The International Physical Activity Questionnaire-Short Form (IPAQ-SF) has been recommended as a cost-effective method to assess physical activity. Several studies validating the IPAQ-SF have been ...conducted with differing results, but no systematic review of these studies has been reported.
The keywords "IPAQ", "validation", and "validity" were searched in PubMed and Scopus. Studies published in English that validated the IPAQ-SF against an objective physical activity measuring device, doubly labeled water, or an objective fitness measure were included.
Twenty-three validation studies were included in this review. There was a great deal of variability in the methods used across studies, but the results were largely similar. Correlations between the total physical activity level measured by the IPAQ-SF and objective standards ranged from 0.09 to 0.39; none reached the minimal acceptable standard in the literature (0.50 for objective activity measuring devices, 0.40 for fitness measures). Correlations between sections of the IPAQ-SF for vigorous activity or moderate activity level/walking and an objective standard showed even greater variability (-0.18 to 0.76), yet several reached the minimal acceptable standard. Only six studies provided comparisons between physical activity levels derived from the IPAQ-SF and those obtained from objective criterion. In most studies the IPAQ-SF overestimated physical activity level by 36 to 173 percent; one study underestimated by 28 percent.
The correlation between the IPAQ-SF and objective measures of activity or fitness in the large majority of studies was lower than the acceptable standard. Furthermore, the IPAQ-SF typically overestimated physical activity as measured by objective criterion by an average of 84 percent. Hence, the evidence to support the use of the IPAQ-SF as an indicator of relative or absolute physical activity is weak.
Confounders can be identified by one of two main strategies: empirical or theoretical. Although confounder identification strategies that combine empirical and theoretical strategies have been ...proposed, the need for adjustment remains unclear if the empirical and theoretical criteria yield contradictory results due to random error. We simulated several scenarios to mimic either the presence or the absence of a confounding effect and tested the accuracy of the exposure-outcome association estimates with and without adjustment. Various criteria (significance criterion, Change-in-estimate(CIE) criterion with a 10% cutoff and with a simulated cutoff) were imposed, and a range of sample sizes were trialed. In the presence of a true confounding effect, unbiased estimates were obtained only by using the CIE criterion with a simulated cutoff. In the absence of a confounding effect, all criteria performed well regardless of adjustment. When the confounding factor was affected by both exposure and outcome, all criteria yielded accurate estimates without adjustment, but the adjusted estimates were biased. To conclude, theoretical confounders should be adjusted for regardless of the empirical evidence found. The adjustment for factors that do not have a confounding effect minimally effects. Potential confounders affected by both exposure and outcome should not be adjusted for.
When using the change-in-estimate criterion, a cutoff of 10% is commonly used to identify confounders. However, the appropriateness of this cutoff has never been evaluated. This study investigated ...cutoffs required under different conditions.
Four simulations were performed to select cutoffs that achieved a significance level of 5% and a power of 80%, using linear regression and logistic regression. A total of 10 000 simulations were run to obtain the percentage differences of the 4 fitted regression coefficients (with and without adjustment).
In linear regression, larger effect size, larger sample size, and lower standard deviation of the error term led to a lower cutoff point at a 5% significance level. In contrast, larger effect size and a lower exposure-confounder correlation led to a lower cutoff point at 80% power. In logistic regression, a lower odds ratio and larger sample size led to a lower cutoff point at a 5% significance level, while a lower odds ratio, larger sample size, and lower exposure-confounder correlation yielded a lower cutoff point at 80% power.
Cutoff points for the change-in-estimate criterion varied according to the effect size of the exposure-outcome relationship, sample size, standard deviation of the regression error, and exposure-confounder correlation.
This paper describes the association between workplace violence and job satisfaction among physicians and nurses in Macau. Convenience sampling was sourced from six health centers under the Macau ...Health Bureau.
This study uses a cross-sectional self-administrative survey. The study used case studies research instruments for workplace violence in the health sector by country (from the ILO, ICN, WHO, PSI), the Minnesota Satisfaction Questionnaire and Perceived Stress Scale. The data collection period spanned from August to December, 2014.
Multiple logistic regression examines levels of intrinsic and extrinsic satisfaction in physicians and nurses and significant correlates affecting their job satisfaction.
A total of 720 (14.9% physicians) participants were recruited. 57.2% of participants reported physical and psychological workplace violence in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying / harassment (14.2%), sexual harassment (4.6%) and racial harassment (2.6%). Nurses were at a significantly higher risk of physical assault and verbal abuse compared to physicians. Patients, patients' relatives, and colleagues were the main perpetrators. Worry about WPV, on-call duty and shift work, experience of bullying and verbal abuse and employment sector emerged as significant correlates affecting the intrinsic and extrinsic job satisfaction of physicians and nurses. Frontline staff, aged 30 and 39, coming from an ethnic minority, and perceived stress were significant correlates affecting nurses' job satisfaction.
WPV remains a significant concern in healthcare settings in Macau. Stakeholders should legally enforce a zero-tolerance policy towards WPV within healthcare workplaces. WPV is detrimental to healthcare professionals' mental wellbeing, risking irreversible physical and psychological harm for its victims.
The current standard practice for measuring sleeping time with accelerometer is to ask the participants to wear it for 7 consecutive days and analysing data from participants who have provided at ...least 4 days of valid data. However, this standard lacks supporting evidence. This study aims to evaluate this standard of practice by examining the reliability of measuring total sleeping time in a representative sample of US adults using accelerometer data from the National Health and Nutritional Survey (NHANES) waves 2011–2012 and 2013–2014. The sample included a total of 14,676 participants, out of which only those who provided data for seven days (n = 9510) were included in the analysis. The results revealed that the intra-class correlation coefficient (ICC) for a single day of measurement was 0.38 for weekdays and 0.27 for weekends. To achieve a reliability of 0.7, measurements for 4 and 7 nights were necessary for weekdays and weekends, respectively. Our simulation study found that the randomly-selected 3-day average of weekday sleeping time strongly correlated with the actual mean (ρ = 0.92), capturing at least 80 % of the variance. However, the randomly-selected 1-day average of weekend sleeping time only captured about 60 % of the variance. In conclusion, we recommend that future accelerometer research adopts a 9-day continuous measurement period, covering four weekend days, to reliably estimate both weekday and weekend sleeping time.
•It is common to measure sleep using 7-day period but its reliability remains unknown.•This study examined the number of days required to measure habitual total sleeping time.•Our results suggest using a 9-day measurement period covering 4 weekend days.
Economic costs of the Russia‐Ukraine war Liadze, Iana; Macchiarelli, Corrado; Mortimer‐Lee, Paul ...
World economy,
April 2023, Letnik:
46, Številka:
4
Journal Article
Recenzirano
The unprovoked and brutal invasion of Ukraine by Russia on 24 February 2022 is imposing a terrible human cost. In this paper, we use the National Institute Global Econometric Model (NiGEM) to ...quantify the impact of the war on the global economy. The war represents a massive cost, equivalent to 1% of global GDP in 2022, or about $1.5 trillion valued at purchasing power parity exchange rates (PPP), compared with our GDP forecast made at the beginning of 2022. Europe is the region affected most, given trade links its proximity to Ukraine and Russia and its reliance on energy and food supplies from those countries. GDP in Europe is expected to shrink by more than 1% in 2022 compared with our forecast at the beginning of 2022. In Western Europe, Germany will be worst affected, followed by France and Italy. GDP in ‘Developing Europe’, where Ukraine is the largest representative, is expected to shrink by 30%. The war will also add about 2% to global inflation in 2022 and 1% in 2023, compared with NIESR's inflation projection at the beginning of 2022.
Hepatic steatosis is associated with increased insulin resistance and tricarboxylic acid (TCA) cycle flux, but decreased ketogenesis and pyruvate dehydrogenase complex (PDC) flux. This study examined ...whether hepatic PDC activation by inhibition of pyruvate dehydrogenase kinase 2 (PDK2) ameliorates these metabolic abnormalities. Wild-type mice fed a high-fat diet exhibited hepatic steatosis, insulin resistance, and increased levels of pyruvate, TCA cycle intermediates, and malonyl-CoA but reduced ketogenesis and PDC activity due to PDK2 induction. Hepatic PDC activation by PDK2 inhibition attenuated hepatic steatosis, improved hepatic insulin sensitivity, reduced hepatic glucose production, increased capacity for β-oxidation and ketogenesis, and decreased the capacity for lipogenesis. These results were attributed to altered enzymatic capacities and a reduction in TCA anaplerosis that limited the availability of oxaloacetate for the TCA cycle, which promoted ketogenesis. The current study reports that increasing hepatic PDC activity by inhibition of PDK2 ameliorates hepatic steatosis and insulin sensitivity by regulating TCA cycle anaplerosis and ketogenesis. The findings suggest PDK2 is a potential therapeutic target for nonalcoholic fatty liver disease.
In the medical field, many outcome variables are dichotomized, and the two possible values of a dichotomized variable are referred to as classes. A dichotomized dataset is class-imbalanced if it ...consists mostly of one class, and performance of common classification models on this type of dataset tends to be suboptimal. To tackle such a problem, resampling methods, including oversampling and undersampling can be used. This paper aims at illustrating the effect of resampling methods using the National Health and Nutrition Examination Survey (NHANES) wave 2009-2010 dataset. A total of 4677 participants aged ≥ 20 without self-reported diabetes and with valid blood test results were analyzed. The Classification and Regression Tree (CART) procedure was used to build a classification model on undiagnosed diabetes. A participant demonstrated evidence of diabetes according to WHO diabetes criteria. Exposure variables included demographics and socio-economic status. CART models were fitted using a randomly selected 70% of the data (training dataset), and area under the receiver operating characteristic curve (AUC) was computed using the remaining 30% of the sample for evaluation (testing dataset). CART models were fitted using the training dataset, the oversampled training dataset, the weighted training dataset, and the undersampled training dataset. In addition, resampling case-to-control ratio of 1:1, 1:2, and 1:4 were examined. Resampling methods on the performance of other extensions of CART (random forests and generalized boosted trees) were also examined. CARTs fitted on the oversampled (AUC = 0.70) and undersampled training data (AUC = 0.74) yielded a better classification power than that on the training data (AUC = 0.65). Resampling could also improve the classification power of random forests and generalized boosted trees. To conclude, applying resampling methods in a class-imbalanced dataset improved the classification power of CART, random forests, and generalized boosted trees.
This paper sets out to estimate the prevalence of workplace violence in relation to socio-demographic characteristics of physicians and nurses working in healthcare settings in Macau.
: Concerted ...efforts worldwide to reduce workplace violence (WPV) have not yet removed medical-related professionals from the threat of patients', family members', and colleagues' physical and other assaults in Southeast Asia.
: The study employs a cross-sectional design to estimate the prevalence and examines the socio-economic and psychological correlates of WPV among medical doctors and nurses in Macau. The data collection period spanned from August to December 2014. Multiple logistic regression examines the prevalence rates of WPV and its associated factors in doctors and nurses.
: A total of 107 doctors (14.9%) and 613 nurses (85.1%) participated in the study; 57.2% had suffered WPV in the preceding year. The most common forms of workplace violence were verbal abuse (53.4%), physical assault (16.1%), bullying/harassment (14.2%), sexual harassment (4.6%), and racial harassment (2.6%). Most violence was perpetrated by patients and their relatives, colleagues, and supervisors.
WPV remains a significant concern in healthcare settings in Macau. Macau's local health authority should consider putting in place a raft of zero-tolerance policies designed to prevent it.
Purpose and methods
This study aimed to validate the single-item sleep duration question used in the National Health And Nutritional Survey (NHANES), “How much sleep do you usually get at night on ...weekdays or workdays (hours)?”, against a wrist-worn accelerometer (ActiGraph GT3X +) in waves 2011–2012 and 2013–2014 among an adult population aged 20 or above (
n
= 8,438, mean age 49.7, 48% male).
Results
The accelerometer-measured and self-reported sleep duration were 6.01 (SD 1.48) and 6.88 (SD 1.40) h/day, respectively, representing a 0.87 h/day of over-reporting (SD 1.90,
p
< 0.001). Such an over-reporting was observed in all subgroups, where the over-reporting ranged from 0.72 (those aged 41–50) to 1.13 h/day (those aged 71 or above). The correlation between accelerometer-measured and self-reported sleep duration was low (
ρ
= 0.14,
p
< 0.001).
Conclusions
The associations between sleep duration and other health outcomes identified using NHANES data should be further tested using more accurate and valid measures of sleep duration.