The COVID-19 pandemic led to the implementation of worldwide restrictive measures to reduce social contact and viral spread. These measures have been reported to have a negative effect on physical ...activity (PA). Studies of PA during the pandemic have primarily used self-reported data. The single academic study that used tracked data did not report on demographics.
This study aimed to explore patterns of smartphone-tracked activity before, during, and immediately after lockdown in the United Kingdom, and examine differences by sociodemographic characteristics and prior levels of PA.
Tracked longitudinal weekly minutes of PA were captured using the BetterPoints smartphone app between January and June 2020. Data were plotted by week, demographics, and activity levels at baseline. Nonparametric tests of difference were used to assess mean and median weekly minutes of activity at significant points before and during the lockdown, and as the lockdown was eased. Changes over time by demographics (age, gender, Index of Multiple Deprivation, baseline activity levels) were examined using generalized estimating equations (GEEs).
There were 5395 users with a mean age of 41 years (SD 12) and 61% (n=3274) were female. At baseline, 26% (n=1422) of users were inactive, 23% (n=1240) were fairly active, and 51% (n=2733) were active. There was a relatively even spread across deprivation deciles (31% n=1693 in the least deprived deciles and 23% in the most n=1261). We found significant changes in PA from the week before the first case of COVID-19 was announced (baseline) to the week that social distancing restrictions were relaxed (Friedman test: χ
=2331, P<.001). By the first full week of lockdown, the median change in PA was 57 minutes less than baseline. This represents a 37% reduction in weekly minutes of PA. Overall, 63% of people decreased their level of activity between baseline and the first week of COVID-19 restrictions. Younger people showed more PA before lockdown but the least PA after lockdown. In contrast, those aged >65 years appeared to remain more active throughout and increased their activity levels as soon as lockdown was eased. Levels of PA among those classed as active at baseline showed a larger drop compared with those considered to be fairly active or inactive. Socioeconomic group and gender did not appear to be associated with changes in PA.
Our tracked PA data suggests a significant drop in PA during the United Kingdom's COVID-19 lockdown. Significant differences by age group and prior PA levels suggests that the government's response to COVID-19 needs to be sensitive to these individual differences and the government should react accordingly. Specifically, it should consider the impact on younger age groups, encourage everyone to increase their PA, and not assume that people will recover prior levels of PA on their own.
Cities are subject to both state and federal regulations that constrain their policy-making autonomy. ...theories of fiscal federalism argue that the smaller geographic scope of cities makes them ...more sensitive to mobility and, consequently, less able to redistribute. ...preexisting preferences surrounding immigration are unlikely to drive the results. ...with respect to immigrant detention, city-level officials do not control whether their resident county enters an intergovernmental service agreement with the Department of Homeland Security to house immigrant detainees. Nonetheless, when county facilities are involved with immigration enforcement, town and city officials—particularly law enforcement officials—are exposed to policies that frame immigrants as lawbreakers rather than as clients or community members.
IMPORTANCE: The early obesogenic home environment is consistently identified as a key influence on child weight trajectories, but little research has examined the mechanisms of that influence. Such ...research is essential for the effective prevention and treatment of overweight and obesity. OBJECTIVE: To test behavioral susceptibility theory’s hypothesis that the heritability of body mass index (BMI) is higher among children who live in more obesogenic home environments. DESIGN, SETTING, AND PARTICIPANTS: This study was a gene-environment interaction twin study that used cross-sectional data from 925 families (1850 twins) in the Gemini cohort (a population-based prospective cohort of twins born in England and Wales between March and December 2007). Data were analyzed from July to October 2013 and in June 2018. EXPOSURES: Parents completed the Home Environment Interview, a comprehensive measure of the obesogenic home environment in early childhood. Three standardized composite scores were created to capture food, physical activity, and media-related influences in the home; these were summed to create an overall obesogenic risk score. The 4 composite scores were split on the mean, reflecting higher-risk and lower-risk home environments. MAIN OUTCOMES AND MEASURES: Quantitative genetic model fitting was used to estimate heritability of age-adjusted and sex-adjusted BMI (BMI SD score, estimated using British 1990 growth reference data) for children living in lower-risk and higher-risk home environments. RESULTS: Among 1850 twins (915 49.5% male and 935 50.5% female; mean SD age, 4.1 0.4 years), the heritability of BMI SD score was significantly higher among children living in overall higher-risk home environments (86%; 95% CI, 68%-89%) compared with those living in overall lower-risk home environments (39%; 95% CI, 21%-57%). The findings were similar when examining the heritability of BMI in the separate food and physical activity environment domains. CONCLUSIONS AND RELEVANCE: These findings support the hypothesis that obesity-related genes are more strongly associated with BMI in more obesogenic home environments. Modifying the early home environment to prevent weight gain may be particularly important for children genetically at risk for obesity.
Introduction
Although programme evaluation is increasingly routinised across the academic health sciences, there is scant research on the factors that shape the scope and quality of evaluation work ...in health professions education. Our research addresses this gap, by studying how the context in which evaluation is practised influences the type of evaluation that can be conducted. Focusing on the context of accreditation, we critically examine the types of paradoxical tensions that surface as evaluation‐leads consider evaluation ideals or best practices in relation to contextual demands associated with accreditation seeking.
Methods
Our methods were qualitative and situated within a critical realist paradigm. Study participants were 29 individuals with roles requiring responsibility and oversight on evaluation work. They worked across 4 regions, within 26 academic health science institutions. Data were collected using semi‐structured interviews and analysed using framework and matrix analyses.
Results
We identified three overarching themes: (i) absence of collective coherence about evaluation practice, (ii) disempowerment of expertise and (iii) tensions as routine practice. Examples of these latter tensions in evaluation work included (i) resourcing accreditation versus resourcing robust evaluation strategy (performing paradox), (ii) evaluation designs to secure accreditation versus design to spur renewal and transformation (performing–learning paradox) and (iii) public dissemination of evaluation findings versus restricted or selective access (publicising paradox). Sub‐themes and illustrative data are presented.
Discussion
Our study demonstrates how the high‐stakes context of accreditation seeking surfaces tensions that can risk the quality and credibility of evaluation practices. To mitigate these risks, those who commission or execute evaluation work must be able to identify and reconcile these tensions. We propose strategies that may help optimise the quality of evaluation work alongside accreditation‐seeking efforts. Critically, our research highlights the limitations of continually positioning evaluation purely as a method versus as a socio‐technical practice that is highly vulnerable to contextual influences.
Check out how @Betty_EvalEd explored the persistent tensions that shape evaluation practice in an accreditation context.
Even as Donald Trump's election has galvanized anti-immigration politics, many local governments have welcomed immigrants, some even going so far as to declare their communities "sanctuary cities" ...that will limit cooperation with federal immigration authorities. But efforts to assist immigrants are not limited to large, politically liberal cities. Since the 1990s, many small to mid-sized cities and towns across the United States have implemented a range of informal practices that help immigrant populations integrate into their communities.Abigail Fisher Williamson explores why and how local governments across the country are taking steps to accommodate immigrants, sometimes despite serious political opposition. Drawing on case studies of four new immigrant destinations—Lewiston, Maine; Wausau, Wisconsin; Elgin, Illinois; and Yakima, Washington—as well as a national survey of local government officials, she finds that local capacity and immigrant visibility influence whether local governments take action to respond to immigrants. State and federal policies and national political rhetoric shape officials' framing of immigrants, thereby influencing how municipalities respond. Despite the devolution of federal immigration enforcement and the increasingly polarized national debate, local officials face on balance distinct legal and economic incentives to welcome immigrants that the public does not necessarily share. Officials' efforts to promote incorporation can therefore result in backlash unless they carefully attend to both aiding immigrants and increasing public acceptance. Bringing her findings into the present, Williamson takes up the question of whether the current trend toward accommodation will continue given Trump's anti-immigrant rhetoric and changes in federal immigration policy.
There is a growing body of research into the total amount and patterns of sitting, standing and stepping in office-based workers and few studies using objectively measured sitting and standing. ...Understanding these patterns may identify daily times opportune for interventions to displace sitting with activity.
A sample of office-based workers (n = 164) residing in England were fitted with thigh-worn ActivPal accelerometers and devices were worn 24 hours a day for five consecutive days, always including Saturday and Sunday and during bathing and sleeping. Daily amounts and patterns of time spent sitting, standing, stepping and step counts and frequency of sit/stand transitions, recorded by the ActivPal accelerometer, were reported.
Total sitting/standing time was similar on weekdays (10.6/4.1 hrs) and weekends (10.6/4.3 hrs). Total step count was also similar over weekdays (9682 ± 3872) and weekends (9518 ± 4615). The highest physical activity levels during weekdays were accrued at 0700 to 0900, 1200 to 1400, and 1700 to 1900; and during the weekend at 1000 to 1700. During the weekday the greatest amount of sitting was accrued at 0900 to 1200, 1400 to 1700, and 2000 to 2300, and on the weekend between 1800 and 2300. During the weekday the greatest amount of standing was accrued between 0700 and 1000 and 1700 and 2100, and on the weekend between 1000 and 1800. On the weekday the highest number of sit/stand transitions occurred between 0800 to 0900 and remained consistently high until 1800. On the weekend, the highest number occurred between 1000 to 1400 and 1900 to 2000.
Office based-workers demonstrate high levels of sitting during both the working week and weekend. Interventions that target the working day and the evenings (weekday and weekend) to displace sitting with activity may offer most promise for reducing population levels of sedentary behaviour and increasing physical activity levels, in office-based workers residing in England.
Domesticated dogs (Canis familiaris) were an important resource for many indigenous groups, including Plains peoples. Plains people used dogs for hauling materials, as camp or village warning ...systems, as sources of food, and as ritual participants. The identification of domestic Plains dogs is complicated by their wolf-like body size, and from hybridization with Canis lupus and Canis latrans, which also appear in the archaeological record. By combining stable carbon, nitrogen, and oxygen isotope analyses with geometric morphometric studies of canid mandibles and lower teeth from Plains Village sites in North Dakota, this article presents a methodology for differentiating wild and domestic canids.
The addition of qualitative methodology to randomised controlled trials evaluating complex interventions allows better understanding of contextualised factors and their potential influence on trial ...delivery and outcomes, as well as opportunities for feedback on trial participation to improve future trial protocols. This study explored the experiences of participation in cancer rehabilitation research during active cancer treatment. Participants were people living with haematological cancer myeloma, undergoing autologous stem cell transplantation (ASCT) recruited to the PERCEPT myeloma pilot trial.
A qualitative semi-structured interview study, embedded within a pilot randomised controlled trial of a physiotherapist-led exercise intervention delivered before, during and after ASCT among people living with myeloma. Transcripts were analysed using reflexive thematic analysis.
Interviews from 16 trial participants (n = 8 intervention group; n = 8 control group; mean age 61 years, 56% male) were analysed. Four main themes were identified: (1) "It's not just beneficial for me, it's for people after me as well"; (2) Disparities in experience of recovery - expectations, feeling prepared and support; (3) "What I wanted to do was build myself back up and prepare"; (4) Active ingredients - participants' experience of the trial intervention. Participants reported both altruistic and perceived personal gain as motivators for enrolling in the trial. Disappointment caused by allocation to control arm may have led to participants seeking exercise elsewhere, indicating possible contamination of control condition. Disparities in experience of recovery from transplant were evident with intervention participants reporting greater trajectory of recovery.
The findings from this embedded qualitative study highlight numerous considerations required when designing pilot and efficacy trials of complex interventions. The addition of qualitative investigation offers greater understanding of motivations for participation, intervention mechanisms at play as well as effects of participation that may impact interpretation of quantitative outcomes.
Qualitative findings from a prospectively registered pilot trial (ISRCTN15875290), registered 13/02/2019.
ObjectivesUnderstanding changes in moderate to vigorous aerobic physical activity (MVPA) and muscle-strengthening activity (MSA) at the start of the COVID-19 pandemic and their correlates ...(socio-demographics, health characteristics, living and exercise conditions and pre-pandemic MVPA/MSA) can inform interventions.DesignA cross-sectional analysis of retrospective and concurrent data on MVPA/MSA.SettingAn online survey in the UK.Participants2657 adults (weighted n=2442, 53.6% women) participating in the baseline survey (29 April 2020–14 June 2020) of the HEalth BEhaviours during the COVID-19 pandemic (HEBECO) study.Primary and secondary outcome measuresMeeting WHO-recommended levels for MVPA/MSA/both (vs meeting neither) during the first lockdown and changes in MVPA/MSA from before to since the COVID-19 pandemic following stratification for pre-pandemic MVPA/MSA.ResultsA third of adults maintained (30.4%), decreased (36.2%) or increased (33.4%) MVPA. For MSA, the percentages were 61.6%, 18.2% and 20.2%, respectively. MVPA increased or decreased by an average of 150 min/week and 219 min/week, respectively, and MSA by 2 days/week. Meeting both MSA+MVPA recommendations since COVID-19 (vs meeting neither) was positively associated with meeting MVPA+MSA before COVID-19 (adjusted OR (aOR)=16.11, 95% CI 11.24 to 23.07) and education: post-16 years of age (aOR=1.57, 95% CI 1.14 to 2.17), and negatively associated with having obesity (aOR=0.49, 95% CI 0.33 to 0.73), older age (65+ years vs ≤34 years; aOR=0.53, 95% CI 0.32 to 0.87) and annual household income of <50 000 GBP (aOR=0.65, 95% CI 0.46 to 0.91). The odds for decreasing MVPA were lower for white ethnicity (aOR=0.62, 95% CI 0.44 to 0.86), education: post-16 years of age (aOR=0.73, 95% CI 0.58 to 0.91) and access to garden/balcony (aOR=0.75, 95% CI 0.60 to 0.94), and were higher for those living in total isolation (aOR=3.81, 95% CI 2.33 to 6.23), with deteriorated psychological well-being (aOR=1.40, 95% CI 1.15 to 1.71) and conditions limiting physical activity (aOR=1.74, 95% CI 1.27 to 2.39). The odds for decreasing MSA were higher for having overweight (aOR=1.88, 95% CI 1.39 to 2.55), obesity (aOR=23.38, 95% CI 2.23 to 5.14) and being employed (aOR=1.81, 95% CI 1.34 to 2.46).ConclusionAerobic and strength training were differently impacted during the first UK lockdown, with poorer outcomes associated with older age, lower education and higher body mass index. Targeted interventions may be required to avoid pandemic-related inequities in physical activity.
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