Impaired physical function associated with childhood obesity: How should we intervene?

- Background This study examined relationships between adiposity, physical functioning and physical activity. - Methods Obese (N=107) and healthy-weight (N=132) children aged 10-13 years underwent assessments of percent body fat (%BF, dual energy X-ray absorptiometry), knee extensor strength (KE, isokinetic dynamometry), cardiorespiratory fitness (CRF, peak oxygen uptake by cycle ergometry), physical health-related quality of life (HRQOL), worst pain intensity and walking capacity [six-minute walk (6MWT)]. Structural equation modelling was used to assess relationships between variables. - Results Moderate relationships were observed between %BF and 6MWT, KE strength corrected for mass and CRF relative to mass (r -.36 to -.69, P≤.007). Weak relationships were found between: %BF and physical HRQOL (r -.27, P=.008); CRF relative to mass and physical HRQOL (r -.24, P=.003); physical activity and 6MWT (r .17, P=.004). Squared multiple correlations showed that 29.6% variance in physical HRQOL was explained by %BF, pain and CRF relative to mass, while 28% variance in 6MWT was explained by %BF and physical activity. - Conclusions It appears that children with a higher body fat percentage have poorer KE strength, CRF and overall physical functioning. Reducing percent fat appears to be the best target to improve functioning. However, a combined approach to intervention, targeting reductions in body fat percentage, pain and improvements in physical activity and CRF may assist physical functioning.

Age, muscle fatigue, and walking endurance in pre-menopausal women

Aging is associated with loss of endurance; however, aging is also associated with decreased fatigue during maximal isometric contractions. The aims of this study were to examine the relationship between age and walking endurance (WE) and maximal isometric fatigue (MIF) and to determine which metabolic/fitness components explain the expected age effects on WE and MIF. Subjects were 96 pre-menopausal women. Oxygen uptake (walking economy) was assessed during a 3-mph walk; aerobic capacity and WE by progressive treadmill test; knee extension strength by isometric contractions, MIF during a 90-s isometric plantar flexion (muscle metabolism measured by 31P MRS). Age was related to increased walking economy (low VO2, r = −0.19, P < 0.03) and muscle metabolic economy (force/ATP, 0.34, P = 0.01), and reduced MIF (−0.26, P < 0.03). However, age was associated with reduced WE (−0.28, P < 0.01). Multiple regression showed that muscle metabolic economy explained the age-related decrease in MIF (partial r for MIF and age −0.13, P = 0.35) whereas walking economy did not explain the age-related decrease in WE (partial r for WE and age −0.25, P < 0.02). Inclusion of VO2max and knee endurance strength accounted for the age-related decreased WE (partial r for WE and age = 0.03, P > 0.80). In premenopausal women, age is related to WE and MIF. In addition, these results support the hypothesis that age-related increases in metabolic economy may decrease MIF. However, decreased muscle strength and oxidative capacity are related to WE.

Modelling bus lost time : an additional parameter influencing bus dwell time and station platform capacity at a BRT station platform

The common approach to estimate bus dwell time at a BRT station is to apply the traditional dwell time methodology derived for suburban bus stops. In spite of being sensitive to boarding and alighting passenger numbers and to some extent towards fare collection media, these traditional dwell time models do not account for the platform crowding. Moreover, they fall short in accounting for the effects of passenger/s walking along a relatively longer BRT platform. Using the experience from Brisbane busway (BRT) stations, a new variable, Bus Lost Time (LT), is introduced in traditional dwell time model. The bus lost time variable captures the impact of passenger walking and platform crowding on bus dwell time. These are two characteristics which differentiate a BRT station from a bus stop. This paper reports the development of a methodology to estimate bus lost time experienced by buses at a BRT platform. Results were compared with the Transit Capacity and Quality of Servce Manual (TCQSM) approach of dwell time and station capacity estimation. When the bus lost time was used in dwell time calculations it was found that the BRT station platform capacity reduced by 10.1%.

The influence of platform walking on BRT station bus dwell time estimation

The common approach to estimate bus dwell time at a BRT station platform is to apply the traditional dwell time methodology derived for suburban bus stops. Current dwell time models are sensitive towards bus type, fare collection policy along with the number of boarding and alighting passengers. However, they fall short in accounting for the effects of passenger/s walking on a relatively longer BRT station platform. Analysis presented in this paper shows that the average walking time of a passenger at BRT platform is 10 times more than that of bus stop. The requirement of walking to the bus entry door at the BRT station platform may lead to the bus experiencing a higher dwell time. This paper presents a theory for a BRT network which explains the loss of station capacity during peak period operation. It also highlights shortcomings of present available bus dwell time models suggested for the analysis of BRT operation.

Busway platform bus capacity analysis

Bus Rapid Transit (BRT), because of its operational flexibility and simplicity, is rapidly gaining popularity with urban designers and transit planners. Earlier BRTs were bus shared lane or bus only lane, which share the roadway with general and other forms of traffic. In recent time, more sophisticated designs of BRT have emerged, such as busway, which has separate carriageway for buses and provides very high physical separation of buses from general traffic. Line capacities of a busway are predominately dependent on bus capacity of its stations. Despite new developments in BRT designs, the methodology of capacity analysis is still based on traditional principles of kerbside bus stop on bus only lane operations. Consequently, the tradition methodology lacks accounting for various dimensions of busway station operation, such as passenger crowd, passenger walking and bus lost time along the long busway station platform. This research has developed a purpose made bus capacity analysis methodology for busway station analysis. Extensive observations of kerbside bus stops and busway stations in Brisbane, Australia were made and differences in their operation were studied. A large scale data collection was conducted using the video recording technique at the Mater Hill Busway Station on the South East Busway in Brisbane. This research identified new parameters concerning busway station operation, and through intricate analysis identified the elements and processes which influence the bus dwell time at a busway station platform. A new variable, Bus lost time, was defined and its quantitative descriptions were established. Based on these finding and analysis, a busway station platform bus capacity methodology was developed, comprising of new models for busway station lost time, busway station dwell time, busway station loading area bus capacity, and busway station platform bus capacity. The new methodology not only accounts for passenger boarding and alighting, but also covers platform crowd and bus lost time in station platform bus capacity estimation. The applicability of this methodology was shown through demonstrative examples. Additionally, these examples illustrated the significance of the bus lost time variable in determining station capacities.

Safety, feasibility and effects of an individualised walking intervention for women undergoing chemotherapy for ovarian cancer : a pilot study

Background: Exercise interventions during adjuvant cancer therapy have been shown to increase functional capacity, relieve fatigue and distress and may assist rates of chemotherapy completion. These studies have been limited to breast, gastric and mixed cancer groups and it is not yet known if a similar intervention is even feasible among women with ovarian cancer. We aimed to assess safety, feasibility and potential effect of a walking intervention in women undergoing chemotherapy for ovarian cancer. Methods: Women newly diagnosed with ovarian cancer were recruited to participate in an individualised walking intervention throughout chemotherapy and were assessed pre-and post-intervention. Feasibility measures included session adherence, compliance with exercise physiologist prescribed walking targets and self-reported program acceptability. Changes in objective physical functioning (6 minute walk test), self-reported distress (Hospital Anxiety and Depression Scale), symptoms (Memorial Symptom Assessment Scale - Physical) and quality of life (Functional Assessment of Cancer Therapy - Ovarian) were calculated, and chemotherapy completion and adverse intervention effects recorded. Results: Seventeen women were enrolled (63% recruitment rate). Mean age was 60 years (SD = 8 years), 88% were diagnosed with FIGO stage III or IV disease, 14 women underwent adjuvant and three neo-adjuvant chemotherapy. On average, women adhered to > 80% of their intervention sessions and complied with 76% of their walking targets, with the majority walking four days a week at moderate intensity for 30 minutes per session. Meaningful improvements were found in physical functioning, physical symptoms, physical well-being and ovarian cancerspecific quality of life. Most women (76%) completed ≥85% of their planned chemotherapy dose. There were no withdrawals or serious adverse events and all women reported the program as being helpful. Conclusions: These positive preliminary results suggest that this walking intervention for women receiving chemotherapy for ovarian cancer is safe, feasible and acceptable and could be used in development of future work. Trial registration: ACTRN12609000252213

Street reads - Creating mobile walking events

By 2012 mobile devices had become the main interface for people to access information about anything from their current GPS position to the latest book reviews. What was less accessible were tools and techniques for writers to leverage this new technology to construct and distribute located stories. This project began with a series of master classes for local Brisbane writers to demonstrate processes and techniques for imagining, constructing and distributing stories. Most significantly, this project equipped writers with how to identify and adopt various mobile services and applications to research, produce and deliver packaged multi-modal content for readers to access and experience stories in the very locations from which they were inspired. Four stories by four writers were selected to be developed and published as location-based events in four different neighbourhoods across Brisbane. These writers were mentored throughout the writing process and a model was developed for them to simply upload several multi-modal chapters for access on location by readers using QR codes. These activities culminated in a major 25 day event presented by Brisbane City Council and supported by Brisbane Writers Festival and Queensland Writers Centre. The 'Street Reads' event presented the four stories on location in Cannon Hill, Darra, Toowong and West End. The significance of the Street Reads project went beyond extending the capacity for writers to access mobile technologies as a new platform for distributing stories. This event also motivated readers to travel to neighbourhoods to experience them in ways that had not previously imagined possible. These located stories were fictionalisations of actual events and characters that have current and historic importance to these places. These histories are hidden from view and yet can provide locals and visitors with a new found appreciation for the past and set an example for how neighbourhoods can become active stages for the sharing of stories inspiring a deeper connection with each other and an agency for participating in the development of the identity of the local places they inhabit together. Due to the success of the project and by employing more advanced tools now available, Street reads has been further developed by Brisbane City Council and is now available as a the Story City App available for download at itunes.

Building communities through co-creative storytelling : sound walking in New England

The Story Project is a small, not-for-profit community media arts company based on the Sunshine Coast hinterland. It specialises in facilitating first-person storytelling. Since 2012 The Story Project has been collaborating with a small community arts organisation based in northern NSW, Uralla Arts, to record local heritage in first-person story form and to curate and present it ways that will appeal to new generations of listeners. The initial collaboration was funded by a Federal government Community Heritage program. The project successfully adapted a participatory method of life storytelling to this regional context and some 40 stories were contributed to a collection. A more ambitious suite of projects to develop soundwalks in a number of towns across the New England region has since grown from this initial collaboration. The soundwalks seek to combine local creative works in oral story, music and visual forms, and make them accessible through an application that can be downloaded to GPS-enabled mobile devices. While soundwalks are not new, the needs and challenges of creative community-building that New England soundwalks attempt to solve in this regional setting hold value for a broader range of interests than just those of the immediate project stakeholders. This paper reports on a research collaboration between The Story Project and QUT researchers that looked at The Story Project’s engagement with Uralla Arts and other New England community-based networks and organisations. It considers how this instance of story-centred, participatory media arts practice contributes to building population-wide capacity for creative expression.

Physiological and symptomatic responses to cycling and walking in intermittent claudication

To shed light on the potential efficacy of cycling as a testing modality in the treatment of intermittent claudication (IC), this study compared physiological and symptomatic responses to graded walking and cycling tests in claudicants. Sixteen subjects with peripheral arterial disease (resting ankle: brachial index (ABI) < 0.9) and IC completed a maximal graded treadmill walking (T) and cycle (C) test after three familiarization tests on each mode. During each test, symptoms, oxygen uptake (VO2), minute ventilation (VE), respiratory exchange ratio (RER) and heart rate (HR) were measured, and for 10 min after each test the brachial and ankle systolic pressures were recorded. All but one subject experienced calf pain as the primary limiting symptom during T; whereas the symptoms were more varied during C and included thigh pain, calf pain and dyspnoea. Although maximal exercise time was significantly longer on C than T (690 +/- 67 vs. 495 +/- 57 s), peak VO2, peak VE and peak heart rate during C and T were not different; whereas peak RER was higher during C. These responses during C and T were also positively correlated (P < 0.05) with each other, with the exception of RER. The postexercise systolic pressures were also not different between C and T. However, the peak decline in ankle pressures from resting values after C and T were not correlated with each other. These data demonstrate that cycling and walking induce a similar level of metabolic and cardiovascular strain, but that the primary limiting symptoms and haemodynamic response in an individual's extremity, measured after exercise, can differ substantially between these two modes.