Impact of clinicians' behavior, an educational intervention with mandated blood pressure and the hypotension prediction index software on intraoperative hypotension: a mixed methods study.

PURPOSE: Intraoperative hypotension (IOH) is associated with adverse outcomes. We therefore explored beliefs regarding IOH and barriers to its treatment. Secondarily, we assessed if an educational intervention and mandated mean arterial pressure (MAP), or the implementation of the Hypotension Prediction Index-software (HPI) were associated with a reduction in IOH. METHODS: Structured interviews (n = 27) and questionnaires (n = 84) were conducted to explore clinicians' beliefs and barriers to IOH treatment, in addition to usefulness of HPI questionnaires (n = 14). 150 elective major surgical patients who required invasive blood pressure monitoring were included in three cohorts to assess incidence and time-weighted average (TWA) of hypotension (MAP < 65 mmHg). Cohort one received standard care (baseline), the clinicians of cohort two had a training on hypotension and a mandated MAP > 65 mmHg, and patients of the third cohort received protocolized care using the HPI. RESULTS: Clinicians felt challenged to manage IOH in some patients, yet they reported sufficient knowledge and skills. HPI-software was considered useful and beneficial. No difference was found in incidence of IOH between cohorts. TWA was comparable between baseline and education cohort (0.15 mmHg [0.05-0.41] vs. 0.11 mmHg [0.02-0.37]), but was significantly lower in the HPI cohort (0.04 mmHg [0.00 to 0.11], p < 0.05 compared to both). CONCLUSIONS: Clinicians believed they had sufficient knowledge and skills, which could explain why no difference was found after the educational intervention. In the HPI cohort, IOH was significantly reduced compared to baseline, therefore HPI-software may help prevent IOH. TRIAL REGISTRATION: ISRCTN 17,085,700 on May 9th, 2019.

High spatial and temporal variation in biomass composition of the novel aquaculture target Ecklonia radiata.

The biomass composition of kelp varies within species both spatially and temporally. However, this variation in biomass quality has not yet been investigated for the native kelp Ecklonia radiata within New Zealand, where the kelp is a target for the emerging seaweed aquaculture industry. In this study we quantified spatial and temporal variation in the composition of E. radiata biomass, collected from 12 sites around the North Island of New Zealand and from 12 months across a full year at a single site (n = 138). High spatial variation was detected for most components, including alginate (range: 16.6 - 22.7% DW, n = 12), fucoidan (range: 1.2 - 1.6% DW, n = 12), phlorotannins (range: 4.8 - 9.3% DW, n = 72), and glucose (range: 9.3 - 22.6% DW, n = 12). The biomass composition of E. radiata varied significantly among sites but with no clear patterns among regions, indicating that geographic differences were mostly local rather than regional, possibly due to site-specific environmental conditions. Significant temporal variation (measured by positive autocorrelation between months) was detected in the content of lipids, proteins, glucose, guluronic acid, nitrogen, phosphorous, iodine, arsenic, and mercury, and for the mannuronic to guluronic acid (M:G) ratio. Overall, E. radiata had comparable biomass composition to that of commercially grown northern hemisphere species but with substantially higher phlorotannin content. These results demonstrate that E. radiata could be a viable southern hemisphere alternative for a broad range of commercial applications. Supplementary Information: The online version contains supplementary material available at 10.1007/s10811-023-02969-2.

Effects of operational parameters on the performance of unialgal Oedogonium sp. filamentous algae nutrient scrubbers under controlled environmental conditions.

Filamentous algae nutrient scrubber (FANS) operating parameters can strongly influence algal biomass productivity and nutrient removal. However, few studies to date have investigated the effects of FANS operating parameters such as initial standing crop, harvesting frequency and influent flow rate on biomass productivity and nutrient removal performance, especially for FANS that cultivate a single species of algae. Therefore, the overall aim of this study was to investigate how operating parameters affect the biomass productivity and nutrient removal performance of Oedogonium sp. - a promising species for unialgal FANS. The initial standing crop had a significant effect on biomass productivity, with productivities being highest (8.6 ± 0.5 g DW biomass m-2day-1) when the initial standing crop was 60-70 g DW m-2. However, the daily nutrient removal rate was highest (0.47 ± 0.06 g N m-2 day-1and 1.24 ± 0.13 g P m-2 day-1) at the highest initial standing crop (100-110 DW m-2). Biomass productivity was highest with a three-day growth period, regardless of size of the initial standing crop. Therefore, a four-day harvesting interval was selected as the optimal harvesting regime to promote exponential growth and high biomass production. Influent flow rate had a significant effect on biomass productivity, which was highest (9.3 ± 1.7 g DW m-2 day-1) for the 1 L min-1 flow rate. This flow rate also gave the highest instantaneous nutrient removal rate (0.05 ± 0.02 g N m-3 and 0.14 ± 0.05 g P m-3). Current results suggest that an optimum initial standing crop of 70-80 g DW m-2, harvesting frequency of four days and influent flow rate of 1 L min-1 (16.7 L min-1 m-1 width) were optimal for Oedogonium sp. cultivated on FANS to maximize their biomass production and nutrient removal under controlled laboratory conditions. These results contribute to understanding the impacts of operating parameters on optimizing unialgal Oedogonium sp. FANS biomass production and nutrient removal performance.

Are all ulvans equal? A comparative assessment of the chemical and gelling properties of ulvan from blade and filamentous Ulva.

Green seaweeds of the genus Ulva are rich in the bioactive sulfated polysaccharide ulvan. Herein we characterise ulvan from Ulva species collected from the Bay of Plenty, Aotearoa New Zealand. Using standardised procedures, we quantified, characterised, and compared ulvans from blade (U. australis, U. rigida, U. sp. B, and Ulva sp.) and filamentous (U. flexuosa, U. compressa, U. prolifera, and U. ralfsii) Ulva species. There were distinct differences in composition and structure of ulvans between morphologies. Ulvan isolated from blade species had higher yields (14.0-19.3 %) and iduronic acid content (IdoA = 7-18 mol%), and lower molecular weight (Mw = 190-254 kDa) and storage moduli (G' = 0.1-6.6 Pa) than filamentous species (yield = 7.2-14.6 %; IdoA = 4-7 mol%; Mw = 260-406 kDa; G' = 22.7-74.2 Pa). These results highlight the variability of the physicochemical properties of ulvan from different Ulva sources, and identifies a morphology-based division within the genus Ulva.

Correction: Algal Bioremediation of Waste Waters from Land-Based Aquaculture Using Ulva: Selecting Target Species and Strains.

[This corrects the article DOI: 10.1371/journal.pone.0077344.].

Biochemical evolution in response to intensive harvesting in algae: Evolution of quality and quantity.

Evolutionary responses to indirect selection pressures imposed by intensive harvesting are increasingly common. While artificial selection has shown that biochemical components can show rapid and dramatic evolution, it remains unclear as to whether intensive harvesting can inadvertently induce changes in the biochemistry of harvested populations. For applications such as algal culture, many of the desirable bioproducts could evolve in response to harvesting, reducing cost-effectiveness, but experimental tests are lacking. We used an experimental evolution approach where we imposed heavy and light harvesting regimes on multiple lines of an alga of commercial interest for twelve cycles of harvesting and then placed all lines in a common garden regime for four cycles. We have previously shown that lines in a heavy harvesting regime evolve a "live fast" phenotype with higher growth rates relative to light harvesting regimes. Here, we show that algal biochemistry also shows evolutionary responses, although they were temporarily masked by differences in density under the different harvesting regimes. Heavy harvesting regimes, relative to light harvesting regimes, had reduced productivity of desirable bioproducts, particularly fatty acids. We suggest that commercial operators wishing to maximize productivity of desirable bioproducts should maintain mother cultures, kept at higher densities (which tend to select for desirable phenotypes), and periodically restart their intensively harvested cultures to minimize the negative consequences of biochemical evolution. Our study shows that the burgeoning algal culture industry should pay careful attention to the role of evolution in intensively harvested crops as these effects are nontrivial if subtle.

Exploration of likely engagement with Monetary Contingency Contracts for weight loss: a questionnaire study.

Monetary Contingency Contracts (MCCs) are schemes that ask individuals to pledge money that is returned contingent on behaviour change. In relation to weight loss, this study explored likely levels of engagement with MCCs, how much individuals would be willing to pay into an MCC, and how these amounts vary under different contract conditions. Fifty-six individuals with BMI above 25 who were motivated to lose weight were recruited. The majority of participants (87.5%) indicated that they would be willing to engage with weight loss MCCs, but showed more reluctance to subscribe to pair-based MCCs which offered; (a) refunds contingent on the weight loss of a weight loss partner, and (b) 'all or nothing refunds' in which no reward is given for any weight loss below the target weight loss goal. This study provides preliminary evidence that individuals motivated to lose weight may be willing to engage with weight loss MCCs. Further research is needed to explore reasons for reluctance to subscribe to MCCs with certain conditions, to inform the design of future experimental studies testing the efficacy of MCCs as part of an intervention for weight loss.

The effect of pair-based monetary contingency contracts for weight loss: Results from a randomized controlled pilot study.

OBJECTIVE: Monetary contingency contracts (MCCs), in which deposited money is returned contingent on weight loss, could promote weight/adiposity reduction. This study piloted individual- and pair-based MCCs (when refunds are contingent on two individuals losing weight) and assessed effects on weight/body composition. METHODS: Seventy-seven participants with BMI greater than 25 kg/m2 were recruited. In a non-blinded, randomized controlled trial conducted in a university laboratory setting, participants were randomized in pairs via a computer-generated sequence to one of four conditions: partner with pair-based refund (P-PBR), partner with individual refund (P-IR), individual weight loss with individual refund (I-IR), or no MCC (comparison). Refunds were contingent on weight loss after 4 and 8 weeks; weight/body composition was measured at 0, 4, and 8 weeks. Primary outcome measures were change in weight and fat mass. RESULTS: Seventy-seven participants (P-PBR n = 16; P-IR n = 20; I-IR n = 22; comparison n = 19) were recruited. Deposit amount was significantly positively associated with reductions in weight/BMI. At 8 weeks, the P-PBR condition reduced fat mass more than all other conditions (P < 0.05) and reduced weight/BMI more than the I-IR condition (P < 0.05). CONCLUSIONS: The large effect of P-PBR on fat mass suggests it would be valuable to conduct a fully powered, randomized controlled trial of pair-based MCCs.

Is there a role for patients and their relatives in escalating clinical deterioration in hospital? A systematic review.

BACKGROUND: Measures exist to improve early recognition of, and response to, deteriorating patients in hospital. However, deteriorating patients continue to go unrecognized. To address this, interventions have been developed that invite patients and relatives to escalate patient deterioration to a rapid response team (RRT). OBJECTIVE: To systematically review articles that describe these interventions and investigate their effectiveness at reducing preventable deterioration. SEARCH STRATEGY: Following PRISMA guidelines, four electronic databases and two web search engines were searched to identify literature investigating patient and relative led escalation. INCLUSION CRITERIA: Articles investigating the implementation or use of systems involving patients and relatives in the detection of clinical patient deterioration and escalation of patient care to address any clinical or non-clinical outcomes were included. Articles' eligibility was validated by a second reviewer (20%). DATA EXTRACTION: Data were extracted according to pre-defined criteria. DATA SYNTHESIS: Narrative synthesis was applied to included studies. MAIN RESULTS: Nine empirical studies and 36 grey literature articles were included in the review. Limited studies were conducted to establish the clinical effectiveness of patient and relative led escalation. Instead, studies investigated the impact of this intervention on health-care staff and available resources. Although appropriate, this reflects the infancy of research in this area. Patients and relatives did not overwhelm resources by activating the RRT. However, they did activate it to address concerns unrelated to patient deterioration. CONCLUSIONS: Activating a RRT may not be the most appropriate or cost-effective method of resolving non-life-threatening concerns.

The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study.

BACKGROUND: There is growing interest in the role of patients in improving patient safety. One such role is providing feedback on the safety of their care. Here we describe the development and feasibility testing of an intervention that collects patient feedback on patient safety, brings together staff to consider this feedback and to plan improvement strategies. We address two research questions: i) to explore the feasibility of the process of systematically collecting feedback from patients about the safety of care as part of the PRASE intervention; and, ii) to explore the feasibility and acceptability of the PRASE intervention for staff, and to understand more about how staff use the patient feedback for service improvement. METHOD: We conducted a feasibility study using a wait-list controlled design across six wards within an acute teaching hospital. Intervention wards were asked to participate in two cycles of the PRASE (Patient Reporting & Action for a Safe Environment) intervention across a six-month period. Participants were patients on participating wards. To explore the acceptability of the intervention for staff, observations of action planning meetings, interviews with a lead person for the intervention on each ward and recorded researcher reflections were analysed thematically and synthesised. RESULTS: Recruitment of patients using computer tablets at their bedside was straightforward, with the majority of patients willing and able to provide feedback. Randomisation of the intervention was acceptable to staff, with no evidence of differential response rates between intervention and control groups. In general, ward staff were positive about the use of patient feedback for service improvement and were able to use the feedback as a basis for action planning, although engagement with the process was variable. Gathering a multidisciplinary team together for action planning was found to be challenging, and implementing action plans was sometimes hindered by the need to co-ordinate action across multiple services. DISCUSSION: The PRASE intervention was found to be acceptable to staff and patients. However, before proceeding to a full cluster randomised controlled trial, the intervention requires adaptation to account for the difficulties in implementing action plans within three months, the need for a facilitator to support the action planning meetings, and the provision of training and senior management support for participating ward teams. CONCLUSIONS: The PRASE intervention represents a promising method for the systematic collection of patient feedback about the safety of hospital care.

The utility of monetary contingency contracts for weight loss: a systematic review and meta-analysis.

Financial incentives to improve health have received increasing attention, but are subject to ethical concerns. Monetary Contingency Contracts (MCCs), which require individuals to deposit money that is refunded contingent on reaching a goal, are a potential alternative strategy. This review evaluates systematically the evidence for weight loss-related MCCs. Randomised controlled trials testing the effect of weight loss-related MCCs were identified in online databases. Random-effects meta-analyses were used to calculate overall effect sizes for weight loss and participant retention. The association between MCC characteristics and weight loss/participant retention effects was calculated using meta-regression. There was a significant small-to-medium effect of MCCs on weight loss during treatment when one outlier study was removed. Group refunds, deposit not paid as lump sum, participants setting their own deposit size and additional behaviour change techniques were associated with greater weight loss during treatment. Post-treatment, there was no significant effect of MCCs on weight loss. There was a significant small-to-medium effect of MCCs on participant retention during treatment. Researcher-set deposits paid as one lump sum, refunds delivered on an all-or-nothing basis and refunds contingent on attendance at classes were associated with greater retention during treatment. Post-treatment, there was no significant effect of MCCs on participant retention. The results support the use of MCCs to promote weight loss and participant retention up to the point that the incentive is removed and identifies the conditions under which MCCs work best.

Methods for the induction of reproduction in a tropical species of filamentous ulva.

The green seaweed Ulva is a major fouling organism but also an edible aquaculture product in Asia. This study quantified for the first time the effect of key factors on the reproduction of a tropical species of filamentous Ulva (Ulva sp. 3). The controlled timing of release of swarmers (motile reproductive bodies) was achieved when experiments were initiated in the early afternoon by exposing the thalli to a temperature shock (4°C) for 10 min and subsequently placing them into autoclaved filtered seawater under a 12 h light: 12 h dark photoperiod at 25°C. The release of swarmers then peaked two days after initiation. In contrast, segmentation, dehydration, salinity or time of initiation of experiments had no effect of any magnitude on reproduction. The released swarmers were predominantly biflagellate (95%), negatively phototactic and germinated without complementary gametes. This indicates that Ulva sp. 3 has a simple asexual life history dominated by biflagellate zoids.

Isolation and identification of oedogonium species and strains for biomass applications.

Freshwater macroalgae from the genus Oedogonium have recently been targeted for biomass applications; however, strains of Oedogonium for domestication have not yet been identified. Therefore, the objective of this study was to compare the performance of isolates of Oedogonium collected from multiple geographic locations under varying environmental conditions. We collected and identified wild-type isolates of Oedogonium from three geographic locations in Eastern Australia, then measured the growth of these isolates under a range of temperature treatments corresponding to ambient conditions in each geographic location. Our sampling identified 11 isolates of Oedogonium that could be successfully maintained under culture conditions. It was not possible to identify most isolates to species level using DNA barcoding techniques or taxonomic keys. However, there were considerable genetic and morphological differences between isolates, strongly supporting each being an identifiable species. Specific growth rates of species were high (>26% day-1) under 7 of the 9 temperature treatments (average tested temperature range: 20.9-27.7°C). However, the variable growth rates of species under lower temperature treatments demonstrated that some were better able to tolerate lower temperatures. There was evidence for local adaptation under lower temperature treatments (winter conditions), but not under higher temperature treatments (summer conditions). The high growth rates we recorded across multiple temperature treatments for the majority of species confirm the suitability of this diverse genus for biomass applications and the domestication of Oedogonium.

Partner- and planning-based interventions to reduce fat consumption: randomized controlled trial.

OBJECTIVE: The research tested the efficacy of partner- and planning-based interventions to reduce dietary fat intake over a 6-month period. DESIGN: Randomized controlled, blinded, parallel trial. METHODS: A computer randomization feature was used to allocate council employees (N = 427, of which 393 completed baseline measures) to one of four conditions (partner + implementation intentions, partner-only, implementation intentions, and control group) before they completed measures at baseline and follow-ups at 1, 3, and 6 months post-baseline. Outcome measures were comprised of validated self-report measures of dietary fat intake (saturated fat intake, fat intake, ratio of 'good' fats to 'bad' fats); psychosocial mediators (enjoyment, intention, self-efficacy, social influence, partner support); weight and waist size (baseline and 6 months only). RESULTS: Data from 393 participants were analysed in accordance with intention-to-treat analyses. All intervention groups reported greater reductions in fat intake than the control group at 3 months. The partner-based groups increased the ratio of 'good' fats to 'bad' fats at 3 and 6 months and lost more inches on their waist, versus the non-partner groups. The impacts of the partner-based manipulations on outcomes were partially mediated by greater perceived social influences, partner support, and enjoyment of avoiding high-fat foods. The partner-based interventions also increased intention and self-efficacy. However, the effects in this study were typically small and generally marginally significant. CONCLUSIONS: Partner-based interventions had some positive benefits on dietary-related outcomes at 3 and 6 months. Support for implementation intentions was more limited.

Developing a reliable and valid patient measure of safety in hospitals (PMOS): a validation study.

INTRODUCTION: Patients represent an important and as yet untapped source of information about the factors that contribute to the safety of their care. The aim of the current study is to test the reliability and validity of the Patient Measure of Safety (PMOS), a brief patient-completed questionnaire that allows hospitals to proactively identify areas of safety concern and vulnerability, and to intervene before incidents occur. METHODS: 297 patients from 11 hospital wards completed the PMOS questionnaire during their stay; 25 completed a second 1 week later. The Agency for Healthcare Research and Quality (AHRQ) safety culture survey was completed by 190 staff on 10 of these wards. Factor structure, internal reliability, test-retest reliability, discriminant validity and convergent validity were assessed. RESULTS: Factor analyses revealed 8 key domains of safety (eg, communication and team work, access to resources, staff roles and responsibilities) explaining 58% variance of the original questionnaire. Cronbach's α (range 0.66-0.89) and test-retest reliability (r=0.75) were good. The PMOS positive index significantly correlated with staff reported 'perceptions of patient safety' (r=0.79) and 'patient safety grade' (r=-0.81) outcomes from the AHRQ (demonstrating convergent validity). A multivariate analysis of variance (MAMOVA) revealed that three PMOS factors and one retained single item discriminated significantly across the 11 wards. DISCUSSION: The PMOS is the first patient questionnaire used to assess factors contributing to safety in hospital settings from a patient perspective. It has demonstrated acceptable reliability and validity. Such information is useful to help hospitals/units proactively improve the safety of their care.

Algal bioremediation of waste waters from land-based aquaculture using ulva: selecting target species and strains.

The optimised reduction of dissolved nutrient loads in aquaculture effluents through bioremediation requires selection of appropriate algal species and strains. The objective of the current study was to identify target species and strains from the macroalgal genus Ulva for bioremediation of land-based aquaculture facilities in Eastern Australia. We surveyed land-based aquaculture facilities and natural coastal environments across three geographic locations in Eastern Australia to determine which species of Ulva occur naturally in this region and conducted growth trials at three temperature treatments on a subset of samples from each location to determine whether local strains had superior performance under local environmental conditions. DNA barcoding using the markers ITS and tufA identified six species of Ulva, with U. ohnoi being the most common blade species and U. sp. 3 the most common filamentous species. Both species occurred at multiple land-based aquaculture facilities in Townsville and Brisbane and multiple strains of each species grew well in culture. Specific growth rates of U. ohnoi and U. sp. 3 were high (over 9% and 15% day(-1) respectively) across temperature treatments. Within species, strains of U. ohnoi had higher growth in temperatures corresponding to local conditions, suggesting that strains may be locally adapted. However, across all temperature treatments Townsville strains had the highest growth rates (11.2-20.4% day(-1)) and Sydney strains had the lowest growth rates (2.5-8.3% day(-1)). We also found significant differences in growth between strains of U. ohnoi collected from the same geographic location, highlighting the potential to isolate and cultivate fast growing strains. In contrast, there was no clearly identifiable competitive strain of filamentous Ulva, with multiple species and strains having variable performance. The fast growth rates and broad geographical distribution of U. ohnoi make this an ideal species to target for bioremediation activities at land-based aquaculture facilities in Eastern Australia.

Selecting reliable and robust freshwater macroalgae for biomass applications.

Intensive cultivation of freshwater macroalgae is likely to increase with the development of an algal biofuels industry and algal bioremediation. However, target freshwater macroalgae species suitable for large-scale intensive cultivation have not yet been identified. Therefore, as a first step to identifying target species, we compared the productivity, growth and biochemical composition of three species representative of key freshwater macroalgae genera across a range of cultivation conditions. We then selected a primary target species and assessed its competitive ability against other species over a range of stocking densities. Oedogonium had the highest productivity (8.0 g ash free dry weight m⁻² day⁻¹), lowest ash content (3-8%), lowest water content (fresh weigh: dry weight ratio of 3.4), highest carbon content (45%) and highest bioenergy potential (higher heating value 20 MJ/kg) compared to Cladophora and Spirogyra. The higher productivity of Oedogonium relative to Cladophora and Spirogyra was consistent when algae were cultured with and without the addition of CO2 across three aeration treatments. Therefore, Oedogonium was selected as our primary target species. The competitive ability of Oedogonium was assessed by growing it in bi-cultures and polycultures with Cladophora and Spirogyra over a range of stocking densities. Cultures were initially stocked with equal proportions of each species, but after three weeks of growth the proportion of Oedogonium had increased to at least 96% (±7 S.E.) in Oedogonium-Spirogyra bi-cultures, 86% (±16 S.E.) in Oedogonium-Cladophora bi-cultures and 82% (±18 S.E.) in polycultures. The high productivity, bioenergy potential and competitive dominance of Oedogonium make this species an ideal freshwater macroalgal target for large-scale production and a valuable biomass source for bioenergy applications. These results demonstrate that freshwater macroalgae are thus far an under-utilised feedstock with much potential for biomass applications.

Developing a patient measure of safety (PMOS).

BACKGROUND: Tools that proactively identify factors that contribute to accidents have been developed within high-risk industries. Although patients provide feedback on their experience of care in hospitals, there is no existing measure which asks patients to comment on the factors that contribute to patient safety incidents. The aim of the current study was to determine those contributory factors from the Yorkshire Contributory Factors Framework (YCFF) that patients are able to identify in a hospital setting and to use this information to develop a patient measure of safety (PMOS). METHODS: Thirty-three qualitative interviews with a representative sample of patients from six units in a teaching hospital in the north of England were carried out. Patients were asked either to describe their most recent/current hospital experience (unstructured) or were asked to describe their experience in relation to specific contributory factors (structured). Responses were coded using the YCFF. Face validity of the PMOS was tested with 12 patients and 12 health professionals, using a 'think aloud' approach, and appropriate revisions made. The research was supported by two patient representatives. RESULTS: Patients were able to comment on/identify 13 of the 20 contributory factors contained within the YCFF domains. They identified contributory factors relating to communication and individual factors more frequently, and contributory factors relating to team factors, and support from central functions less frequently. In addition, they identified one theme not included in the YCFF: dignity and respect. The draft PMOS showed acceptable face validity. DISCUSSION: Patients are able to identify factors which contribute to the safety of their care. The PMOS provides a way of systematically assessing these and has the potential to help health professionals and healthcare organisations understand and identify, safety concerns from the patients' perspective, and, in doing so, make appropriate service improvements.

Development and validation of the Online Self-reported Walking and Exercise Questionnaire (OSWEQ).

BACKGROUND: Precise measurement of physical activity (PA) is required to identify current levels and changes in PA within a population, and to gauge effectiveness of interventions. METHODS: The Online Self-reported Walking and Exercise Questionnaire (OSWEQ) was developed for monitoring PA via the Web. Forty-nine participants (mean ± SD; age = 27 ± 11.9 yrs) completed the OSWEQ and International PA Questionnaire (IPAQ) short form 3 times [T1/T2/T3 (separated by 7-days)] and wore an Actigraph-GT3X-accelerometer for 7-days between T2-T3. For each measure, estimates of average MET·min·day(-1) and time spent in moderate PA (MPA), vigorous PA (VPA) and moderate and vigorous PA (MVPA) were obtained. RESULTS: The OSWEQ and IPAQ demonstrated test-retest reliability for MPA, VPA, and MVPA minutes and average MET·min·day(-1) between T1-T2 (OSWEQ range, r = .71-.77; IPAQ range, r = .59-.79; all, P < .01). The OSWEQ and IPAQ, compared with the GT3X, had lower estimates (mean error ± 95% PI) of MVPA MET·min·day(-1) by 150.4 ± 477.6 and 247.5 ± 477.5, respectively. CONCLUSIONS: The OSWEQ demonstrates good test-retest reliability over 7-days and better group level estimates of MET·min·day(-1) than the IPAQ, compared with the GT3X. These results suggest that the OSWEQ is a reliable and valid measure among young/working age adults and could be useful for monitoring PA trends over time.