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SIGNIFICANCE: This work is significant because it is the first Cochrane systemic review that compares the comfort and safety of hydrogel and silicone hydrogel soft contact lenses (SCL). PURPOSE: This study aimed to conduct a systemic review of randomized trials comparing the comfort and safety of silicone hydrogel and hydrogel SCLs. METHODS: CENTRAL, MEDLINE Ovid, EMBASE.com, PubMed, LILACS, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform were searched on or before June 24, 2022, to identify randomized clinical trials that compared silicone hydrogel and hydrogel SCLs. RESULTS: Seven trials were identified and evaluated. One trial reported Ocular Surface Disease Index results, with the evidence being very uncertain about the effects of SCL material on Ocular Surface Disease Index scores (mean difference, -1.20; 95% confidence interval, -10.49 to 8.09). Three trials reported visual analog scale comfort score results, with no clear difference in comfort between materials, although results were of low certainty; trial results could not be combined because the three trials reported results at different time points. None of the included trials reported Contact Lens Dry Eye Questionnaire 8 or Standard Patient Evaluation of Eye Dryness scores. There was no evidence of a clinically meaningful difference (>0.5 unit) between daily disposable silicone hydrogel and hydrogel SCLs in corneal staining, conjunctival staining, or conjunctival redness (very low certainty evidence). CONCLUSIONS: The overall evidence for a difference between all included silicone hydrogel and hydrogel SCL trials was of very low certainty, with most trials judged as having a high overall risk of bias. There was insufficient evidence to support recommending one SCL material over the other. Future well-designed trials are needed to generate high certainty evidence to further clarify differences in SCL material comfort and safety.
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OBJECTIVE: Built environment interventions provide structural solutions to complex urban challenges. Though community voices are part of municipal decision-making, planners and public health professionals need tools to better integrate their perspectives for desired changes (what) when implementing built environment interventions (how). We present two simultaneous concept mapping exercises conducted in Montréal, Canada, to facilitate the consideration of these dimensions. METHODS: Community members were prompted about neighbourhood changes that could improve their quality of life; stakeholders were prompted about factors that contribute to successful implementation of interventions. Through each exercise, items were generated, grouped, and rated on importance and feasibility. Concept maps were produced using multidimensional scaling and hierarchical cluster analysis. The clusters identified by community members and stakeholders were combined into a Community × Stakeholder Matrix, which supported discussions on interventions with the research's Advisory Committee. RESULTS: Thirty-two community members generated 41 responses, which resulted in 6 clusters: (1) strengthen public transportation, (2) reduce space dedicated to cars, (3) foster local social connections, (4) develop quality cycling infrastructure, (5) improve pedestrian accessibility, and (6) green the city. Thirty-seven stakeholders generated 40 items, which resulted in 5 clusters: (1) collaboration with stakeholders and citizens, (2) planning and evaluation, (3) common vision for the future, (4) regulatory framework and funding, and (5) context-informed approach. CONCLUSION: Capturing the collective vision of our urban environments and the processes underlying change through concept mapping can lead to more successful changes. We propose combining understandings of the what and how into a matrix to support evaluation and strategic planning of interventions and better integrate community voices into operational planning.
RéSUMé: OBJECTIF: Les interventions sur le cadre bâti peuvent offrir des solutions structurelles aux défis urbains complexes. Bien que les communautés fassent partie du processus décisionnel municipal, les urbanistes et les professionnels de la santé publique ont besoin d'outils pour mieux intégrer leurs perspectives sur les changements souhaités (le quoi) dans la mise en Åuvre réussie des programmes et des interventions sur l'environnement bâti (le comment). Nous présentons deux exercices simultanés de cartographie conceptuelle menés à Montréal, Canada, visant à capter ces dimensions de mise en Åuvre. MéTHODES: Les membres de la communauté ont été sondés sur les changements dans leur quartier qui seraient susceptibles d'améliorer leur qualité de vie, tandis que des acteurs municipaux ont été sondés sur les facteurs qui contribuent à la réussite de la mise en Åuvre des interventions urbaines. Pour chaque exercice, des items ont été générés, regroupés et notés en fonction de leur importance et de leur faisabilité. Des cartes conceptuelles ont été produites à l'aide d'analyse multivariée d'étalonnage multidimensionnel et d'une analyse hiérarchique ascendante. Les regroupements identifiés par les membres de la communauté et les acteurs municipaux ont été combinés dans une matrice communauté × acteurs municipaux, qui a encadré une discussion sur les interventions sur le cadre bâti avec le comité consultatif du programme de recherche. RéSULTATS: Trente-deux membres de la communauté ont généré 41 réponses uniques, qui ont formé 6 regroupements : (1) renforcer les transports en commun, (2) réduire l'espace dédié aux voitures, (3) favoriser le lien social local, (4) développer des infrastructures cyclables de qualité, (5) améliorer l'accessibilité piétonne, et (6) verdir la ville. Trente-sept acteurs municipaux ont généré 40 éléments uniques, qui ont mené à 5 regroupements : (1) collaboration avec les parties prenantes et les citoyens, (2) planification et évaluation, (3) vision commune pour l'avenir, (4) cadre réglementaire et financement, et (5) approche contextuelle. CONCLUSION: En captant la vision collective sur nos environnements urbains et la compréhension des processus sous-jacents au changement avec la cartographie conceptuelle, les transformations urbaines peuvent être plus réussies et plus inclusives. Nous proposons de combiner les perspectives sur le quoi et le comment dans une matrice pour soutenir l'évaluation et la planification stratégique d'interventions, tout en promouvant l'intégration des voix de la communauté dans la planification opérationnelle de l'aménagement urbain.
Subject(s)
Built Environment , Community Participation , Stakeholder Participation , Humans , Quebec , Cities , Health Promotion/organization & administration , Urban Health , Concept Formation , Residence Characteristics , City PlanningABSTRACT
There is an obligation among those teaching epidemiology to incorporate principles of equity, diversity, and inclusion (EDI) into the curriculum. While there is a well-established literature related to teaching epidemiology, this literature rarely addresses critical aspects of EDI. To our knowledge, there is no working group or central point of discussion and learning for incorporating EDI into epidemiology teaching in Canada. To address this gap, we convened a workshop entitled "Incorporating EDI into the epidemiology and biostatistics curriculum and classroom." The workshop discussed nine strategies to incorporate EDI in the epidemiology curriculum: positionality (or reflexivity) statements; opportunities for feedback; land acknowledgements; clarifying the purpose of collecting data on race and ethnicity, sex and gender, Indigeneity; acknowledging that race/ethnicity is a social construct, not a biological variable; describing incidence and prevalence of disease; demonstrating explicit bias using directed acyclic graphs (DAGs); critical appraisal of study population diversity; and admission criteria and considerations. Key take-aways from the workshop were the need to be more intentional when determining the validity of evidence, particularly with respect to historical context and the need to recognize that there is no single solution that will address EDI.
RéSUMé: Les personnes qui enseignent l'épidémiologie ont l'obligation d'intégrer les principes d'équité, de diversité et d'inclusion (EDI) dans le programme d'études. Bien qu'il existe une littérature bien établie sur l'enseignement de l'épidémiologie, cette littérature aborde rarement les aspects critiques de l'EDI. À notre connaissance, il n'existe pas de groupe de travail ou de point central de discussion et d'apprentissage pour l'intégration de l'EDI dans l'enseignement de l'épidémiologie au Canada. Pour combler cette lacune, nous avons organisé un atelier intitulé « Incorporer l'EDI dans le programme d'enseignement de l'épidémiologie et de la biostatistique et dans la salle de classe ¼. L'atelier a examiné neuf stratégies visant à intégrer l'EDI dans le programme d'enseignement de l'épidémiologie : déclarations de positionnement (ou de réflexivité); occasions pour partager de la rétroaction; reconnaissances territoriales; clarification de l'objectif derrière la collecte de données sur la race et l'ethnicité, le sexe et le genre et l'indigénéité; reconnaissance du fait que la race/l'ethnicité est une construction sociale et non une variable biologique; description de l'incidence et de la prévalence des maladies; démonstration de parti pris explicites à l'aide de graphe orienté acyclique (DAG); évaluation critique de la diversité de l'échantillon étudié; et critères et considérations d'admission. Les principaux enseignements tirés de l'atelier sont la nécessité d'être plus intentionnel dans la détermination de la validité des données probantes, en particulier en ce qui concerne le contexte historique, et la nécessité de reconnaître qu'il n'existe pas de solution unique pour prendre en compte les principes de l'EDI.
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INTRODUCTION: Improving sustainable transportation options will help cities tackle growing challenges related to population health, congestion, climate change and inequity. Interventions supporting active transportation face many practical and political hurdles. Implementation science aims to understand how interventions or policies arise, how they can be translated to new contexts or scales and who benefits. Sustainable transportation interventions are complex, and existing implementation science frameworks may not be suitable. To apply and adapt implementation science for healthy cities, we have launched our mixed-methods research programme, CapaCITY/É. We aim to understand how, why and for whom sustainable transportation interventions are successful and when they are not. METHODS AND ANALYSIS: Across nine Canadian municipalities and the State of Victoria (Australia), our research will focus on two types of sustainable transportation interventions: all ages and abilities bicycle networks and motor vehicle speed management interventions. We will (1) document the implementation process and outcomes of both types of sustainable transportation interventions; (2) examine equity, health and mobility impacts of these interventions; (3) advance implementation science by developing a novel sustainable transportation implementation science framework and (4) develop tools for scaling up and scaling out sustainable transportation interventions. Training activities will develop interdisciplinary scholars and practitioners able to work at the nexus of academia and sustainable cities. ETHICS AND DISSEMINATION: This study received approval from the Simon Fraser University Office of Ethics Research (H22-03469). A Knowledge Mobilization Hub will coordinate dissemination of findings via a website; presentations to academic, community organisations and practitioner audiences; and through peer-reviewed articles.
Subject(s)
Capacity Building , Implementation Science , Humans , Cities , Canada , VictoriaABSTRACT
The purpose of this study was to assess the feasibility and acceptability of a mobile intervention that promotes smoking cessation and physical activity among Latinos living in the United States. Twenty Latino adults who smoked and did not meet recommended levels of physical activity were recruited using community-based recruitment strategies. Participants received Actívatexto, a theory-based, culturally accommodated, 12-week text messaging intervention (available in English and Spanish) that promotes smoking cessation and physical activity. Actívatexto integrates four components: (i) a text messaging program, (ii) a wearable device, (iii) an online dashboard where the research team manages participants' incoming and outgoing data from both the text messaging program and wearable device, and (iv) nicotine replacement therapies (NRT). We assessed self-reported 7-day point prevalence smoking abstinence at month 3, weekly minutes of moderate to vigorous physical activity (MVPA), pharmacotherapy adherence, and satisfaction. At baseline, participants' mean age was 47.3 years old (SD 16.0), 55% of participants were female, and 60% indicated that Spanish was their language of preference. Seventy-five percent of participants smoked 1-10 cigarettes daily and 35% smoked their first cigarette within 5 minutes after waking up. At month 3, 14 participants (70%) self-reported 7-day point prevalence smoking abstinence (90% follow-up rate). Fitbit-assessed mean minutes of MVPA per week increased from 113 (SD 127; range: 0-399) at week 1 to 177 (SD 163; range: 0-513) at month 3 (P = 0.15). Sixteen participants (88.9%, 16/18) reported NRT use in the past 90 days. Most participants reported being extremely satisfied or satisfied with the intervention (88.9%, 16/18). SIGNIFICANCE: Actívatexto resulted in a noteworthy cessation rate at month 3 (70%), increased mean weekly minutes of MVPA, produced high use of NRT, and was well received by participants. Additional testing in a randomized clinical trial is warranted to assess the efficacy of the intervention.
Subject(s)
Smoking Cessation , Female , Humans , Male , Middle Aged , Exercise , Feasibility Studies , Hispanic or Latino , Tobacco Use Cessation DevicesABSTRACT
Urban environmental factors such as air quality, heat islands, and access to greenspaces and community amenities impact public health. Some vulnerable populations such as low-income groups, children, older adults, new immigrants, and visible minorities live in areas with fewer beneficial conditions, and therefore, face greater health risks. Planning and advocating for equitable healthy urban environments requires systematic analysis of reliable spatial data to identify where vulnerable populations intersect with positive or negative urban/environmental characteristics. To facilitate this effort in Canada, we developed HealthyPlan.City ( https://healthyplan.city/ ), a freely available web mapping platform for users to visualize the spatial patterns of built environment indicators, vulnerable populations, and environmental inequity within over 125 Canadian cities. This tool helps users identify areas within Canadian cities where relatively higher proportions of vulnerable populations experience lower than average levels of beneficial environmental conditions, which we refer to as Equity priority areas. Using nationally standardized environmental data from satellite imagery and other large geospatial databases and demographic data from the Canadian Census, HealthyPlan.City provides a block-by-block snapshot of environmental inequities in Canadian cities. The tool aims to support urban planners, public health professionals, policy makers, and community organizers to identify neighborhoods where targeted investments and improvements to the local environment would simultaneously help communities address environmental inequities, promote public health, and adapt to climate change. In this paper, we report on the key considerations that informed our approach to developing this tool and describe the current web-based application.
Subject(s)
Public Health , Humans , Canada , Internet , Vulnerable Populations , Urban Health , Residence Characteristics , Built Environment , Health Equity , Cities , Environmental HealthABSTRACT
In brief: Females with obesity may experience infertility and can improve their fertility through exercise. This review found that most exercise interventions improve fertility outcomes regardless of technique, intensity, or duration. More detailed reporting through the lens of exercise prescription should be included in future studies. Abstract: Female infertility disproportionately affects people with obesity. Exercise often improves fertility outcomes for this population, however, there is limited prescriptive evidence. Specifically, there is a lack of information on the ideal type, frequency, intensity, and setting of exercise to improve fertility outcomes. Using principles of exercise prescription, this review aimed to describe the scope of exercise interventions that have been explored and fertility outcomes measured for people with female infertility and obesity. A search was completed in PubMed, Embase, Cochrane, and CINAHL, identifying 16 relevant published articles. Overall, exercise had a positive impact on female fertility outcomes in people with obesity, though there were large variations in the exercise interventions prescribed and outcomes measured. Cyclic exercise (i.e. walking and cycling) was the most common technique incorporated, though a combination of cyclic, acyclic (i.e. circuit training and boot camp), or individualization was often used. Several fertility outcomes were reported; however, the rate of conception, pregnancy, and live birth rates were the most common, which, we suggest, should always be reported in fertility intervention research. We stress that future studies provide more thorough descriptions of their implemented exercise interventions to facilitate reproducibility and comparisons between studies. Closer attention to the principles of exercise prescription when developing and reporting exercise interventions will help improve fertility outcomes, mainly live birth rates, for those with female infertility and obesity.
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Exercise , Fertility , Infertility, Female , Obesity , Humans , Female , Infertility, Female/therapy , Obesity/therapy , Fertility/physiology , Pregnancy , Exercise Therapy/methods , Pregnancy RateABSTRACT
Background: Cycling infrastructure investments support active transportation, improve population health, and reduce health inequities. This study examines the relationship between changes in cycling infrastructure (2011-2016) and census tract (CT)-level measures of material deprivation, visible minorities, and gentrification in Montreal. Methods: Our outcomes are the length of protected bike lanes, cyclist-only paths, multi-use paths, and on-street bike lanes in 2011, and change in total length of bike lanes between 2011 and 2016 at the CT level. Census data provided measures of the level of material deprivation and of the percentage of visible minorities in 2011, and if a CT gentrified between 2011 and 2016. Using a hurdle modeling approach, we explore associations among these CT-level socioeconomic measures, gentrification status, baseline cycling infrastructure (2011), and its changes (2011-2016). We further tested if these associations varied depending on the baseline level of existing infrastructure, to assess if areas with originally less resources benefited less or more. Results: In 2011, CTs with higher level of material deprivation or greater percentages of visible minorities had less cycling infrastructure. Overall, between 2011 and 2016, cycling infrastructure increased from 7.0% to 10.9% of the road network, but the implementation of new cycling infrastructure in CTs with no pre-existing cycling infrastructure in 2011 was less likely to occur in CTs with a higher percentage of visible minorities. High-income CTs that were ineligible for gentrification between 2011 and 2016 benefited less from new cycling infrastructure implementations compared to low-income CTs that were not gentrified during the same period. Conclusion: Montreal's municipal cycling infrastructure programs did not exacerbate socioeconomic disparities in cycling infrastructure from 2011 to 2016 in CTs with pre-existing infrastructure. However, it is crucial to prioritize the implementation of cycling infrastructure in CTs with high populations of visible minorities, particularly in CTs where no cycling infrastructure currently exists.
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BACKGROUND: Human activity Recognition (HAR) using smartphone sensors suffers from two major problems: sensor orientation and placement. Sensor orientation and sensor placement problems refer to the variation in sensor signal for a particular activity due to sensors' altering orientation and placement. Extracting orientation and position invariant features from raw sensor signals is a simple solution for tackling these problems. Using few heuristic features rather than numerous time-domain and frequency-domain features offers more simplicity in this approach. The heuristic features are features which have very minimal effects of sensor orientation and placement. In this study, we evaluated the effectiveness of four simple heuristic features in solving the sensor orientation and placement problems using a 1D-CNN-LSTM model for a data set consisting of over 12 million samples. METHODS: We accumulated data from 42 participants for six common daily activities: Lying, Sitting, Walking, and Running at 3-Metabolic Equivalent of Tasks (METs), 5-METs and 7-METs from a single accelerometer sensor of a smartphone. We conducted our study for three smartphone positions: Pocket, Backpack and Hand. We extracted simple heuristic features from the accelerometer data and used them to train and test a 1D-CNN-LSTM model to evaluate their effectiveness in solving sensor orientation and placement problems. RESULTS: We performed intra-position and inter-position evaluations. In intra-position evaluation, we trained and tested the model using data from the same smartphone position, whereas, in inter-position evaluation, the training and test data was from different smartphone positions. For intra-position evaluation, we acquired 70-73% accuracy; for inter-position cases, the accuracies ranged between 59 and 69%. Moreover, we performed participant-specific and activity-specific analyses. CONCLUSIONS: We found that the simple heuristic features are considerably effective in solving orientation problems. With further development, such as fusing the heuristic features with other methods that eliminate placement issues, we can also achieve a better result than the outcome we achieved using the heuristic features for the sensor placement problem. In addition, we found the heuristic features to be more effective in recognizing high-intensity activities.
Subject(s)
Heuristics , Smartphone , Humans , Human Activities , Walking , Accelerometry/methodsABSTRACT
Oxygen minimum zones in the open ocean are predicted to significantly increase in volume over the coming decades as a result of anthropogenic climatic warming. The resulting reduction in dissolved oxygen (DO) in the pelagic realm is likely to have detrimental impacts on water-breathing organisms, particularly those with higher metabolic rates, such as billfish, tunas, and sharks. However, little is known about how free-living fish respond to low DO environments, and therefore, the effect increasing OMZs will have cannot be predicted reliably. Here, we compare the responses of two active predators (bigeye tuna Thunnus obesus and yellowfin tuna Thunnus albacares) to DO at depth throughout the eastern Pacific Ocean. Using time-series data from 267 tagged tunas (59,910 days) and 3D maps of modelled DO, we find that yellowfin tuna respond to low DO at depth by spending more time in shallower, more oxygenated waters. By contrast, bigeye tuna, which forage at deeper depths well below the thermocline, show fewer changes in their use of the water column. However, we find that bigeye tuna increased the frequency of brief upward vertical excursions they performed by four times when DO at depth was lower, but with no concomitant significant difference in temperature, suggesting that this behaviour is driven in part by the need to re-oxygenate following time spent in hypoxic waters. These findings suggest that increasing OMZs will impact the behaviour of these commercially important species, and it is therefore likely that other water-breathing predators with higher metabolic rates will face similar pressures. A more comprehensive understanding of the effect of shoaling OMZs on pelagic fish vertical habitat use, which may increase their vulnerability to surface fisheries, will be important to obtain if these effects are to be mitigated by future management actions. Supplementary Information: The online version contains supplementary material available at 10.1007/s00227-023-04366-2.
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In this study, we compared location data from a dedicated Global Positioning System (GPS) device with location data from smartphones. Data from the Interventions, Equity, and Action in Cities Team (INTERACT) Study, a study examining the impact of urban-form changes on health in 4 Canadian cities (Victoria, Vancouver, Saskatoon, and Montreal), were used. A total of 337 participants contributed data collected for about 6 months from the Ethica Data smartphone application (Ethica Data Inc., Toronto, Ontario, Canada) and the SenseDoc dedicated GPS (MobySens Technologies Inc., Montreal, Quebec, Canada) during the period 2017-2019. Participants recorded an average total of 14,781 Ethica locations (standard deviation, 19,353) and 197,167 SenseDoc locations (standard deviation, 111,868). Dynamic time warping and cross-correlation were used to examine the spatial and temporal similarity of GPS points. Four activity-space measures derived from the smartphone app and the dedicated GPS device were compared. Analysis showed that cross-correlations were above 0.8 at the 125-m resolution for the survey and day levels and increased as cell size increased. At the day or survey level, there were only small differences between the activity-space measures. Based on our findings, we recommend dedicated GPS devices for studies where the exposure and the outcome are both measured at high frequency and when the analysis will not be aggregate. When the exposure and outcome are measured or will be aggregated to the day level, the dedicated GPS device and the smartphone app provide similar results.
Subject(s)
Mobile Applications , Smartphone , Humans , Geographic Information Systems , Surveys and Questionnaires , OntarioABSTRACT
BACKGROUND: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.
Subject(s)
Environment , Exercise , Humans , Delphi Technique , Built Environment , Research DesignABSTRACT
BACKGROUND: Schools may be high-leverage points for the promotion of physical activity (PA), yet little is known about school built and social environments among youth at high risk of obesity. PURPOSE: To characterise school built and social environments that may be salient for PA and to examine associations between school PA environments and PA in youth at risk of obesity. METHODS: Data from youth attending 206 schools (314 youth in 2005-2008, and 129 youth in 2008-2010) within the QUALITY cohort study, a longitudinal investigation of youth at high risk of obesity were used. Features of schools, based on built, policy/programming and social environments were identified using principal components (PC) analysis. Gender-stratified generalized estimating equation (GEE) models were used to explore associations between school features and accelerometer measured mean counts per minute (MCPM), mean daily moderate-to-vigorous physical activity (MVPA) and the odds of meeting MVPA guidelines cross-sectionally and prospectively using 90% confidence intervals. RESULTS: Nine PCs were identified. Associations were observed between PA and 7 of the 9 PCs. The social environment seemed to be particularly important. Social Norms to Promote PA was associated with an increase in girls' baseline MCPM and MVPA. High Willingness to Promote PA was associated with boys' MCPM, MVPA, and odds of meeting MVPA guidelines, at both baseline and follow-up. CONCLUSION: School built and social contexts may be associated with PA cross-sectionally and over time. Further studies are necessary to confirm the direction and magnitude of effects and to establish their relevance to school-based health promotion efforts.
Subject(s)
Exercise , Obesity , Male , Female , Humans , Adolescent , Cohort Studies , Obesity/epidemiology , Schools , Social EnvironmentABSTRACT
BACKGROUND: The social and behavioural factors related to physical activity among adults are well known. Despite the overlapping nature of these factors, few studies have examined how multiple predictors of physical activity interact. This study aimed to identify the relative importance of multiple interacting sociodemographic and work-related factors associated with the daily physical activity patterns of a population-based sample of workers. METHODS: Sociodemographic, work, screen time, and health variables were obtained from five, repeated cross-sectional cohorts of workers from the Canadian Health Measures Survey (2007 to 2017). Classification and Regression Tree (CART) modelling was used to identify the discriminators associated with six daily physical activity patterns. The performance of the CART approach was compared to a stepwise multinomial logistic regression model. RESULTS: Among the 8,909 workers analysed, the most important CART discriminators of daily physical activity patterns were age, job skill, and physical strength requirements of the job. Other important factors included participants' sex, educational attainment, fruit/vegetable intake, industry, work hours, marital status, having a child living at home, computer time, and household income. The CART tree had moderate classification accuracy and performed marginally better than the stepwise multinomial logistic regression model. CONCLUSION: Age and work-related factors-particularly job skill, and physical strength requirements at work-appeared as the most important factors related to physical activity attainment, and differed based on sex, work hours, and industry. Delineating the hierarchy of factors associated with daily physical activity may assist in targeting preventive strategies aimed at promoting physical activity in workers.
Subject(s)
Academic Success , Adult , Child , Humans , Canada , Cross-Sectional Studies , Exercise , Decision TreesABSTRACT
BACKGROUND: Ocular discomfort is the leading cause of permanent discontinuation of soft contact lens (SCL) wear. Silicone hydrogel and hydrogel materials are the two major categories of SCLs, with silicone hydrogel materials being newer and more breathable than hydrogel materials. Whether comfort is associated with SCL material is controversial despite numerous studies. Similarly, the difference between these materials in terms of safety outcomes (e.g. frequency of microbial keratitis) is unclear. OBJECTIVES: To evaluate the comparative effectiveness and safety of silicone hydrogel compared with hydrogel SCLs on self-reported comfort, dry eye test results, and adverse events in SCL-wearing adults 18 years of age or older. SEARCH METHODS: The Cochrane Eyes and Vision Information Specialist searched the electronic databases for randomized controlled trials (RCTs). There were no restrictions on language or date of publication. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, including the Cochrane Eyes and Vision Trials Register; 2022, Issue 6), MEDLINE Ovid, Embase.com, PubMed, LILACS (Latin American and Caribbean Health Science Information database), ClinicalTrials.gov, and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We also searched the reference lists of identified studies, review articles, and guidelines for information about relevant studies that may not have been identified by our search strategy. Furthermore, we contacted investigators regarding ongoing trials. The most recent database search was conducted on 24 June 2022. SELECTION CRITERIA: Our search selection criteria included RCTs, quasi-RCTs, and cross-over RCTs. DATA COLLECTION AND ANALYSIS: We applied standard Cochrane methodology. MAIN RESULTS: We included seven parallel-group RCTs conducted in the USA, the UK, Australia, Germany, India, and Turkey. A total of 1371 participants were randomized. The duration of SCL wear ranged from one to 52 weeks. Study characteristics and risk of bias The median number of participants per trial was 120 (interquartile range: 51 to 314), and the average age ranged from 20.7 to 33.0 years. Women represented the majority of participants (range 55% to 74.9%; 5 RCTs). Collectively, the included trials compared eight different silicone hydrogel SCLs with three different hydrogel SCLs. Five trials compared daily disposable SCLs, and two compared extended wear SCLs (worn for seven days and six nights). New SCL wearers were enrolled in three trials. Two trials included both new and established SCL wearers, and two trials did not report participants' history of SCL use. Five trials were sponsored by industry. We judged the overall risk of bias to be 'high' or 'some concerns' for the safety and efficacy outcomes. Findings One trial reported Ocular Surface Disease Index (OSDI) results, with the evidence being very uncertain about the effects of SCL material on OSDI scores (mean difference -1.20, 95% confidence interval [CI] -10.49 to 8.09; 1 RCT, 47 participants; very low certainty evidence). Three trials reported visual analog scale comfort score results, with no clear difference in comfort between materials, but the evidence was of very low certainty; trial results could not be combined because the three trials reported results at different time points. The evidence is very uncertain about the effect of SCL material on discontinuation of contact lens wear (risk ratio [RR] 0.64, 95% CI 0.11 to 3.74; 1 RCT, 248 participants). None of the included trials reported Contact Lens Dry Eye Questionnaire (CLDEQ-8) or Standard Patient Evaluation of Eye Dryness (SPEED) scores. There was no evidence of a clinically meaningful difference (> 0.5 unit) between daily disposable silicone hydrogel and hydrogel SCLs in corneal staining, conjunctival staining, or conjunctival redness (very low certainty evidence). Adverse events Very low certainty evidence from two trials comparing daily disposable SCLs suggested no evidence of a difference between lens materials in the risk of vision-threatening adverse events at one to four weeks (RR 0.68, 95% CI 0.08 to 5.51; 2 RCTs, 368 participants). Two trials comparing extended wear SCLs indicated that hydrogel SCLs may have a 2.03 times lower risk of adverse events at 52 weeks compared with silicone hydrogel SCLs (RR 2.03, 95% CI 1.38 to 2.99; 815 participants), but the certainty of evidence was very low. AUTHORS' CONCLUSIONS: The overall evidence for a difference between all included silicone hydrogel and hydrogel SCLs was of very low certainty, with most trials at high overall risk of bias. The majority of studies did not assess comfort using a validated instrument. There was insufficient evidence to support recommending one SCL material over the other. For extended wear, hydrogel SCL may have a lower risk of adverse events at 52 weeks compared to silicon hydrogel. Future well-designed trials are needed to generate high certainty evidence to further clarify differences in SCL material comfort and safety.
Subject(s)
Contact Lenses, Hydrophilic , Silicones , Adult , Female , Humans , Adolescent , Young Adult , Hydrogels , Face , Contact Lenses, Hydrophilic/adverse effects , Patient Reported Outcome Measures , Randomized Controlled Trials as TopicABSTRACT
Walking is a simple way to improve health through physical activity. Yet many people experience barriers to walking from a variety of physical, social, and psychological factors that impact their mobility. A challenge for managing and studying pedestrian environments is that barriers often occur at local scales (e.g., sidewalk features), yet such fine scale data on pedestrian facilities and experiences are often lacking or out of date. In response, our team developed WalkRollMap.org an online mapping tool that empowers communities by providing them with tools for crowdsourcing their own open data source. In this manuscript we highlight key functions of the tool, discuss initial approaches to community outreach, and share trends in reporting from the first nine months of operation. As of July 27, 2022, there have been 897 reports, of which 53% served to identify hazards, 34% missing amenities, and 14% incidents. The most frequently reported issues were related to sidewalks (15%), driver behavior (19%), and marked crosswalks (7%). The most common suggested amenities were sidewalks, marked crosswalks, connections (i.e., pathways between streets), and curb cuts. The most common types of incidents all included conflicts with vehicles. Data compiled through WalkRollMap.org offer unique potential for local and timely information on microscale barriers to mobility and are available for use by anyone as data are open and downloadable.
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While vaccines and antivirals are now being deployed for the current SARS-CoV-2 pandemic, we require additional antiviral therapeutics to not only effectively combat SARS-CoV-2 and its variants, but also future coronaviruses. All coronaviruses have relatively similar genomes that provide a potential exploitable opening to develop antiviral therapies that will be effective against all coronaviruses. Among the various genes and proteins encoded by all coronaviruses, one particularly "druggable" or relatively easy-to-drug target is the coronavirus Main Protease (3CLpro or Mpro), an enzyme that is involved in cleaving a long peptide translated by the viral genome into its individual protein components that are then assembled into the virus to enable viral replication in the cell. Inhibiting Mpro with a small-molecule antiviral would effectively stop the ability of the virus to replicate, providing therapeutic benefit. In this study, we have utilized activity-based protein profiling (ABPP)-based chemoproteomic approaches to discover and further optimize cysteine-reactive pyrazoline-based covalent inhibitors for the SARS-CoV-2 Mpro. Structure-guided medicinal chemistry and modular synthesis of di- and tri-substituted pyrazolines bearing either chloroacetamide or vinyl sulfonamide cysteine-reactive warheads enabled the expedient exploration of structure-activity relationships (SAR), yielding nanomolar potency inhibitors against Mpro from not only SARS-CoV-2, but across many other coronaviruses. Our studies highlight promising chemical scaffolds that may contribute to future pan-coronavirus inhibitors.
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COVID-19 , SARS-CoV-2 , Humans , Cysteine , Antiviral Agents/pharmacology , Antiviral Agents/chemistry , Protease Inhibitors/pharmacology , Protease Inhibitors/chemistry , Molecular Docking SimulationABSTRACT
While census-defined measures of gentrification are often used in research on gentrification and health, surveys can be used to better understand how residents perceive neighborhood change, and the implications for mental health. Whether or not gentrification affects mental health may depend on the extent to which an individual perceives changes in their neighborhood. Using health and map-based survey data, collected from 2020 to 2021, from the Interventions, Research, and Action in Cities Team, we examined links between perceptions of neighborhood change, census-defined neighborhood gentrification at participant residential addresses, and mental health among 505 adults living in Montréal. After adjusting for age, gender, race, education, and duration at current residence, greater perceived affordability and more positive feelings about neighborhood changes were associated with better mental health, as measured by the mental health component of the short-form health survey. Residents who perceived more change to the social environment had lower mental health scores, after adjusting individual covariates. Census-defined gentrification was not significantly associated with mental health, and perceptions of neighborhood change did not significantly modify the effect of gentrification on mental health. Utilizing survey tools can help researchers understand the role that perceptions of neighborhood change play in the understanding how neighborhood change impacts mental health.
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BACKGROUND: The Canadian 24-Hour Movement Guidelines for adults provide specific recommendations for levels of physical activity, sedentary behavior, and sleep (ie, the movement behaviors) required for optimal health. Performance of the movement behaviors is associated with improved mental well-being. However, most postsecondary students do not meet the movement behavior recommendations within the Canadian 24-Hour Movement Guidelines and experience increased stress and declining well-being, suggesting the need for an intervention targeting students' movement behaviors. OBJECTIVE: We aimed to develop and implement a theory-informed intervention intended to improve the movement behaviors and mental well-being of first-year postsecondary students. METHODS: The Intervention Mapping protocol was applied in the development and implementation of the intervention. Intervention Mapping entailed performing a needs assessment, determining the intervention outcomes, selecting theory- and evidence-based change methods and applications, preparing and producing intervention plans and materials, developing the implementation plan, and finally developing an evaluation plan. The Theoretical Domains Framework and the Behavior Change Wheel were also used in conjunction with the Intervention Mapping protocol to ensure a solid theoretical basis for the intervention. This protocol led to the development and implementation of a 6-week, theory-informed ParticipACTION app-based intervention aimed at helping first-year postsecondary students improve their movement behaviors and mental well-being. The developed app content provided students with information on each of the movement behaviors and behavioral strategies (ie, goal setting, action planning, monitoring, and coping planning). The use of Intervention Mapping allowed for the continuous involvement of various multidisciplinary partners and end users, ensuring that the intervention design and implementation was appropriate for the target audience. The feasibility, acceptability, and potential impact of the intervention will be examined in a subsequent proof-of-concept study at 2 Canadian university campuses. RESULTS: Participant recruitment occurred during September 2021, and the intervention was conducted from October to December 2021. The deadline for completion of the postintervention questionnaire by participants was mid-December 2021. The analysis of data examining the feasibility, acceptability, and potential impact of the intervention began in January 2022, with the publication of the proof-of-concept evaluation expected in 2023. CONCLUSIONS: Intervention Mapping with the Theoretical Domains Framework and Behavior Change Wheel was a useful approach to combine evidence and theoretical concepts to guide the design and implementation of a ParticipACTION app-based intervention targeting postsecondary students' movement behaviors and mental well-being. This process may serve as an example for other researchers developing multiple behavior change app-based interventions. Should the forthcoming evaluation demonstrate the intervention's acceptability, feasibility, and potential impact, the intervention may provide a scalable method of improving postsecondary students' movement behaviors and mental well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/39977.
ABSTRACT
There has been a growing interest in the "metaverse," and discourse about how this platform may contribute to different fields of science is already beginning to emerge. In this paper, we discuss key opportunities and uncertainties about how a metaverse might contribute to advancing knowledge in the interdisciplinary field of the built environment and public health aimed at reducing noncommunicable diseases.