risk of developing chronic diseases. Canada's Truth and Reconciliation Commission emphasizes reducing barriers to participation in physical activity and recommends the creation of culturally relevant and supportive policies and programing. Physical activity is a cornerstone in health promotion and public health to combat chronic diseases; however, in Canada, Indigenous developed physical activity programing is sparse, and those targeting women are non-existent in some regions. Makoyoh'sokoi (The Wolf Trail Program) is an 18-week long, holistic wellness program that was created by and for Indigenous women. Makoyoh'sokoi was developed by communities following extensive consultation and cultural oversight. Makoyoh'sokoi's core program consists of 12 weeks of weekly physical activity programing and health education, followed by another 6 weeks of weekly health education. Notably, communities have control over the program to modify based on individual needs and challenges. Programs commence and conclude with a ceremony with Elders giving a blessing and opening each other to connection. The goals of Makoyoh'sokoi are to empower women, improve health outcomes, and to implement a sustainable program by training a network of community members in their respective communities to facilitate delivery.
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Affiliation(s)
| | | | | | - Tia Black
- University of Calgary, AB, Calgary, Canada
| | | | - Erin Cameron
- Northern Ontario School of Medicine, Sudbury, ON, Canada
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Naish C, McCormack GR, Blackstaffe A, Frehlich L, Doyle-Baker PK. An Observational Study on Play and Physical Activity Associated with a Recreational Facility-Led Park-Based "Loose Parts" Play Intervention during the COVID-19 Pandemic. Children (Basel) 2023; 10:1049. [PMID: 37371280 DOI: 10.3390/children10061049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
Play is a human right, yet opportunities for unstructured play are declining. The COVID-19 pandemic further reduced children's play opportunities. We conducted an observational study of a novel community-based intervention (play hubs) that facilitated unstructured play by offering loose parts in parks (Calgary, Canada) during the pandemic. Our descriptive study included systematic observation using the System for Observing Children's Activity and Relationships During Play (SOCARP) and Tool for Observing Play Outdoors (TOPO) to capture physical activity, play, and social and environment interactions among children participating in the play hubs for 10-weeks in 2021 (n = 160) and 2022 (n = 147). Play hub attendance was low. Most children observed were aged 5 to 12 years (2021: 93% and 2022 98%), with boys and girls represented (2021: 58% male/42% female and 2022: 52% male/48% female). Standing, sitting, and moderate activity were common activities. Physical, exploratory, and expressive play were common, while digital, bio, and rule-based play were less common. Children typically played alone or in small groups and engaged with loose parts or played in the open spaces. The play hubs encouraged unstructured play and promoted positive social interactions among children, despite the challenges of implementing a community-based intervention under pandemic public health restrictions.
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Affiliation(s)
- Calli Naish
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Department of Communication, Media and Film, Faculty of Arts, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan
- School of Planning, Architecture, and Landscape, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Anita Blackstaffe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Patricia K Doyle-Baker
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- School of Planning, Architecture, and Landscape, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 4N1, Canada
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Stafl L, Benham JL, Frehlich L, Donovan LE, Yamamoto JM. Missed antenatal diabetes care appointments and neonatal outcomes for pregnancies with Type 1 and Type 2 diabetes. Diabet Med 2023; 40:e14950. [PMID: 36054517 DOI: 10.1111/dme.14950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/26/2022] [Accepted: 08/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is limited information regarding the association between missed appointments and neonatal outcomes for diabetes in pregnancy. STUDY METHODS This retrospective live birth cohort included pregnant women with Type 1 or 2 diabetes who attended specialized clinics from 2008 to 2020. The association between at least one missed antenatal diabetes appointments and outcomes were assessed using logistic regression and reported as adjusted odds ratios (aOR) (95% confidence interval). Mediation analyses were conducted to examine if above target HbA1c mediated these relationships. RESULTS The cohort included 407 and 902 women with Type 1 and 2 diabetes, respectively, of whom 25.1% and 34.5% missed at least one appointment. Women with Type 1 diabetes who missed an appointment were more likely to have a caesarean section (aOR 1.95 [1.15, 3.31]) and their babies more likely to be admitted to the neonatal intensive care unit (aOR 2.25 [1.35, 3.75]). Women with Type 2 diabetes who missed an appointment were more likely to have a large-for-gestational-age infant (aOR 1.61 [1.13, 2.28]), and an extreme large-for-gestational-age infant (aOR 1.69 [1.02, 2.81]) compared with women who did not miss appointments. Above target HbA1c mediated the relationship between missed appointments and caesarean delivery in Type 1 diabetes and large-for-gestational age and extreme large-for-gestational age in Type 2 diabetes. CONCLUSION In individuals with Type 1 and 2 diabetes, there are differences in neonatal outcomes between those who missed an appointment compared to those who did not. It remains unclear if missed diabetes appointments are causative or a marker of other health behaviours or risk factors leading to neonatal morbidity.
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Affiliation(s)
- Lenka Stafl
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jamie L Benham
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lois E Donovan
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Obstetrics and Gynaecology and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Jennifer M Yamamoto
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Internal Medicine, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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Forbes N, Gupta S, Frehlich L, Meng ZW, Ruan Y, Montori S, Chebaa BR, Dunbar KB, Heitman SJ, Feagins LA, Albéniz E, Pohl H, Bourke MJ. Clip closure to prevent adverse events after EMR of proximal large nonpedunculated colorectal polyps: meta-analysis of individual patient data from randomized controlled trials. Gastrointest Endosc 2022; 96:721-731.e2. [PMID: 35667388 DOI: 10.1016/j.gie.2022.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/18/2022] [Accepted: 05/24/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS After EMR, prophylactic clipping is often performed to prevent clinically significant post-EMR bleeding (CSPEB) and other adverse events (AEs). Prior evidence syntheses have lacked sufficient power to assess clipping in relevant subgroups or in nonbleeding AEs. We performed a meta-analysis of individual patient data (IPD) from randomized trials assessing the efficacy of clipping to prevent AEs after EMR of proximal large nonpedunculated colorectal polyps (LNPCPs) ≥20 mm. METHODS We searched EMBASE, MEDLINE, Cochrane Central Registry of Controlled Trials, and PubMed from inception to May 19, 2021. Two reviewers screened citations in duplicate. Corresponding authors of eligible studies were invited to contribute IPD. A random-effects 1-stage model was specified for estimating pooled effects, adjusting for patient sex and age and for lesion location and size, whereas a fixed-effects model was used for traditional meta-analyses. RESULTS From 3145 citations, 4 trials were included, representing 1248 patients with proximal LNPCPs. The overall rate of CSPEB was 3.5% and 9.0% in clipped and unclipped patients, respectively. IPD were available for 1150 patients, in which prophylactic clipping prevented CSPEB with an odds ratio (OR) of .31 (95% confidence interval [CI], .17-.54). Clipping was not associated with perforation or abdominal pain, with ORs of .78 (95% CI, .17-3.54) and .67 (95% CI, .20-2.22), respectively. CONCLUSIONS Prophylactic clipping is efficacious in preventing CSPEB after EMR of proximal LNPCPs. Therefore, clip closure should be considered a standard component of EMR of LNPCPs in the proximal colon.
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Affiliation(s)
- Nauzer Forbes
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Sunil Gupta
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia; Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Levi Frehlich
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Zhao Wu Meng
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Yibing Ruan
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Sheyla Montori
- Gastrointestinal Endoscopy Research Unit, Navarrabiomed Biomedical Research Center, UPNA, IdiSNA, Pamplona, Spain
| | - Benjamin R Chebaa
- Department of Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Kerry B Dunbar
- Department of Medicine, VA North Texas Healthcare System, Dallas, Texas, USA; Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Steven J Heitman
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Linda A Feagins
- Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Eduardo Albéniz
- Gastrointestinal Endoscopy Research Unit, Navarrabiomed Biomedical Research Center, UPNA, IdiSNA, Pamplona, Spain; Endoscopy Unit, Gastroenterology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Heiko Pohl
- Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA; Department of Gastroenterology, VA Medical Center, White River Junction, Vermont, USA; Department of Gastroenterology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Michael J Bourke
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia; Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
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Frehlich L, Christie CD, Ronksley PE, Turin TC, Doyle-Baker P, McCormack GR. The neighbourhood built environment and health-related fitness: a narrative systematic review. Int J Behav Nutr Phys Act 2022; 19:124. [PMID: 36153538 PMCID: PMC9509561 DOI: 10.1186/s12966-022-01359-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background There is increasing evidence demonstrating the importance of the neighbourhood built environment in supporting physical activity. Physical activity provides numerous health benefits including improvements in health-related fitness (i.e., muscular, cardiorespiratory, motor, and morphological fitness). Emerging evidence also suggests that the neighbourhood built environment is associated with health-related fitness. Our aim was to summarize evidence on the associations between the neighbourhood built environment and components of health-related fitness in adults. Methods We undertook a systematic review following PRISMA guidelines. Our data sources included electronic searches in MEDLINE, Embase, CINAHL, Web of Science, SPORTDiscus, Environment Complete, ProQuest Dissertations and Theses, and Transport Research International Documentation from inception to March 2021. Our eligibility criteria consisted of observational and experimental studies estimating associations between the neighbourhood built environment and health-related fitness among healthy adults (age ≥ 18 years). Eligible studies included objective or self-reported measures of the neighbourhood built environment and included either objective or self-reported measures of health-related fitness. Data extraction included study design, sample characteristics, measured neighbourhood built environment characteristics, and measured components of health-related fitness. We used individual Joanna Briggs Institute study checklists based on identified study designs. Our primary outcome measure was components of health-related fitness (muscular; cardiorespiratory; motor, and morphological fitness). Results Twenty-seven studies (sample sizes = 28 to 419,562; 2002 to 2020) met the eligibility criteria. Neighbourhood destinations were the most consistent built environment correlate across all components of health-related fitness. The greatest number of significant associations was found between the neighbourhood built environment and morphological fitness while the lowest number of associations was found for motor fitness. The neighbourhood built environment was consistently associated with health-related fitness in studies that adjusted for physical activity. Conclusion The neighbourhood built environment is associated with health-related fitness in adults and these associations may be independent of physical activity. Longitudinal studies that adjust for physical activity (including resistance training) and sedentary behaviour, and residential self-selection are needed to obtain rigorous causal evidence for the link between the neighbourhood built environment and health-related fitness. Trial registration Protocol registration: PROSPERO number CRD42020179807. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01359-0.
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McCormack GR, Patterson M, Frehlich L, Lorenzetti DL. The association between the built environment and intervention-facilitated physical activity: a narrative systematic review. Int J Behav Nutr Phys Act 2022; 19:86. [PMID: 35836196 PMCID: PMC9284898 DOI: 10.1186/s12966-022-01326-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background A diverse range of interventions increase physical activity (PA) but few studies have explored the contextual factors that may be associated with intervention effectiveness. The built environment (BE) may enhance or reduce the effectiveness of PA interventions, especially interventions that encourage PA in neighbourhood settings. Several studies have investigated the effects of the neighbourhood BE on intervention-facilitated PA, however, a comprehensive review of evidence has yet to be conducted. In our systematic review, we synthesize evidence from quantitative studies that have examined the relationships between objectively-measured neighbourhood BE and intervention-facilitated PA in adults. Method In October 2021, we searched 7 databases (Medline, CINAHL, Embase, Web of Science, SPORTDiscus, Environment Complete, and Cochrane Central Register of Controlled Trials) for English-language studies reporting on randomized and non-randomized experiments of physical activity interventions involving adults (≥18 years) and that estimated the association between objectively-measured BE and intervention-facilitated physical activity. Results Twenty articles, published between 2009 and 2021, were eligible for inclusion in the review. Among the 20 articles in this review, 13 included multi-arm experiments and 7 included single-arm experiments. Three studies examined PA interventions delivered at the population level and 17 examined interventions delivered at the individual level. PA intervention characteristics were heterogeneous and one-half of the interventions were implemented for at least 12-months (n = 10). Most studies were undertaken in North America (n = 11) and most studies (n = 14) included samples from populations identified as at risk of poor health (i.e., metabolic disorders, coronary heart disease, overweight, cancer, high blood pressure, and inactivity). Fourteen studies found evidence of a neighbourhood BE variable being negatively or positively associated with intervention-facilitated PA. Conclusion Approximately 70% of all studies reviewed found evidence for an association between a BE variable and intervention-facilitated PA. The BE’s potential to enhance or constrain the effectiveness of PA interventions should be considered in their design and implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01326-9.
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Affiliation(s)
- Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, N.W., Calgary, Alberta, T2N 4Z6, Canada. .,Faculty of Kinesiology, University of Calgary, Calgary, Canada. .,Faculty of Environmental Design, University of Calgary, Calgary, Canada. .,Faculty of Sport Sciences, Waseda University, Shinjuku City, Japan.
| | - Michelle Patterson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, N.W., Calgary, Alberta, T2N 4Z6, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, N.W., Calgary, Alberta, T2N 4Z6, Canada
| | - Diane L Lorenzetti
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, N.W., Calgary, Alberta, T2N 4Z6, Canada.,Health Sciences Library, University of Calgary, Calgary, Canada
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Bansal S, Lu F, Frehlich L, Wong JK, Burak KW, Wilson SR. Correction to: A new proposal for secondary surveillance following potentially curative therapy of HCC: alternating MRI and CEUS. Abdom Radiol (NY) 2022; 47:1207. [PMID: 34997842 PMCID: PMC8863689 DOI: 10.1007/s00261-021-03385-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Bansal S, Lu F, Frehlich L, Wong JK, Burak KW, Wilson SR. A new proposal for secondary surveillance following potentially curative therapy of HCC: alternating MRI and CEUS. Abdom Radiol (NY) 2022; 47:618-629. [PMID: 34800161 PMCID: PMC8807441 DOI: 10.1007/s00261-021-03331-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/16/2022]
Abstract
Purpose A high recurrence rate following ablative therapy of hepatocellular carcinoma (HCC) necessitates routine follow-up imaging (secondary surveillance) to facilitate early re-treatment. We evaluate our unique secondary surveillance algorithm (with use of alternating MRI and CEUS) by assessment of the relative diagnostic accuracy of MRI and CEUS in detection of residual/recurrent tumor. Potential benefits of alternating surveillance are compared to the use of MRI alone. Materials and methods This prospective observational IRB approved study included 231 patients with 354 treated tumors between January 2017 and June 2020. Treated lesions underwent secondary surveillance for a minimum of 7 months and up to 3 years, median follow-up 14 months. Secondary surveillance involved MRI performed at 1 month after treatment, followed by CEUS and MRI at alternate 3-month intervals (i.e., CEUS at month 4, MRI at month 7, etc.), for a total of 2 years. An equivocal finding on one imaging modality triggered expeditious evaluation with the alternate modality. Arterial phase hyperenhancement and washout comprise the classic features of recurrent tumor on both modalities. Results A total of 746 MRI and 712 CEUS examinations were performed, and a total of 184 tumor recurrences detected, MRI (n = 82) and CEUS (n = 102) (p = 0.19). There was no difference in the sensitivity (71.0–85.0% and 80.9–92.0%), specificity (97.4–99.2% and 98.5–99.9%), and area under the ROC curve (0.85–0.92 and 0.91–0.96) between MRI and CEUS, respectively. 23 of 82 recurrent tumors identified on MRI were equivocal and confirmed with expedited CEUS. 9 equivocal cases on MRI were disproved by expedited CEUS. On CEUS, 1 of the 102 recurrent tumors was equivocal and confirmed on MRI, and 2 equivocal CEUS cases were disproved by MRI. Conclusion MRI and CEUS performed similarly in our secondary surveillance algorithm for HCC in their ability to detect tumor recurrence, and showed no significant difference in their relative diagnostic test accuracy measures. Of greater interest, equivocal results on MRI (typically due to difficulty in distinguishing tumor recurrence from post-treatment change/shunting) were either confirmed or disproven by CEUS in all cases. Secondary surveillance of treated HCC with alternating MRI and CEUS shows equivalent performance of each modality. CEUS resolves equivocal MRI and optimally demonstrates APHE and washout in tumor recurrence. Graphic abstract ![]()
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Affiliation(s)
- Sanjay Bansal
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Fangshi Lu
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Jason K Wong
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Kelly W Burak
- Department of Gastroenterology, University of Calgary, Calgary, AB, Canada
| | - Stephanie R Wilson
- Department of Radiology, University of Calgary, Calgary, AB, Canada.
- Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada.
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12
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Forbes N, Frehlich L, Borgaonkar M, Leontiadis GI, Tse F. Canadian Association of Gastroenterology (CAG) Position Statement on the Use of Hyoscine- n-butylbromide (Buscopan) During Gastrointestinal Endoscopy. J Can Assoc Gastroenterol 2021; 4:259-268. [PMID: 34877465 PMCID: PMC8643672 DOI: 10.1093/jcag/gwab038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/21/2022] Open
Abstract
Hyoscine butylbromide, also known as hyoscyamine or scopolamine, and sold under the trade name Buscopan, is an antimuscarinic agent commonly used to induce smooth muscle relaxation and reduce spasmodic activity of the gastrointestinal (GI) tract during endoscopic procedures. However, the balance between desirable and undesirable (adverse) effects is not clear when used during GI endoscopy. The Clinical Affairs Committee of the Canadian Association of Gastroenterology (CAG) conducted systematic reviews and applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations for the use of Buscopan during GI endoscopy. To summarize, we recommend against the use of Buscopan before or during colonoscopy (strong recommendation, high certainty of evidence). We suggest against the use of Buscopan before or during gastroscopy (conditional recommendation, very low certainty of evidence). We suggest the use of Buscopan before or during ERCP (conditional recommendation, very low certainty of evidence). More research is needed to determine whether patients undergoing advanced procedures such as endoscopic mucosal resection or endoscopic submucosal dissection benefit from its use. Buscopan should be used with caution in patients with cardiac comorbidities. According to its product monograph, Buscopan is contraindicated in patients with tachycardia, angina, and cardiac failure. Thus, Buscopan should be used very cautiously in patients with these conditions, and only when the potential benefits of its use outweigh the potential risks in a particular case. Such patients require careful cardiac monitoring in an environment where resuscitation equipment and appropriately trained staff to use it are readily available. According to its product monograph, Buscopan is also contraindicated in patients with prostatic hypertrophy with urinary retention, and therefore, should be used very cautiously in such patients as well, and only when the potential benefits of its use outweigh the potential risks in a particular case. Obtaining a preprocedural history of glaucoma is unlikely to be of value when considering Buscopan use. However, in cases where Buscopan has been used, patients should be counselled postprocedurally and told to present to an emergency facility should they experience eye pain, redness, decreased vision, nausea and vomiting or headache.
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Affiliation(s)
- Nauzer Forbes
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Mark Borgaonkar
- Faculty of Medicine, Memorial University, St John's, Newfoundland and Labrador, Canada
| | - Grigorios I Leontiadis
- Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.,Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Frances Tse
- Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada.,Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
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13
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Stafl L, Yamamoto J, Benham J, Donovan L, Frehlich L. Do Missed Antenatal Diabetes Care Appointments Affect Neonatal Outcomes for Pregnancies Complicated by Type 1 and Type 2 Diabetes? Can J Diabetes 2021. [DOI: 10.1016/j.jcjd.2021.09.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Frehlich L, Christie C, Ronksley P, Turin TC, Doyle-Baker P, McCormack G. Association between neighborhood built environment and health-related fitness: a systematic review protocol. JBI Evid Synth 2021; 19:2350-2358. [PMID: 33993146 DOI: 10.11124/jbies-20-00354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this review is to summarize the current literature on the association between the neighborhood built environment and components of health-related fitness. The findings may be useful for policy-makers and health professionals to inform the development of health-supportive neighborhood built environments. INTRODUCTION There is accumulating evidence linking neighborhood built environments to health, including physical activity and chronic health conditions, yet little is known about the potential links between the built environment and health-related fitness. Although physical activity and health-related fitness are intimately linked, health-related fitness is thought to be a more proximate and stronger correlate of health. Understanding how the built environment influences health-related fitness will allow better health-promoting urban design and population-level interventions. INCLUSION CRITERIA Published and unpublished evidence will be included if it has a quantitative component and the sample includes adults aged 18 years or older, with no physical disabilities or health issues that may affect health-related fitness. The exposure of interest will be objectively measured and self-reported neighborhood built characteristics. The outcome of interest will be objectively measured and self-reported components of health-related fitness (ie, morphological, muscular, motor, and cardiorespiratory fitness). METHODS We will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Databases used in the search will include MEDLINE, Embase, CINAHL, Web of Science, SPORTDiscus, Environment Complete, and Transport Research International Documentation with no date or language restrictions. Two independent reviewers will screen titles and abstracts, and assess full-text studies against the inclusion criteria. Study quality will be assessed by two independent reviewers using the critical appraisal tools from JBI. A narrative approach will be used to synthesize the study findings; if data permit, a meta-analysis will be completed. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020179807.
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Affiliation(s)
- Levi Frehlich
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Chelsea Christie
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul Ronksley
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tanvir C Turin
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Gavin McCormack
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Faculty of Sport Sciences, Waseda University, Shinjuku City, Japan
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15
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Frehlich L, Christie C, Ronksley P, Turin TC, Doyle-Baker P, McCormack G. 1185The association between neighbourhood built environment and health-related fitness: A systematic review. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Few studies have investigated potential links between the built environment and health-related fitness, even though there is some evidence linking neighbourhood built environments to physical activity behaviors and chronic health conditions.
Methods
Following PRISMA guidelines eight databases were searched from inception to August 2020 using a combination of built environment and health-related fitness terms. Inclusion criteria was limited to quantitative studies that sampled of adults aged 18 years or older with no physical disabilities or health issues that may impact health-related fitness.
Results
Of the 26,219 citations identified within our comprehensive search, 25 studies met eligibility and underwent data extraction and quality assessment. Objectively measured built environment characteristics (e.g., improved sidewalks, higher street connectivity, older neighbourhoods, higher residential density, and higher land use mix) were associated with increased flexibility, cardiorespiratory fitness, grip strength, and body composition. Moreover, perceptions of neighbourhood features such as higher neighbourhood walkability, greater park access and quality, and lower neighbourhood crime, were associated with increased perceived cardiorespiratory fitness, muscular strength, flexibility, and overall fitness. However, many of these findings were from cross-sectional studies where adjustment for key confounders varied. Results also varied by sex in the small number of studies that provided sex-specific stratifications.
Conclusions
This project may help elucidate the pathway between the built environment and health-related fitness.
Key messages
Neighbourhood built environment features are associated with aspects of health-related fitness.
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Affiliation(s)
| | | | | | | | | | - Gavin McCormack
- University of Calgary, Calgary, Canada
- Waseda University, Shinjuku, Japan
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16
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Bishay K, Meng ZW, Frehlich L, James MT, Kaplan GG, Bourke MJ, Hilsden RJ, Heitman SJ, Forbes N. Prophylactic clipping to prevent delayed colonic post-polypectomy bleeding: meta-analysis of randomized and observational studies. Surg Endosc 2021; 36:1251-1262. [PMID: 33751224 DOI: 10.1007/s00464-021-08398-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/12/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS Delayed post-polypectomy bleeding (DPPB) is a commonly described adverse event following polypectomy. Prophylactic clipping may prevent DPPB in some patient subgroups. We performed a meta-analysis to assess both the efficacy and real-world effectiveness of prophylactic clipping. METHODS We performed a database search through March 2020 for clinical trials or observational studies assessing prophylactic clipping and DPPB. Pooled risk ratios (RR) were calculated using random effects models. Subgroup, sensitivity, and meta-regression analyses were performed to elucidate clinical or methodological factors associated with effects on outcomes. RESULTS A total of 2771 citations were screened, with 11 randomized controlled trials (RCTs) and 9 observational studies included, representing 24,670 colonoscopies. DPPB occurred in 2.0% of patients overall. The pooled RR of DPPB was 0.47 (95% CI 0.29-0.77) from RCTs enrolling only patients with polyps ≥ 20 mm. Remaining pooled RCT data did not demonstrate a benefit for clipping. The pooled RR of DPPB was 0.96 (95% CI 0.61-1.51) from observational studies including all polyp sizes. For patients with proximal polyps of any size, the RR was 0.73 (95% CI 0.33-1.62) from RCTs. Meta-regression confirmed that polyp size ≥ 20 mm significantly influenced the effect of clipping on DPPB. CONCLUSION Pooled evidence demonstrates a benefit when clipping polyps measuring ≥ 20 mm, especially in the proximal colon. In lower-risk subgroups, prophylactic clipping likely results in little to no difference in DPPB.
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Affiliation(s)
- Kirles Bishay
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Zhao Wu Meng
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Matthew T James
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Gilaad G Kaplan
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Michael J Bourke
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, NSW, Australia.,Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Robert J Hilsden
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB, Canada
| | - Steven J Heitman
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.,Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB, Canada
| | - Nauzer Forbes
- Division of Gastroenterology, Department of Medicine, University of Calgary, TRW 6D19, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. .,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada. .,Forzani & MacPhail Colon Cancer Screening Centre, Alberta Health Services, Calgary, AB, Canada.
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17
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Bishay K, Meng Z, Frehlich L, James MT, Kaplan GG, Bourke MJ, Hilsden RJ, Heitman S, Forbes N. A116 PROPHYLACTIC CLIPPING TO PREVENT DELAYED COLONIC POST-POLYPECTOMY BLEEDING: META-ANALYSIS OF RANDOMIZED AND OBSERVATIONAL STUDIES. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Delayed post-polypectomy bleeding (DPPB) is a commonly described adverse event following polypectomy. Prophylactic clipping may prevent DPPB in some patient subgroups. We performed a meta-analysis to assess both the efficacy and real-world effectiveness of prophylactic clipping.
Aims
We performed a meta-analysis to assess both the efficacy and real-world effectiveness of prophylactic clipping.
Methods
We performed a database search through March 2020 for clinical trials or observational studies assessing prophylactic clipping and DPPB. Pooled risk ratios (RR) were calculated using random effects models. Subgroup, sensitivity and meta-regression analyses were performed to elucidate clinical or methodological factors associated with effects on outcomes.
Results
A total of 2,771 citations were screened, with 11 randomized controlled trials (RCTs) and 9 observational studies included, representing 24,670 colonoscopies. DPPB occurred in 2.0% of patients overall. The pooled RR of DPPB was 0.47 (95% CI 0.29 – 0.77) from RCTs enrolling only patients with polyps ≥ 20 mm. Remaining pooled RCT data did not demonstrate a benefit for clipping. The pooled RR of DPPB was 0.96 (95% CI 0.61 – 1.51) from observational studies including all polyp sizes. For patients with proximal polyps of any size, the RR was 0.73 (95% CI 0.33 - 1.62) from RCTs. Meta-regression confirmed that polyp size ≥ 20 mm significantly influenced the effect of clipping on DPPB.
Conclusions
Pooled evidence demonstrates a benefit when clipping polyps measuring ≥ 20 mm, especially in the proximal colon. In lower-risk subgroups, prophylactic clipping should not be performed.
Funding Agencies
None
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Affiliation(s)
- K Bishay
- University of Calgary, Calgary, AB, Canada
| | - Z Meng
- University of Calgary, Calgary, AB, Canada
| | - L Frehlich
- University of Calgary, Calgary, AB, Canada
| | - M T James
- University of Calgary, Calgary, AB, Canada
| | - G G Kaplan
- University of Calgary, Calgary, AB, Canada
| | - M J Bourke
- University of Sydney, Westmead, New South Wales, Australia
| | | | - S Heitman
- University of Calgary, Calgary, AB, Canada
| | - N Forbes
- University of Calgary, Calgary, AB, Canada
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18
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McCormack GR, Frehlich L, Blackstaffe A, Turin TC, Doyle-Baker PK. Physical Fitness And Neighborhood Design - Walkability, Cardiorespiratory Fitness, Muscular Strength, And Flexibility In Adults. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000686320.83459.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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19
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Yano S, Koohsari MJ, Shibata A, Ishii K, Frehlich L, McCormack GR, Oka K. Physical Activity and Sedentary Behavior Assessment: A Laboratory-Based Evaluation of Agreement between Commonly Used ActiGraph and Omron Accelerometers. Int J Environ Res Public Health 2019; 16:ijerph16173126. [PMID: 31466248 PMCID: PMC6747086 DOI: 10.3390/ijerph16173126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022]
Abstract
Different models of accelerometer have the potential to provide a different estimate of the same physical activity or sedentary behavior. Our study compared the outputs of the Active Style Pro (ASP) and ActiGraph (AG) devices in assessing predicted metabolic equivalents (METs) for specific activities under laboratory conditions. Thirty healthy young adults wore two hip accelerometers (ASP and AG), simultaneously while performing twenty-two activities (eight sedentary, eight household, and six ambulatory activities) in a controlled laboratory setting. For the AG, predicted METs for each activity was calculated using four equations based on vertical-axis and vector magnitude data. Separate paired t-tests and Bland–Altman analysis examined the difference and agreement in METs between AG using four commonly used equations and ASP measurements for each activity. AG devices using different equations calculated significantly different outcomes for most activities compared with ASP devices. The smallest differences in predicted METs estimates between ASP and AG were observed for ambulatory activities. Ambulatory activities demonstrated the best agreement between ASP and AG regardless of which AG equation was used. Our findings can be used to assist researchers in their selection of accelerometer and output estimation equations for measuring physical activity and sedentary behavior in adults.
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Affiliation(s)
- Shohei Yano
- Institute for Sport Sciences, Waseda University, Saitama 359-1192, Japan.
| | - Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Ai Shibata
- Faculty of Health and Sports Sciences, University of Tsukuba, Ibaraki 305-8574, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan
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20
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Frehlich L, Blackstaffe A, McCormack GR. Test-Retest Reliability and Walk Score ® Neighbourhood Walkability Comparison of an Online Perceived Neighbourhood-Specific Adaptation of the International Physical Activity Questionnaire (IPAQ). Int J Environ Res Public Health 2019; 16:ijerph16111917. [PMID: 31151210 PMCID: PMC6603616 DOI: 10.3390/ijerph16111917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/24/2019] [Accepted: 05/28/2019] [Indexed: 01/04/2023]
Abstract
There is a growing public health interest in the contributions of the built environment in enabling and supporting physical activity. However, few tools measuring neighbourhood-specific physical activity exist. This study assessed the reliability of an established physical activity tool (International Physical Activity Questionnaire: IPAQ) adapted to capture perceived neighbourhood-specific physical activity (N-IPAQ) administered via the internet and compared N-IPAQ outcomes to differences in neighbourhood Walk Score®. A sample of n = 261 adults completed an online questionnaire on two occasions at least seven days apart. Questionnaire items captured walking, cycling, moderate-intensity, and vigorous-intensity physical activity, undertaken inside the participant's perceived neighbourhood in the past week. Intraclass correlations, Spearman's rank correlation, and Cohen's Kappa coefficients estimated item test-retest reliability. Regression estimated the associations between self-reported perceived neighbourhood-specific physical activity and Walk Score®. With the exception of moderate physical activity duration, participation and duration for all physical activities demonstrated moderate reliability. Transportation walking participation and duration was higher (p < 0.05) in more walkable neighbourhoods. The N-IPAQ administered online found differences in neighbourhoods that vary in their walkability. Future studies investigating built environments and self-reported physical activity may consider using the online version of the N-IPAQ.
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Affiliation(s)
- Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
| | - Anita Blackstaffe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
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21
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Yano S, Koohsari MJ, Shibata A, Ishii K, Frehlich L, McCormack GR, Oka K. Comparison of Older and Newer Generation Active Style Pro Accelerometers in Physical Activity and Sedentary Behavior Surveillance under a Free-Living Environment. Int J Environ Res Public Health 2019; 16:ijerph16091597. [PMID: 31067688 PMCID: PMC6539210 DOI: 10.3390/ijerph16091597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 11/16/2022]
Abstract
Background. Comparability of accelerometers in epidemiological studies is important for public health researchers. This study aimed to compare physical activity (light, LPA; moderate, MPA; and moderate-to-vigorous, MVPA) and sedentary behavior (SB) data collected using two Omron triaxial accelerometer generations (Active style Pro, ASP) among a sample of Japanese workers in a free-living environment. Methods. Thirty active and sedentary workers (24–62 years) wore two types of ASP accelerometers, the HJA-350IT (350IT) and the HJA-750C (750C), simultaneously for seven consecutive days to represent a typical week. The accelerometers estimated daily average step counts and time spent per day in LPA, MPA, and MVPA. If a participant had data for ≥4 days (>10 h/day) it was considered valid. The difference and agreement between the two ASPs were analyzed using a paired t-test, intra-class correlation coefficients (ICC), and a Bland–Altman analysis in total and for each type of worker. Results. Among all workers, the 750C measured significantly (p < 0.05) less SB, MPA, MVPA, and more LPA compared with the 350IT. The agreements in ICC were high (ICC ≥ 0.94). Conclusions. Compared with the 350IT, the newer generation 750C ASP accelerometer may not provide equivalent estimates of activity time, regardless of the type of physical activity.
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Affiliation(s)
- Shohei Yano
- Institute for Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan.
| | - Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan.
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne 3004, Australia.
| | - Ai Shibata
- Faculty Health and Sports Sciences, University of Tsukuba, Tsukuba 305-8574, Japan.
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan.
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa 359-1192, Japan.
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22
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Forbes N, Frehlich L, James MT, Hilsden RJ, Kaplan GG, Wilson TA, Lorenzetti DL, Tate DJ, Bourke MJ, Heitman SJ. Routine Prophylactic Endoscopic Clipping Is Not Efficacious in the Prevention of Delayed Post-Polypectomy Bleeding: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Can Assoc Gastroenterol 2018; 2:105-117. [PMID: 31294373 PMCID: PMC6619410 DOI: 10.1093/jcag/gwy033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background and Aims Colorectal cancer (CRC) can be prevented through colonoscopic polypectomy, but this exposes patients to risks, including delayed post-polypectomy bleeding (DPPB). Endoscopists increasingly use clips prophylactically with the aim of preventing DPPB. However, clips are costly, and data to support their efficacy in this context are inconsistent. We performed a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of prophylactic clipping for preventing DPPB. Methods We searched electronic databases and other relevant sources for randomized controlled trials assessing the efficacy of prophylactic clipping versus no clipping for the prevention of DPPB. Pooled relative risks were determined using a fixed-effects model. Subgroup analyses were also performed. Results A total of 2305 citations were initially screened. Seven randomized controlled trials satisfied all criteria for inclusion. The quality of included studies was generally low to moderate. A total of 2851 patients underwent 5405 polypectomies. Delayed post-polypectomy bleeding occurred at an overall pooled rate of 2.5%. No overall benefit of clipping for preventing DPPB was observed, with a pooled relative risk of 0.86 (95% confidence interval [CI], 0.55 to 1.36). No significant patient or polyp factors predicting DPPB were found through subgroup analyses. No publication bias was identified. Conclusions Randomized trials to date do not demonstrate a protective effect of prophylactic clipping for the prevention of DPPB, and therefore, the practice of routine prophylactic clipping appears unjustified. Additional high quality randomized trials are required to identify higher-risk groups that may benefit from prophylactic clipping.
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Affiliation(s)
- Nauzer Forbes
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Matthew T James
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Robert J Hilsden
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Gilaad G Kaplan
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Todd A Wilson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Diane L Lorenzetti
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David J Tate
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Michael J Bourke
- Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia.,Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Steven J Heitman
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Frehlich L, Friedenreich C, Nettel-Aguirre A, McCormack GR. Test-retest reliability of a modified International Physical Activity Questionnaire (IPAQ) to capture neighbourhood physical activity. jhse 2018. [DOI: 10.14198/jhse.2018.131.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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