The relationship between obesity, low back pain, and lumbar disc degeneration when genetics and the environment are considered: a systematic review of twin studies

BACKGROUND CONTEXT: The relationships between obesity and low back pain (LBP) and lumbar disc degeneration (LDD) remain unclear. It is possible that familial factors, including genetics and early environment, affect these relationships.PURPOSE: To investigate the relationship between obesity-related measures (eg, weight, body mass index [BMI]) and LBP and LDD using twin studies, where the effect of genetics and early environment can be controlled.STUDY DESIGN: A systematic review with meta-analysis.METHODS: MEDLINE, CINAHL, Scopus, Web of Science, and EMBASE databases were searched from the earliest records to August 2014. All cross-sectional and longitudinal observational twin studies identified by the search strategy were considered for inclusion. Two investigators independently assessed the eligibility, conducted the quality assessment, and extracted the data. Metaanalyses (fixed or random effects, as appropriate) were used to pool studies'estimates of association.RESULTS: In total, 11 articles met the inclusion criteria. Five studies were included in the LBP analysis and seven in the LDD analysis. For the LBP analysis, pooling of the five studies showed that the risk of having LBP for individuals with the highest levels of BMI or weight was almost twice that of people with a lower BMI (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.6-2.0; I-2 = 0%). A dose-response relationship was also identified. When genetics and the effects of a shared early environment were adjusted for using a within-pair twin case-control analysis, pooling of three studies showed a reduced but statistically positive association between obesity and prevalence of LBP (OR 1.5; 95% CI 1.1-2.1; I-2 = 0%). However, the association was further diminished and not significant (OR 1.4; 95% CI 0.8-2.3; I-2 = 0%) when pooling included two studies on monozygotic twin pairs only. Seven studies met the inclusion criteria for LDD. When familial factors were not controlled for, body weight was positively associated with LDD in all five cross-sectional studies. Only two cross-sectional studies investigated the relationship between obesity-related measures and LDD accounting for familial factors, and the results were conflicting. One longitudinal study in LBP and three longitudinal studies in LDD found no increase in risk in obese individuals, whether or not familial factors were controlled for.CONCLUSIONS: Findings from this review suggest that genetics and early environment are possible mechanisms underlying the relationship between obesity and LBP; however, a direct causal link between these conditions appears to be weak. Further longitudinal studies using the twin design are needed to better understand the complex mechanisms underlying the associations between obesity, LBP, and LDD.

On the relationship between squid and the environment: artisanal jigging for Loligo plei at Sao Sebastiao Island (24 degrees S), southeastern Brazil

The squid Loligo plei concentrates in the southeastern Brazil Bight, where it has traditionally supported small-scale fisheries around Sao Sebastiao Island (SSI). Sea surface temperature (SST), chlorophyll-a (Chl a), windspeed, wave height, rainfall, and lunar phase are related to fishing records and to the results of a survey of local fishers to investigate how they believe environmental variables might affect catches of L. plei. Daily fishery-dependent data over the years 2005-2009 were obtained from a fishing cooperative and were matched with satellite and meteorological forecast data. Generalized linear models were used to explore the significance of environmental variables in relation to variability in catch and catch per unit effort (cpue). Squid are fished with jigs in water shallower than 20 m, generally where SST is warmer and Chl a and windspeed are lower. Cpue and monthly catches decreased from 2005 to 2008, followed by a slight increase in 2009. The correlations between fishery and environmental data relate well to fishers` oceanological knowledge, underscoring the potential of incorporating such knowledge into evaluations of the fishery.

The relationship between gamma Cassiopeiae's X-ray emission and its circumstellar environment

gamma Cas is the prototypical classical Be star and is recently best known for its variable hard X-ray emission. To elucidate the reasons for this emission, we mounted a multiwavelength campaign in 2010 centered around four XMM-Newton observations. The observational techniques included long baseline optical interferometry (LBOI) from two instruments at CHARA, photometry carried out by an automated photometric telescope and H alpha observations. Because gamma Cas is also known to be in a binary, we measured radial velocities from the H alpha line and redetermined its period as 203.55 +/- 0.20 days and its eccentricity as near zero. The LBOI observations suggest that the star's decretion disk was axisymmetric in 2010, has an system inclination angle near 45 degrees, and a larger radius than previously reported. In addition, the Be star began an "outburst" at the beginning of our campaign, made visible by a brightening and reddening of the disk during our campaign and beyond. Our analyses of the new high resolution spectra disclosed many attributes also found from spectra obtained in 2001 (Chandra) and 2004 (XMM-Newton). As well as a dominant hot (approximate to 14 keV) thermal component, the familiar attributes included: (i) a fluorescent feature of Fe K even stronger than observed at previous times; (ii) strong lines of N VII and Ne XI lines indicative of overabundances; and (iii) a subsolar Fe abundance from K-shell lines but a solar abundance from L-shell ions. We also found that two absorption columns are required to fit the continuum. While the first one maintained its historical average of 1 x 10(21) cm(-2), the second was very large and doubled to 7.4 x 10(23) cm(-2) during our X-ray observations. Although we found no clear relation between this column density and orbital phase, it correlates well with the disk brightening and reddening both in the 2010 and earlier observations. Thus, the inference from this study is that much (perhaps all?) of the X-ray emission from this source originates behind matter ejected by gamma Cas into our line of sight.

Arctic network builders : the Arctic Coal Company's operations on Spitsbergen and its relationship with the environment

In 1906, two American industrialists, John Munroe Longyear and Frederick Ayer, formed the Arctic Coal Company to make the first large scale attempt at mining in the high-Arctic location of Spitsbergen, north of the Norwegian mainland. In doing so, they encountered numerous obstacles and built an organization that attempted to overcome them. The Americans sold out in 1916 but others followed, eventually culminating in the transformation of a largely underdeveloped landscape into a mining region. This work uses John Law’s network approach of the Actor Network Theory (ANT) framework to explain how the Arctic Coal Company built a mining network in this environmentally difficult region and why they made the choices they did. It does so by identifying and analyzing the problems the company encountered and the strategies they used to overcome them by focusing on three major components of the operations; the company’s four land claims, its technical system and its main settlement, Longyear City. Extensive comparison between aspects of Longyear City and the company’s choices of technology with other American examples place analysis of the company in a wider context and helps isolate unique aspects of mining in the high-Arctic. American examples dominate comparative sections because Americans dominated the ownership and upper management of the company.

The relationship between the field-shifting phenomenon and representational coherence of place cells in CA1 and CA3 in a cue-altered environment.

Subfields of the hippocampus display differential dynamics in processing a spatial environment, especially when changes are introduced to the environment. Specifically, when familiar cues in the environment are spatially rearranged, place cells in the CA3 subfield tend to rotate with a particular set of cues (e.g., proximal cues), maintaining a coherent spatial representation. Place cells in CA1, in contrast, display discordant behaviors (e.g., rotating with different sets of cues or remapping) in the same condition. In addition, on average, CA3 place cells shift their firing locations (measured by the center of mass, or COM) backward over time when the animal encounters the changed environment for the first time, but not after that first experience. However, CA1 displays an opposite pattern, in which place cells exhibit the backward COM-shift only from the second day of experience, but not on the first day. Here, we examined the relationship between the environment-representing behavior (i.e., rotation vs. remapping) and the COM-shift of place fields in CA1 and CA3. Both in CA1 and CA3, the backward (as well as forward) COM-shift phenomena occurred regardless of the rotating versus remapping of the place cell. The differential, daily time course of the onset/offset of backward COM-shift in the cue-altered environment in CA1 and CA3 (on day 1 in CA1 and from day 2 onward in CA3) stems from different population dynamics between the subfields. The results suggest that heterogeneous, complex plasticity mechanisms underlie the environment-representating behavior (i.e., rotate/remap) and the COM-shifting behavior of the place cell.

The relationship between physical activity and perceived built environment factors among adult Mexican Americans living in Brownsville, Texas

Background. Physical Activity (PA) is a central part in the fight to reduce obesity rates that are higher in Mexican Americans in the United States than any other ethnic groups. More than half of all Americans do not meet the daily PA recommendations and 48% of Mexican Americans do not exercise. The built environment is believed to affect participation in physical activity. The influence of the built environmental on physical activity levels in low-income Mexican Americans living along the Texas-Mexico border has not been investigated. ^ Purpose. The purpose of this secondary data analysis was trifold: (1) to determine the levels of self-reported PA in adults living in Brownsville, Texas; (2) to characterize the perceptions of this population regarding the built environment; and (3) to determine the association between self-reported PA and the built environment in Mexican Americans living in Brownsville, Texas. ^ Methods. 400 participants from the Tu Salud ¡Sí Cuenta! (TSSC) community-wide campaign were included in this secondary data analysis. Percentages for level of physical activity and the built environment were calculated using SPSS. Perceptions of the built environment were assessed by 14 items. Logistic regression analysis was used to assess the relationship between physical activity and built environment. All models were adjusted for age, gender, and level of education. ^ Results. The majority of men (41.97%) and women (59%), combined (56.7%)did not meet the 2008 PA Guidelines for Americans. We analyzed 14 built environment variables to characterize participants’ perceptions of the built environment. We conducted odds ratio (OR) to find if those who met PA levels associated the built environment such as neighborhood shops ([OR:1.806], CI:1.074,3.038 ]) bus stops ([OR:1.436], CI:.806,2.558) unattended stray dogs ([OR: 1.806], CI:1. 074,3.038), sidewalk access ([OR: .858],CI:.437,1.686), access to free parks ([OR:.549],CI:.335,.900) heavy traffic in neighborhood ([OR:.802], CI:.501,1.285), crime rate ([OR:.779], CI:.494,1.228) ranked the highest by mean score. The association between physical activity and the perceived built environment factors for Mexican Americans participating in the TSSCStudy were weakly associated. ^ Conclusions. This study provides evidence that PA levels are low in this Mexican American population. The built environment factors assessed in this study characterized the need for further studies of the variables that are seen as important to the Mexican American population. Lastly, the association of PA levels to the built environment was weak overall and further studies are recommended of the built environment.^

HEALTH MAINTENANCE ORGANIZATION ENVIRONMENT: AN EMPIRICAL STUDY OF THE RELATIONSHIP OF EXTERNAL CONTEXT AND PERFORMANCE

The research project is an extension of a series of administrative science and health care research projects evaluating the influence of external context, organizational strategy, and organizational structure upon organizational success or performance. The research will rely on the assumption that there is not one single best approach to the management of organizations (the contingency theory). As organizational effectiveness is dependent on an appropriate mix of factors, organizations may be equally effective based on differing combinations of factors. The external context of the organization is expected to influence internal organizational strategy and structure and in turn the internal measures affect performance (discriminant theory). The research considers the relationship of external context and organization performance.^ The unit of study for the research will be the health maintenance organization (HMO); an organization the accepts in exchange for a fixed, advance capitation payment, contractual responsibility to assure the delivery of a stated range of health sevices to a voluntary enrolled population. With the current Federal resurgence of interest in the Health Maintenance Organization (HMO) as a major component in the health care system, attention must be directed at maximizing development of HMOs from the limited resources available. Increased skills are needed in both Federal and private evaluation of HMO feasibility in order to prevent resource investment and in projects that will fail while concurrently identifying potentially successful projects that will not be considered using current standards.^ The research considers 192 factors measuring contextual milieu (social, educational, economic, legal, demographic, health and technological factors). Through intercorrelation and principle components data reduction techniques this was reduced to 12 variables. Two measures of HMO performance were identified, they are (1) HMO status (operational or defunct), and (2) a principle components factor score considering eight measures of performance. The relationship between HMO context and performance was analysed using correlation and stepwise multiple regression methods. In each case it has been concluded that the external contextual variables are not predictive of success or failure of study Health Maintenance Organizations. This suggests that performance of an HMO may rely on internal organizational factors. These findings have policy implications as contextual measures are used as a major determinant in HMO feasibility analysis, and as a factor in the allocation of limited Federal funds. ^

Objective assessment of the built environment and its relationship to physical activity and obesity

The role of physical activity in the promotion of individual and population health has been well documented in research and policy publications. Significant research activities have produced compelling evidence for the support of the positive association between physical activity and improved health. Despite the knowledge about these public health benefits of physical activity, over half of US adults do not engage in physical activity at levels consistent with public health recommendations. Just as physical inactivity is of significant public health concern in the US, the prevalence of obesity (and its attendant co-morbidities) is also increasing among US adults.^ Research suggests racial and ethnic disparities relevant to physical inactivity and obesity in the US. Various studies have shown more favorable outcomes among non-Hispanic whites when compared to other minority groups as far as physical activity and obesity are concerned. The health disparity issue is especially important because Mexican-Americans who are the fastest growing segment of the US population are disproportionately affected by physical inactivity and obesity by a significant margin (when compared to non-Hispanic whites), so addressing the physical inactivity and obesity issues in this group is of significant public health concern. ^ Although the evidence for health benefits of physical activity is substantial, various research questions remain on the potential motivators for engaging in physical activity. One area of emerging interest is the potential role that the built environment may play in facilitating or inhibiting physical activity.^ In this study, based on an ongoing research project of the Department of Epidemiology at the University of Texas M. D. Anderson Cancer Center, we examined the built environment, measured objectively through the use of geographical information systems (GIS), and its association with physical activity and obesity among a cohort of Mexican- Americans living in Harris County, Texas. The overall study hypothesis was that residing in dense and highly connected neighborhoods with mixed land-use is associated with residents’ increased participation in physical activity and lowered prevalence of obesity. We completed the following specific aims: (1) to generate a land-use profile of the study area and create a “walkability index” measure for each block group within the study area; (2) to compare the level of engagement in physical activity between study participants that reside in high walkability index block groups and those from low walkability block groups; (3) to compare the prevalence of obesity between study participants that reside in high walkability index block groups and those from low walkability block groups. ^ We successfully created the walkability index as a form of objective measure of the built environment for portions of Harris County, Texas. We used a variety of spatial and non-spatial dataset to generate the so called walkability index. We are not aware of previous scholastic work of this kind (construction of walkability index) in the Houston area. Our findings from the assessment of relationships among walkability index, physical activity and obesity suggest the following, that: (1) that attempts to convert people to being walkers through health promotion activities may be much easier in high-walkability neighborhoods, and very hard in low-walkability neighborhoods. Therefore, health promotion activities to get people to be active may require supportive environment, walkable in this case, and may not succeed otherwise; and (2) Overall, among individuals with less education, those in the high walkability index areas may be less obese (extreme) than those in the low walkability area. To the extent that this association can be substantiated, we – public health practitioners, urban designers, and policy experts – we may need to start thinking about ways to “retrofit” existing urban forms to conform to more walkable neighborhoods. Also, in this population especially, there may be the need to focus special attention on those with lower educational attainment.^

Modelling the relationship between urban environment and travel behaviour: policy and indicators

Due to the necessity to undertake activities, every year people increase their standards of travelling (distance and time). Urban sprawl development plays an important role in these "enlargements". Thus, governments invest money in an exhaustiva search for solutions to high levels of congestion and car-trips. The complex relationship between urban environment and travel behaviour has been studied in a number of cases. Thus, the objective of this paper is to answer the important question of which land-use attributes influence which dimensions of travel behaviour, and to verify to what extent specific urban planning measures affect the individual decision process, by exhaustiva statistical and systematic tests. This paper found that a crucial issue in the analysis of the relationship between the built environment and travel behaviour is the definition of indicators. As such, we recommend a feasible list of indicators to analyze this relationship.

The relationship of migrant workers' attitudes and behavior to their work environment /

"Final report to: Director, Office of Manpower, Automation & Training, U.S. Department of Labor, of research supported by the U.S. Department of Labor."