Baseline evaluation of environmental physical activity and nutrition support of Texas Medical Center hospital worksites

Background: Obesity is a major health problem in the United States that has reached epidemic proportions. With most U.S adults spending the majority of their waking hours at work, the influence of the workplace environment on obesity is gaining in importance. Recent research implicates worksites as providing an 'obesogenic' environment as they encourage overeating and reduce the opportunity for physical activity. Objective: The aim of this study is to describe the nutrition and physical activity environment of Texas Medical Center (TMC) hospitals participating in the Shape Up Houston evaluation study to develop a scoring system to quantify the environmental data collected using the Environmental Assessment Tool (EAT) survey and to assess the inter-observer reliability of using the EAT survey. Methods: A survey instrument that was adapted from the Environmental Assessment Tool (EAT) developed by Dejoy DM et al in 2008 to measure the hospital environmental support for nutrition and physical activity was used for this study. The inter-observer reliability of using the EAT survey was measured and total percent agreement scores were computed. Most responses on the EAT survey are dichotomous (Yes and No) and these responses were coded with a '0' for a 'no' response and a '1' for a 'yes' response. A summative scoring system was developed to quantify these responses. Each hospital was given a score for each scale and subscale on the EAT survey in addition to a total score. All analyses were conducted using Stata 11 software. Results: High inter-observer reliability is observed using EAT. The percentage agreement scores ranged from 94.4%–100%. Only 2 of the 5 hospitals had a fitness facility onsite and scores for exercise programs and outdoor facilities available for hospital employees ranged from 0–62% and 0–37.5%, respectively. The healthy eating percentage for hospital cafeterias range from 42%–92% across the different hospitals while the healthy vending scores were 0%–40%. The total TMC 'healthy hospital' score was 49%. Conclusion: The EAT survey is a reliable instrument for measuring the physical activity and nutrition support environment of hospital worksites. The study results showed a large variability among the TMC hospitals in the existing physical activity and nutrition support environment. This study proposes cost effective policy changes that can increase environmental support to healthy eating and active living among TMC hospital employees.^

Thomas F. X. Noble, images, iconoclasm, and the carolingians, (The Middle Ages series), University of Pennsylvania Press, Philadelphia, 2009; 488 p., ISBN 978-0-8122-4141-9

Fil: Peretó Rivas, Rubén.

Niall W. Slater, Spectator Politics. Metatheatre and Performance in Aristophanes , Philadelphia, University of Pennsylvania Press, 2002, x + 362 pp.

Fil: Fernández, Claudia Nélida. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Niall W. Slater, Spectator Politics. Metatheatre and Performance in Aristophanes , Philadelphia, University of Pennsylvania Press, 2002, x + 362 pp.

Fil: Fernández, Claudia Nélida. Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación; Argentina.

Contributions from the Botanical Laboratory of the University of Pennsylvania.

1, 1892-1897

Contributions from the Botanical Laboratory of the University of Pennsylvania.

5, 1919-1920

Report of the Committee appointed by the Philomathean Society of the University of Pennsylvania to translate the inscription on the Rosetta stone.

The "Report" includes the hieroglyphic text, translations of the three texts, and an essay on Ptolemee Epiphanes. The "Appendix" contains a facsimile of the demotic text and the Greek text.

The Pennsylvania gazette ... Weekly magazine of the University of Pennsylvania.

"Pub. 1729 to 1748 by Ben. J. Franklin, founder of the university. Revived ... as the official weekly magazine of the University of Pennsylvania."

The Alumni register of the University of Pennsylvania.

Description based on: Volume 2, no. 1 (Nov. 1897); title from cover.

Study of consumer expenditures, incomes, and savings; statistical tables: Urban U. S.--1950, tabulated by the Bureau of Labor Statistics, U. S. Dept. of Labor, for the Wharton School of Finance and Commerce, University of Pennsylvania.

Mode of access: Internet.

A short introduction to Latin grammar : for the use of the University of Pennsylvania, in Philadelphia /

"Appendix, containing references to several of the rules of syntax, &c.": p. [121]-128.

Studies from the John Herr Musser Department of Research Medicine of the University of Pennsylvania; collected reprints.

Mode of access: Internet.