Children's perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: A qualitative and quantitative study

Environmental factors may have an important influence on children’s physical activity, yet children’s perspectives of their home and neighborhood environments have not been widely assessed. The aim of this study was to investigate children’s perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their home and neighborhood environments. A subsample of children photographed places and things in these environments that were important to them. The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity and sedentary pursuits; food items and locations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children’s physical activity. These findings contribute to a broader understanding of children’s perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.

Association of family environment with children's television viewing and with low level of physical activity

Objective: This study examined associations between the family environment and children's television (TV) viewing and likelihood of being low-active.
Research Methods and Procedures: In 2001, children were recruited from 19 primary schools in Melbourne, Australia. Parents completed a questionnaire about their child's TV viewing and the family environment. Children also completed a questionnaire and wore an accelerometer for 8 days. Movement counts were used to identify low-active children (lowest quartile). Data were analyzed in May 2004.
Results: The sample consisted of 878 children (mean age = 11.5 0.6 yrs). Multiple logistic regression revealed that socioeconomic status [adjusted odds ratios (AOR) = 0.4 boys], frequency families watched TV together (AOR = 2.0 boys), mothers' (AOR = 1.8 boys; AOR = 2.5 girls) and fathers' (AOR = 2.6 boys; AOR = 2.8 girls) TV viewing, and rules prohibiting TV during mealtimes (AOR = 0.6 boys; AOR = 0.6 girls) related to children watching TV 2 h/d. Variables associated with low-level physical activity included self-reported enjoyment of Internet use (AOR = 1.7 boys) and preference for watching TV (AOR = 2.3 girls), perception that mother uses computer a lot (AOR = 1.9 boys) and likes using the computer (AOR = 0.6 girls), fathers' reported computer/electronic games use (AOR = 1.7 girls), frequency families used computer together (AOR = 0.4 girls), rules that TV viewing must be supervised (AOR = 1.9 boys; AOR = 0.6 girls), and having pay TV (AOR = 0.6 boys) and electronic games at home (AOR = 2.6 boys).
Discussion: These findings suggest that the relationships between the family environment and TV viewing and low-level activity are complex and that these behaviors are distinct.

Social innovators or lagging behind: factors that influence managers' time use

Purpose – The broad aim of this paper is to investigate whether managers in Australia allocate their time differently than other occupational groups, and the impact gender and life situation (using marital status and presence or absence of dependent children as a proxy) has on time allocation.
Design/methodology/approach – To address these broad aims, data are drawn from the 1997 Australian Time Use Survey. This is a nationally representative survey that examines how people in different circumstances allocate time to different activities. Findings – The results of this study highlight three important issues. The first is that male and female managers display different patterns of time use. Male managers' time is dominated by paid employment activities, whereas female managers' time is spent predominantly on employment and domestic activities. The second is that life situation impacts on the time use of female managers, but not male managers. The third important find of this study is that managers' time use is different to other occupational groups. Practical implications – These findings have policy implications relating to work-life balance, career progression and changes in patterns of work. In terms of work-life issues, it reveals that male and female managers face a “time squeeze”, with some evidence of a “second-shift” for female managers. In addition, the findings provide insight into the work-life issues faced by male and female managers. Originality/value – The results of this inquiry provide insight into how different individuals spend their time – insight into “lifestyles”. However, in-depth qualitative studies are required to reveal why individuals allocate their time in this way and to understand the opportunities and constraints individuals face in time allocation.

The experiences and adjustments of women following their first acute myocardial infarction

Very little is known about cardiovascular disease (CVD) in women and their specific needs throughout their recovery process. This study aimed to explore the experiences and adjustments of women following their first AMI. Naturalistic inquiry was used and six women were interviewed post their first AMI. Two major themes were identified: (1) 'the initial experience/event' which identifies events and emotions leading up to, and during, the hospital admission; and (2) 'support: for who and how' exploring the importance of support throughout the recovery process.

The women in this study did not see themselves at risk of an AMI regardless of their lifestyles and when it did occur they adopted a variety of coping mechanisms in order to adjust to their trauma. The findings highlight the need for an increase in community awareness and education surrounding the risk factors of heart disease and its signs and symptoms, to minimize delayed hospital presentations.

People, places...and other people? Integrating understanding of intrapersonal, social and environmental determinants of physical activity

“People or places: what should be the target?” was the provocative title of a keynote session at the fifth Australian National Physical Activity Conference held in Melbourne in 2005. This paper will argue that in fact there need not be major conflict between these views, and that couching recent debate about physical activity promotion as a polarised choice between these presents a false dichotomy. To illustrate this, the paper will consider several problems with singular approaches to understanding and promoting physical activity, and will then describe emerging empirical evidence on the nexus between people and places. To balance an increasing emphasis in the scientific literature on physical environmental determinants of physical activity, the role of intrapersonal and social factors will also be revisited. It is concluded that growing evidence supporting the multiple domains of influence on physical activity justifies calls for multi-disciplinary and multi-sectoral partnerships and approaches to the promotion of active lifestyles.

Interventions for preventing obesity in childhood. A systematic review

Background The prevalence of obesity and overweight is increasing worldwide. Obesity in children impacts on their health in both short- and long-term. Obesity prevention strategies are poorly understood.

Objective To assess the effectiveness of interventions designed to prevent obesity in childhood.

Search strategy Electronic databases were searched from January 1985 to October 1999.

Selection criteria Data from randomized control trials and non-randomized trials with concurrent control group were included. A priori, studies with follow up of 1 year minimum were selected however, this was subsequently amended to include studies with a minimum follow up of three months.

Data collection & analysis Two reviewers independently extracted data and assessed study quality.

Main results Seven studies were included, three long-term (>1 years) and four short-term (>3 months and <1 years). The studies included were diverse in terms of study design and quality, target population, theoretical underpinning of intervention approach, and outcome measures. As such, it was not appropriate to combine study findings using statistical methods.

Conclusions Two of the long-term studies (one focused on dietary education and physical activity vs. control, and the other only on dietary education vs. control), resulted in a reduction in the prevalence on obesity, but the third, which focused on dietary education and physical activity, found no effect. Of the four short-term studies, three focused simply on physical activity/reduction of sedentary behavious vs. control. Two of these studies resulted in a reduction in the prevalence of obesity in intervention groups compared with control groups, and another study found a non-significant reduction. The fourth study focused on dietary education and physical activity, and did not find an effect on obesity, but did report a reduction in fat intake. Overall, the findings of the review suggest that currently there is limited quality data on the effectiveness of obesity prevention programmes and as such no generalizable conclusions can be drawn. The need for well-designed studies that examine a range of interventions remains a priority.

An evaluation of personal greenhouse gas calculators

Personal greenhouse gas calculators (PGGC) are important tools to raise awareness of the impact of personal behaviour on carbon dioxide emissions. Per capita, Australians are the highest emitters of greenhouse gases in the world and the task for them to reduce emissions to sustainable levels will be particularly challenging. This paper reviews six PGGC promoted in Australia and evaluates them for their consistency. The emissions for an individual currently practicing a modest green lifestyle are calculated and compared. Emission calculations were found to differ by an order of magnitude in some cases. It was also found that users of PGGC are not adequately informed about the limitations of the calculators. The adoption of modest and radical green lifestyles reduced greenhouse gas emissions to 83% and 53% of the average Australian, indicating that behavioural changes by consumers alone will be insufficient to reduce emissions to sustainable levels.

High-intensity resistance training improves glycemic control in older patients with type 2 diabetes

OBJECTIVE -- To examine the effect of high-intensity progressive resistance training combined with moderate weight loss on glycemic control and body composition in older patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS -- Sedentary, overweight men and women with type 2 diabetes, aged 60-80 years (n = 36), were randomized to high-intensity progressive resistance training plus moderate weight loss (RT & WL group) or moderate weight loss plus a control program (WL group). Clinical and laboratory measurements were assessed at 0, 3, and 6 months.

RESULTS -- HbA._1c fell significantly more in RT & WL than WL at 3 months (0.6 ± or -] 0.7 vs. 0.07 ± 0.8%, P < 0.05) and 6 months (1.2 ±1.0 vs. 0.4 ±0.8, P < 0.05). Similar reductions in body weight (RT & WL 2.5 ±2.9 vs. WL 3.1±2.1 kg) and fat mass (RT & WL 2.4 ± 2.7 vs. WL 2.7±2.5 kg) were observed after 6 months. In contrast, lean body mass (LBM) increased in the RT & WL group (0.5 ±1.1 kg) and decreased in the WL group (0.4±1.0) after 6 months (P < 0.05). There were no between-group differences for fasting glucose, insulin, serum lipids and lipoproteins, or resting blood pressure.

CONCLUSIONS -- High-intensity progressive resistance training, in combination with moderate weight loss, was effective in improving glycemic control in older patients with type 2 diabetes. Additional benefits of improved muscular strength and LBM identify high-intensity resistance training as a feasible and effective component in the management program for older patients with type 2 diabetes.

Physical activity and television viewing in relation to risk and undiagnosed abnormal glucose metabolism in adults

OBJECTIVE--The goal of this study was to assess the associations of physical activity time and television (TV) time with risk of "undiagnosed" abnormal glucose metabolism in Australian adults.

RESEARCH DESIGN AND METHODS--This population-based cross-sectional study using a stratified cluster design involving 42 randomly selected Census Collector Districts across Australia included 8,299 adults aged 25 years or older who were free from new type 2 diabetes and self-reported ischemic disease and did not take lipid lowering or antihypertensive drugs. Abnormal glucose metabolism (impaired fasting glycetnia [IFG], impaired glucose tolerance [IGT], or new type 2 diabetes) was based on an oral glucose tolerance test Self reported physical activity time and TV time (previous week) were assessed using interviewer administered questionnaires.

RESULTS--Alter adjustment for known confounders and TV time, the odds ratio (OR) of having abnormal glucose metabolism was 0.62 (95% CI 0.41-0.96) in men and 0.71 (0.501.00) in women for those engaged in physical activity [greater than or equal to] 2.5 h/week compared with those who were sedentary (0 h/week). The ORs of having abnormal glucose metabolism were 1.16 (0.791.70) in men and 1.49 (1.12-1.99) in women who watched TV > 14 h/week compared with those who watched [less than or equal to] 7.0 h/week. Higher TV viewing (> 14 h/week) was also associated with an increased risk of new type 2 diabetes in men and women and IGT in women compared with those watching < 14 h/week. Total physical activity of [greater than or equal to] 2.5 h/week was associated with a reduced risk of IFG, IGT, and new type 2 diabetes in both sexes: however, only the association with IGT in women was statistically significant.

CONCLUSIONS--These findings suggest a protective effect of physical activity and a deleterious effect of TV time on the risk of abnormal glucose metabolism in adults. Population strategies to reduce risk of abnormal glucose metabolism should focus on reducing sedentary behaviors such as TV time, as well as increasing physical activity.

Continuity of care and general wellbeing of patients with comorbidities requiring joint replacement

Aim. The aim of this paper is to examine the continuity of care and general wellbeing of patients with comorbidities undergoing elective total hip or knee joint replacement.
Background. Advances in medical science and improved lifestyles have reduced mortality rates in most Western countries. As a result, there is an ageing population with a concomitant growth in the number of people who are living with multiple chronic illnesses, commonly referred to as comorbidities. These patients often require acute care services, creating a blend of acute and chronic illness needs. For example, joint replacement surgery is frequently performed to improve impaired mobility associated with osteoarthritis.
Method. A purposive sample of twenty participants with multiple comorbidities who required joint replacement surgery was recruited to obtain survey, interview and medical record audit data. Data were collected during 2004 and 2005.
Findings. Comorbidity care was poorly co-ordinated prior to having surgery, during the acute care stay and following surgery and primarily entailed prescribed medicines. The main focus in acute care was patient throughput following joint replacement surgery according to a prescribed clinical pathway. General wellbeing was less than optimal: participants reported pain, fatigue, insomnia and alterations in urinary elimination as the chief sources of discomfort during the course of the study.
Conclusion. Continuity of care of comorbidities was lacking. Comorbidities affected patient general wellbeing and delayed recovery from surgery. Acute care, clinical pathways and the specialisation of medicine and nursing subordinated the general problem of patients with comorbidities. Systems designed to integrate and co-ordinate chronic illness care had limited application in the acute care setting. A multidisciplinary, holistic approach is required. Recommendations for further research conclude this paper.

Association of television viewing with fasting and 2-h postchallenge plasma glucose levels in adults without diagnosed diabetes

OBJECTIVE—We examined the associations of television viewing time with fasting plasma glucose (FPG) and 2-h postchallenge plasma glucose (2-h PG) levels in Australian adults.

RESEARCH DESIGN AND METHODS—A total of 8,357 adults aged >35 years who were free from diagnosed diabetes and who attended a population-based cross-sectional study (Australian Diabetes, Obesity and Lifestyle Study [AusDiab]) were evaluated. Measures of FPG and 2-h PG were obtained from an oral glucose tolerance test. Self-reported television viewing time (in the previous week) was assessed using an interviewer-administered questionnaire. Homeostasis model assessment (HOMA) of insulin sensitivity (HOMA-%S) and ß-cell function (HOMA-%B) were calculated based on fasting glucose and insulin concentrations.

RESULTS—After adjustment for confounders and physical activity time, time spent watching television in women was positively associated with 2-h PG, log fasting insulin, and log HOMA-%B and inversely associated with log HOMA-%S (P < 0.05) but not with FPG. No significant associations were observed with glycemic measures in men. The ß-coefficients across categories of average hours spent watching television per day (<1.0, 1.0–1.9, 2.0–2.9, 3.0–3.9, and ≥4.0) for 2-h PG in women were 0 (reference), 0.009, 0.047, 0.473, and 0.501, respectively (P for trend = 0.02).

CONCLUSIONS—Our findings highlight the unique deleterious relationship of sedentary behavior (indicated by television viewing time) and glycemic measures independent of physical activity time and adiposity status. These relationships differed according to sex and type of glucose measurement, with the 2-h PG measure being more strongly associated with television viewing. The findings suggest an important role for reducing sedentary behavior in the prevention of type 2 diabetes and cardiovascular disease, especially in women.

Neighborhood walkability and TV viewing time among Australian adults

Background
Built-environment attributes of a neighborhood are associated with participation in physical activity and may also influence time spent in sedentary behaviors. Associations of neighborhood walkability (based on dwelling density, street connectivity, land-use mix, and net retail area) and television viewing time were compared in a large, spatially-derived sample of Australian adults.

Methods
Neighborhood-level variables (walkability and socioeconomic status [SES]) were calculated in 154 Australian census collection districts using Geographic Information Systems. Individual-level variables (TV viewing time, time spent in leisure-time physical activity, height, weight, and sociodemographic variables) were collected from adults living in urban areas of Adelaide, Australia using a mail survey (N=2224) in 2003–2004. Multilevel linear regression analysis was conducted in 2006 separately for men and women to examine variations in TV viewing time across tertiles of walkability.

Results
Neighborhood walkability was negatively associated with TV viewing time in women, but not in men. After controlling for neighborhood SES, body mass index, physical activity, and sociodemographic variables, women living in medium- and high-walkable neighborhoods reported significantly less TV viewing time per day (14 minutes and 17 minutes, respectively) compared to those residing in low-walkable neighborhoods.

Conclusions
Built-environment attributes of neighborhoods that are related to physical activity also may play an important role in influencing sedentary behavior, particularly among women. Considering the effects of prolonged sedentary time on health risks, which are independent of physical activity, there is the need for further research to explore how environmental characteristics may contribute to the amount of time spent in sedentary behavior.

Objectively measured light-intensity physical activity is independently associated with 2-H plasma glucose

Objective: We examined the associations of objectively measured sedentary time, light-intensity physical activity, and moderate- to vigorous-intensity activity with fasting and 2-h postchallenge plasma glucose in Australian adults.

Research Design and Methods: A total of 67 men and 106 women (mean age ± SD 53.3 ± 11.9 years) without diagnosed diabetes were recruited from the 2004–2005 Australian Diabetes, Obesity, and Lifestyle (AusDiab) study. Physical activity was measured by Actigraph  accelerometers worn during waking hours for 7 consecutive days and summarized as sedentary time (accelerometer counts/min <100; average hours/day), light-intensity (counts/min 100-1951), and moderate- to vigorous-intensity (counts/min ≥1,952). An oral glucose tolerance test was used to ascertain 2-h plasma glucose and fasting plasma glucose.

Results: After adjustment for confounders (including waist circumference), sedentary time was positively associated with 2-h plasma glucose (b = 0.29, 95% CI 0.11–0.48, P = 0.002); light-intensity activity time (b = –0.25, –0.45 to –0.06, P = 0.012) and moderate- to vigorous-intensity activity time (b = –1.07, –1.77 to –0.37, P = 0.003) were negatively associated. Light-intensity activity remained significantly associated with 2-h plasma glucose following further adjustment for moderate- to vigorous-intensity activity (b = –0.22, –0.42 to –0.03, P = 0.023). Associations of all activity measures with fasting plasma glucose were nonsignificant (P > 0.05).

Conclusions: These data provide the first objective evidence that light-intensity physical activity is beneficially associated with blood glucose and that sedentary time is unfavorably associated with blood glucose. These objective data support previous findings from studies using self-report measures, and suggest that substituting light-intensity activity for television viewing or other sedentary time may be a practical and achievable preventive strategy to reduce the risk of type 2 diabetes and cardiovascular disease.

Detection and habitat use of the rufous bristlebird (Dasyornis broadbenti) in coastal heathland, in south-western Victoria, Australia

The Rufous Bristlebird (Dasyornis broadbenti) is a sedentary, ground-dwelling passerine of southern Australia, which is listed as nationally vulnerable, and as near-threatened (lower risk) in Victoria. The species inhabits a variety of vegetation, including shrub thickets in coastal gullies to heathlands on limestone cliffs. This study aimed to assess the size, distribution and habitat use of a population of the subspecies D. b.  broadbenti at Portland in south-western Victoria. Monthly surveys (2002–03) were conducted on foot for 1 h after official sunrise and 1 h before official sunset, and presence of Bristlebirds recorded using vocalisations and sightings. Observations outside of the survey times were also recorded to estimate the size of territories and core area of occupancy. To quantify habitat preferences, vegetation composition and structure were measured in areas where Bristlebirds were present, as well as surrounding areas where they were not detected. The population in the survey areas was estimated at between 70 and 86 individuals in the 170-ha survey area. The estimated size of territories of eight selected pairs of Bristlebirds ranged from 0.5 to 3 ha, with core areas of occupancy ranging from 0.2 to 0.6 ha. During the nesting season (August November) Bristlebirds were detected at greater frequencies in the core area of occupancy within each territory. Significant associations were found between the presence of Bristlebirds and floristic associations dominated by the native environmental weeds Acacia sophorae and Leptospermum laevigatum. Bristlebird presence was significantly positively correlated with increasing vegetation density in the mid-canopy level (80–120 cm) indicating that vegetation structure is a key factor in habitat use.

Health behaviors among individuals with schizophrenia and depression

This article presents findings from a study that evaluated the utility of Protection Motivation Theory to explain cardiovascular health behaviors among people with schizophrenia (n = 83) and depression (n = 70). Results indicated that the prevalence of overweight, cigarette smoking and a sedentary lifestyle were greater among people with a mental illness compared to individuals without a mental illness. Major predictors were high levels of fear of cardiovascular disease, lack of knowledge of correct dietary principles, lower self-efficacy, limited social support and psychiatric symptoms. Implications of these results are discussed in designing education and preventive health programs for individuals with schizophrenia and Mental Depressive Disorder (MDD).