Does the built environment influence location- and trip-based sedentary behaviors? Evidence from a GPS-based activity space approach of neighborhood effects on older adults.

OBJECTIVE: Evidence on the influence of built environments on sedentary behaviors remains unclear and is often contradictory. The main limitations encompass the use of self-reported proxies of sedentary time (ST), the scarce consideration of the plurality of sedentary behaviors, and environmental exposures limited to the residential neighborhood. We investigated the relationships between GPS-based activity space measures of environmental exposures and accelerometer-based ST measured in total, at the place of residence, at all locations, and during trips. METHODS: This study is part of the CURHA project, based on 471 older adults residing in Luxembourg, who wore a GPS receiver and a tri-axial accelerometer during 7 days. Daily ST was computed in total, at the residence, at all locations and during trips. Environmental exposures included exposure to green spaces, walking, biking, and motorized transportation infrastructures. Associations between environments and ST were examined using linear and negative binomial mixed models, adjusted for demographics, self-rated health, residential self-selection, weather conditions and wear time. RESULTS: Participants accumulated, on average, 8 h and 14 min of ST per day excluding sleep time. ST spent at locations accounted for 83 % of the total ST. ST spent at the residence accounted for 87 % of the location-based ST and 71 % of the total ST. Trip-based ST represents 13 % of total ST, and 4 % remained unclassified. Higher street connectivity was negatively associated with total ST, while the density of parking areas correlated positively with total and location-based ST. Stronger associations were observed for sedentary bouts (uninterrupted ST over 20 and 30 min). CONCLUSION: Improving street connectivity and controlling the construction of new parking, while avoiding the spatial segregation of populations with limited access to public transport, may contribute to limit ST. Such urban planning interventions may be especially efficient in limiting the harmful uninterrupted bouts of ST among older adults.

Changes in physical activity by context and residential greenness among recent retirees: Longitudinal GPS and accelerometer study.

This study examined the changes in accelerometer-measured physical activity by GPS-measured contexts among Finnish retirees (n = 45 (537 measurement days)) participating in a physical activity intervention. We also assessed whether residential greenness, measured with Normalized Difference Vegetation Index, moderated the changes. Moderate-to-vigorous physical activity (MVPA) increased at home by 7 min/day, (P < 0.001) and during active travel by 5 min/day (P = 0.03). The participants with the highest vs. lowest greenness had 25 min/day greater increase in MVPA over the follow-up (P for Time*Greenness interaction = 0.04). In conclusion, retirees participating in the intervention increased their MVPA both at home and in active travel, and more so if they lived in a greener area.

Mid-term follow-up after maze IV procedures for concomitant atrial fibrillation.

BACKGROUND: We performed a retrospective analysis of the maze IV procedures performed in our surgical department for concomitant atrial fibrillation. METHODS: Preoperative, in-hospital and postoperative follow-up data were collected from 46 consecutive patients who underwent the maze IV operation between April 2006 and December 2010. All electrocardiograms and Holters were reviewed. RESULTS: One patient died in-hospital. During a mean follow-up of 25 +/- 16.3 months seven patients died: two related to a hemorrhagic stroke, one due to right ventricular failure, the remainder deaths were not cardiac related. The success rate, defined as no recurrence of AF or atrial flutter with a blanking period of 6 months postoperatively, was 73.7%. Plots of probability of freedom of atrial fibrillation over time are drawn and reach a stable level after one year. CONCLUSIONS: The mid term results of the maze IV procedures for concomitant atrial fibrillation are very good. The results are stable for the remainder of follow-up.

Neighborhood environments, mobility, and health: towards a new generation of studies in environmental health research.

While public policies seek to promote active transportation, there is a lack of information on the social and environmental factors associated with the adoption of active transportation modes. Moreover, despite the consensus on the importance of identifying obesogenic environmental factors, most published studies only take into account residential neighborhoods in the definition of exposures. There are at least three major reasons for incorporating daily mobility in public health research: (i) to identify specific population groups, including socially disadvantaged populations, who experience mobility or spatial accessibility deficits; (ii) to study the environmental determinants of transportation habits and investigate the complex relationships between transportation (as a source of physical activity, pollutants, and accidents) and physical activity and health; and (iii) to improve the assessment of spatial accessibility to resources and exposure to environmental hazards by accounting for daily trajectories for a better understanding of their health effects. There is urgent need to develop novel methods to better assess daily mobility. The RECORD Study relies on (i) an electronic survey of regular mobility to assess the chronic exposure to environmental conditions over a relatively long period, and (ii) Global Positioning System tracking to evaluate precisely acute environmental exposures over a much shorter period. The present article argues that future research should combine these two approaches. Gathering scientific evidence on the relationships between the environments, mobility/transportation, and health should allow public health and urban planning decision makers to better take into account the individual and environmental barriers to the adoption of active transportation and to define innovative intervention strategies addressing obesogenic environments to reduce disparities in excess weight.