Test-retest reliability of four physical activity measures used in population surveys

Accurate monitoring of prevalence and trends in population levels of physical activity (PA) is a fundamental public health need. Test-retest reliability (repeatability) was assessed in population samples for four self-report PA measures: the Active Australia survey (AA, N=356), the short International Physical Activity Questionnaire (IPAQ, N=104), the physical activity items in the Behavioral Risk Factor Surveillance System (BRFSS, N=127) and in the Australian National Health Survey (NHS, N=122). Percent agreement and Kappa statistics were used to assess reliability of classification of activity status as 'active', 'insufficiently active' or 'sedentary'. Intraclass correlations (ICCs) were used to assess agreement on minutes of activity reported for each item of each survey and for total minutes. Percent agreement scores for activity status were very good on all four instruments, ranging from 60% for the NHS to 79% for the IPAQ. Corresponding Kappa statistics ranged from 0.40 (NHS) to 0.52 (AA). For individual items, ICCs were highest for walking (0.45 to 0.78) and vigorous activity (0.22 to 0.64) and lowest for the moderate questions (0.16 to 0.44). All four measures provide acceptable levels of test-retest reliability for assessing both activity status and sedentariness, and moderate reliability for assessing total minutes of activity.

Clinical use of objective measures of physical activity

With measurement of physical activity becoming more common in clinical practice, it is imperative that healthcare professionals become more knowledgeable about the different methods available to objectively measure physical activity behaviour. Objective measures do not rely on information provided by the patient, but instead measure and record the biomechanical or physiological consequences of performing physical activity, often in real time. As such, objective measures are not subject to the reporting bias or recall problems associated with self-report methods. The purpose of this article was to provide an overview of the different methods used to objectively measure physical activity in clinical practice. The review was delimited to heart rate monitoring, accelerometers and pedometers since their small size, low participant burden and relatively low cost make these objective measures appropriate for use in clinical practice settings. For each measure, strengths and weakness were discussed; and whenever possible, literature-based examples of implementation were provided.

Quantitative sensory measures distinguish office workers with varying levels of neck pain and disability

This study was undertaken to investigate any relationship between sensory features and neck pain in female office workers using quantitative sensory measures to better understand neck pain in this group. Office workers who used a visual display monitor for more than four hours per day with varying levels of neck pain and disability were eligible for inclusion. There were 85 participants categorized according to their scores on the neck disability index (NDI): 33 with no pain (NDI < 8); 38 with mild levels of pain and disability (NDI 9–29); 14 with moderate levels of pain (NDI ⩾ 30). A fourth group of women without neck pain (n = 22) who did not work formed the control group. Measures included: thermal pain thresholds over the posterior cervical spine; pressure pain thresholds over the posterior neck, trapezius, levator scapulae and tibialis anterior muscles, and the median nerve trunk; sensitivity to vibrotactile stimulus over areas of the hand innervated by the median, ulnar and radial nerves; sympathetic vasoconstrictor response. All tests were conducted bilaterally. ANCOVA models were used to determine group differences between the means for each sensory measure. Office workers with greater self-reported neck pain demonstrated hyperalgesia to thermal stimuli over the neck, hyperalgesia to pressure stimulation over several sites tested; hypoaesthesia to vibration stimulation but no changes in the sympathetic vasoconstrictor response. There is evidence of multiple peripheral nerve dysfunction with widespread sensitivity most likely due to altered central nociceptive processing initiated and sustained by nociceptive input from the periphery.

Comparison of 3 accelerometer data reduction approaches, step counts, and 2 self-report measures for estimating physical activity in free-living adults

Background Accelerometers have become one of the most common methods of measuring physical activity (PA). Thus, validity of accelerometer data reduction approaches remains an important research area. Yet, few studies directly compare data reduction approaches and other PA measures in free-living samples. Objective To compare PA estimates provided by 3 accelerometer data reduction approaches, steps, and 2 self-reported estimates: Crouter's 2-regression model, Crouter's refined 2-regression model, the weighted cut-point method adopted in the National Health and Nutrition Examination Survey (NHANES; 2003-2004 and 2005-2006 cycles), steps, IPAQ, and 7-day PA recall. Methods A worksite sample (N = 87) completed online-surveys and wore ActiGraph GT1M accelerometers and pedometers (SW-200) during waking hours for 7 consecutive days. Daily time spent in sedentary, light, moderate, and vigorous intensity activity and percentage of participants meeting PA recommendations were calculated and compared. Results Crouter's 2-regression (161.8 +/- 52.3 minutes/day) and refined 2-regression (137.6 +/- 40.3 minutes/day) models provided significantly higher estimates of moderate and vigorous PA and proportions of those meeting PA recommendations (91% and 92%, respectively) as compared with the NHANES weighted cut-point method (39.5 +/- 20.2 minutes/day, 18%). Differences between other measures were also significant. Conclusions When comparing 3 accelerometer cut-point methods, steps, and self-report measures, estimates of PA participation vary substantially.

Using objective physical activity measures with youth : How many days of monitoring are needed?

Purpose The purpose of this study was to establish the minimal number of days of monitoring required for accelerometers to assess usual physical activity in children. Methods A total of 381 students (189 M, 192 F) wore a CSA 7164 uniaxial accelerometer for seven consecutive days. To examine age-related trends students were grouped as follows: Group I: grades 1-3 (N = 92); Group II: grades 4-6 (N = 98); Group III: grades 7-9 (N = 97); Group IV: grades 10-12 (N = 94). Average daily time spent in moderate-to-vigorous physical activity (MVPA) was calculated from minute-by-minute activity counts using the regression equation developed by Freedson et al. (1997). Results Compared with adolescents in grades 7 to 12, children in grades 1 to 6 exhibited less day-to-day variability in MVPA behavior. Spearman-Brown analysts indicated that between 4 and 5 d of monitoring would be necessary to a achieve a reliability of 0.80 in children, and between 8 and 9 d of monitoring would be necessary to achieve a reliability of 0.80 in adolescents. Within all grade levels, the 7-d monitoring protocol produced acceptable estimates of daily participation in MVPA (R = 0.76 (0.71-0.81) to 0.87 (0.84-0.90)). Compared with weekdays, children exhibited significantly higher levels of MVPA on weekends, whereas adolescents exhibited significantly lower levels of MVPA on weekends. Principal components analysis revealed two distinct time components for MVPA during the day for children (early morning, rest of the day), and three distinct time components for MVPA during the day for adolescents (morning, afternoon, early evening). Conclusions These results indicate that a 7-d monitoring protocol provides reliable estimates of usual physical activity behavior in children and adolescents and accounts for potentially important differences in weekend versus weekday activity behavior as well as differences in activity patterns within a given day.

Test-retest reliability of physical activity measures used in Australian population surveys

PURPOSE Accurate monitoring of prevalence and trends in population levels of physical activity is fundamental to the planning of health promotion and disease-prevention strategies. Test-retest reliability (repeatability) was assessed for four self-report measures of physical activity commonly used in population surveys: the Active Australia survey (AA, N=356), the short form of the International Physical Activity Questionnaire (IPAQ-S, N=104), the physical activity items in the Behavioral Risk Factor Surveillance System (BRFSS, N=127) and the physical activity items in the Australian National Health Survey (NHS, N=122). METHODS Percent agreement and Kappa statistics were used to assess the reliability of classification of activity status (where ‘active’= 150 minutes of activity per week) and sedentariness (where ‘sedentary’ = reporting no physical activity). Intraclass correlations (ICCs) were used to assess agreement on minutes of activity reported for each item of each survey and on total minutes reported in each survey. RESULTS Percent agreement scores for both activity status and sedentariness were very good on all four instruments. Overall the percent agreement between repeated surveys was between 73% (NHS) and 87% (IPAQ) for the criterion measure of achieving 150 minutes per week, and between 77% (NHS) and 89% (IPAQ) for the criterion of being sedentary. Corresponding Kappa statistics ranged from 0.46 (NHS) to 0.61 (AA) for activity status and from 0.20 (BRFSS) to 0.52 (AA) for sedentariness. For the individual items ICCs were highest for walking (0.45 to 0.56) and vigorous activity (0.22 to 0.64) and lowest for the moderate questions (0.16 to 0.44). CONCLUSION All four measures provide acceptable levels of test-retest reliability for assessing both activity status and sedentariness, and moderate reliability for assessing total minutes of activity. Supported by the Australian Commonwealth Department of Health and Ageing.

Measures of nutrient processes as indicators of stream ecosystem health

To better understand how freshwater ecosystems respond to changes in catchment land-use, it is important to develop measures of ecological health that include aspects of both ecosystem structure and function. This study investigated measures of nutrient processes as potential indicators of stream ecosystem health across a land-use gradient from relatively undisturbed to highly modified. A total of seven indicators (potential denitrification; an index of denitrification potential relative to sediment organic matter; benthic algal growth on artificial substrates amended with (a) N only, (b) P only, and (c) N and P; and δ15N of aquatic plants and benthic sediment) were measured at 53 streams in southeast Queensland, Australia. The indicators were evaluated by their response to a defined gradient of agricultural land-use disturbance as well as practical aspects of using the indicators as part of a monitoring program. Regression models based on descriptors of the disturbance gradient explained a large proportion of the variation in six of the seven indicators. Denitrification index, algal growth in N amended substrate, and δ15N of aquatic plants demonstrated the best regression. However, the δ15N value of benthic sediment was found to be the best indicator overall for incorporation into a monitoring program, as samples were relatively easy to collect and process, and were successfully collected at more than 90% of the study sites.

Dynamic modelling of long-term care decisions

This paper describes and analyzes research on the dynamics of long-term care and the policy relevance of identifying the sources of persistence in caregiving arrangements (including the effect of dynamics on parameter estimates, implications for family welfare, parent welfare, child welfare, and cost of government programs). We discuss sources and causes of observed persistence in caregiving arrangements including inertia/state dependence (confounded by unobserved heterogeneity) and costs of changing caregivers. We comment on causes of dynamics including learning/human capital accumulation; burnout; and game-playing. We suggest how to deal with endogenous geography; dynamics in discrete and continuous choices; and equilibrium issues (multiple equilibria, dynamic equilibria). We also present an overview of commonly used longitudinal data sets and evaluate their relative advantages/disadvantages. We also discuss other data issues related to noisy measures of wealth and family structure. Finally, we suggest some methods to handle econometric problems such as endogeneous geography. © 2014 Springer Science+Business Media New York.

Supply, demand, and equilibrium in the market for CRNAs

This study determined the current trends in supply, demand, and equilibrium (ie, the level of employment where supply equals demand) in the market for Certified Registered Nurse Anesthetists (CRNAs). It also forecasts future needs for CRNAs given different possible scenarios. The impact of the current availability of CRNAs, projected retirements, and changes in the demand for surgeries are considered in relation to CRNAs needed for the future. The study used data from many sources to estimate models associated with the supply and demand for CRNAs and the relationship to relevant community and policy characteristics such as per capita income of the community and managed care. These models were used to forecast changes in surgeries and in the supply of CRNAs in the future. The supply of CRNAs has increased in recent years, stimulated by shortages of CRNAs and subsequent increases in the number of CRNAs trained. However, the increases have not offset the number of retiring CRNAs to maintain a constant age in the CRNA population. The average age will continue to increase for CRNAs in the near future despite increases in CRNAs trained. The supply of CRNAs in relation to surgeries will increase in the near future.

Lanthanum oxide nanostructured films synthesized using hot dense and extremely non-equilibrium plasma for nanoelectronic device applications

Lanthanum oxide (La2O3) nanostructured films are synthesized on a p-type silicon wafer by ablation of La2O3 pellet due to interaction with hot dense argon plasmas in a modified dense plasma focus (DPF) device. The nanostructured films are investigated using scanning electron microscopy (SEM), atomic force microscopy (AFM), and X-ray diffraction (XRD) spectra. SEM study shows the formation of nano-films having nano-size structures with the average nanostructures size ~25, ~53, and ~45 nm for one, two, and three DPF shots, respectively. The nanostructures sizes and morphology of nano-films are consistent between the AFM and SEM analyses. XRD spectra confirms nano-sized La2O3 with an average grain size ~34, ~51, and ~42 nm for one, two, and three DPF shots, respectively. The electrical properties such as current-voltage and capacitance-voltage (C-V) characteristics of the Al-La2O3-Si metal-oxide- semiconductor (MOS) capacitor structure are measured. The current conduction mechanism of the MOS capacitors is also demonstrated. The C-V characteristics are further used to obtain the electrical parameters such as the dielectric constant, oxide thickness, flat-band capacitance, and flat-band voltage of the MOS capacitors. These measurements demonstrate significantly lower leakage currents without any commonly used annealing or doping, thereby revealing a significant improvement of the MOS nanoelectronic device performance due to the incorporation of the DPF-produced La2O3 nano-films.

Si quantum dots embedded in an amorphous SiC matrix : nanophase control by non-equilibrium plasma hydrogenation

Nanophase nc-Si/a-SiC films that contain Si quantum dots (QDs) embedded in an amorphous SiC matrix were deposited on single-crystal silicon substrates using inductively coupled plasma-assisted chemical vapor deposition from the reactive silane and methane precursor gases diluted with hydrogen at a substrate temperature of 200 °C. The effect of the hydrogen dilution ratio X (X is defined as the flow rate ratio of hydrogen-to-silane plus methane gases), ranging from 0 to 10.0, on the morphological, structural, and compositional properties of the deposited films, is extensively and systematically studied by scanning electron microscopy, high-resolution transmission electron microscopy, X-ray diffraction, Raman spectroscopy, Fourier-transform infrared absorption spectroscopy, and X-ray photoelectron spectroscopy. Effective nanophase segregation at a low hydrogen dilution ratio of 4.0 leads to the formation of highly uniform Si QDs embedded in the amorphous SiC matrix. It is also shown that with the increase of X, the crystallinity degree and the crystallite size increase while the carbon content and the growth rate decrease. The obtained experimental results are explained in terms of the effect of hydrogen dilution on the nucleation and growth processes of the Si QDs in the high-density plasmas. These results are highly relevant to the development of next-generation photovoltaic solar cells, light-emitting diodes, thin-film transistors, and other applications.

On equilibrium states and dust charging in dusty plasmas

The dust-charge variation process is revisited, accounting for the background density variation associated with electron capture and release by the dust grains. It appears possible to maintain overall charge neutrality in the plasma without any external particle source or sink. It is shown that if the dust charge and density are sufficiently high, the effect of the background electron density variation on dust-charge relaxation is important. The equilibrium dust charge and its rate of variation are obtained for dusty plasmas subject to strong UV irradiation. The latter releases photoelectrons from the dust surface and can significantly affect the equilibrium dust charge, its variation rate, as well as the overall charge neutrality in the plasma.

Equilibrium and relaxation of particulate charge in fluorocarbon plasmas

Charging of micron-size particulates, often appearing in fluorocarbon plasma etching experiments, is considered. It is shown that in inductively coupled and microwave slot-excited plasmas of C4F8 and Ar gas mixtures, the equilibrium particle charge and charge relaxation processes are controlled by a combination of microscopic electron, atomic (Ar+ and F+), and molecular ion (CF+ 3, CF+ 2, and CF+) currents. The impact of molecular ion currents on the particulate charging and charge relaxation processes is analyzed. It is revealed that in low-power (<0.5 kW) microwave slot-excited plasmas, the impact of the combined molecular ion current to the total positive microscopic current on the particle can be as high as 40%. The particulate charge relaxation rate in fluorocarbon plasmas appears to exceed 108 s-1, which is almost one order of magnitude higher than that from purely argon plasmas. This can be attributed to the impact of positive currents of fluorocarbon molecular ions, as well as to the electron density fluctuations with particle charge, associated with electron capture and release by the particulates.

Extremely non-equilibrium synthesis of luminescent zinc oxide nanoparticles through energetic ion condensation in a dense plasma focus device

Luminescent ZnO nanoparticles have been synthesized on silicon and quartz substrates under extremely non-equilibrium conditions of energetic ion condensation during the post-focus phase in a dense plasma focus (DPF) device. Ar+, O+, Zn+ and ZnO+ ions are generated as a result of interaction of hot and dense argon plasma focus with the surfaces of ZnO pellets placed at the anode. It is found that the sizes, structural and photoluminescence (PL) properties of the ZnO nanoparticles appear to be quite different on Si(1 0 0) and quartz substrates. The results of x-ray diffractometry and atomic force microscopy show that the ZnO nanoparticles are crystalline and range in size from 5-7 nm on Si(1 0 0) substrates to 10-38 nm on quartz substrates. Room-temperature PL studies reveal strong peaks related to excitonic bands and defects for the ZnO nanoparticles deposited on Si (1 0 0), whereas the excitonic bands are not excited in the quartz substrate case. Raman studies indicate the presence of E2 (high) mode for ZnO nanoparticles deposited on Si(1 0 0).

Rapid, low-temperature synthesis of nc-Si in high-density, non-equilibrium plasmas : enabling nanocrystallinity at very low hydrogen dilution

Nanocrystalline silicon thin films were deposited on single-crystal silicon and glass substrates simultaneously by inductively coupled plasma-assisted chemical vapor deposition from the reactive silane reactant gas diluted with hydrogen at a substrate temperature of 200 °C. The effect of hydrogen dilution ratio X (X is defined as the flow rate ratio of hydrogen to silane gas), ranging from 1 to 20, on the structural and optical properties of the deposited films, is extensively investigated by Raman spectroscopy, X-ray diffraction, Fourier transform infrared absorption spectroscopy, UV/VIS spectroscopy, and scanning electron microscopy. Our experimental results reveal that, with the increase of the hydrogen dilution ratio X, the deposition rate Rd and hydrogen content CH are reduced while the crystalline fraction Fc, mean grain size δ and optical bandgap ETauc are increased. In comparison with other plasma enhanced chemical vapor deposition methods of nanocrystalline silicon films where a very high hydrogen dilution ratio X is routinely required (e.g. X > 16), we have achieved nanocrystalline silicon films at a very low hydrogen dilution ratio of 1, featuring a high deposition rate of 1.57 nm/s, a high crystalline fraction of 67.1%, a very low hydrogen content of 4.4 at.%, an optical bandgap of 1.89 eV, and an almost vertically aligned columnar structure with a mean grain size of approximately 19 nm. We have also shown that a sufficient amount of atomic hydrogen on the growth surface essential for the formation of nanocrystalline silicon is obtained through highly-effective dissociation of silane and hydrogen molecules in the high-density inductively coupled plasmas. © 2009 The Royal Society of Chemistry.