Physical activity and population health outcomes

SMA members Neville Owen, Adrian Bauman, Wendy Brown and Stewart Trost have recently been awarded two NHMRC grants for research which will focus on understanding and influencing physical activity to improve population health outcomes. They were awarded under the Capital Building for Population Health scheme and the Program Grants scheme. The total value of the grants is 86.5 million over five years. The new grants will allow the researchers to conduct rigorous behavioural and epidemiological research which will inform the development of innovative primary and secondary prevention initiatives and determine their effectiveness. This is important, because physical activity is significantly implicated in the prevention and management of established chronic health problems such as cardiovascular disease, type 2 diabetes, osteoporosis and some forms of cancer. It also has a key role to play in addressing the growing epidemic of childhood and adult obesity, and in the maintenance of functional well-being with age. However, in recent years, physical activity levels in Australia have declined, indicating that the net sum of all our efforts to encourage physical activity participation require renewed and innovative efforts. The proposed research programs will be based on the researchers' cross-disciplinary backgrounds in exercise physiology, psychology, health promotion and epidemiology, and will be integrated across four main domains:..

Advances in population surveillance for physical activity and sedentary behavior : reliability and validity of time use surveys

Many countries conduct regular national time use surveys, some of which date back as far as the 1960s. Time use surveys potentially provide more detailed and accurate national estimates of the prevalence of sedentary and physical activity behavior than more traditional self-report surveillance systems. In this study, the authors determined the reliability and validity of time use surveys for assessing sedentary and physical activity behavior. In 2006 and 2007, participants (n = 134) were recruited from work sites in the Australian state of New South Wales. Participants completed a 2-day time use diary twice, 7 days apart, and wore an accelerometer. The 2 diaries were compared for test-retest reliability, and comparison with the accelerometer determined concurrent validity. Participants with similar activity patterns during the 2 diary periods showed reliability intraclass correlations of 0.74 and 0.73 for nonoccupational sedentary behavior and moderate/vigorous physical activity, respectively. Comparison of the diary with the accelerometer showed Spearman correlations of 0.57-0.59 and 0.45-0.69 for nonoccupational sedentary behavior and moderate/vigorous physical activity, respectively. Time use surveys appear to be more valid for population surveillance of nonoccupational sedentary behavior and health-enhancing physical activity than more traditional surveillance systems. National time use surveys could be used to retrospectively study nonoccupational sedentary and physical activity behavior over the past 5 decades.

Comparison of surveys used to measure physical activity

Objective To compare the level of agreement in results obtained from four physical activity (PA) measurement instruments that are in use in Australia and around the world. Methods 1,280 randomly selected participants answered two sets of PA questions by telephone. 428 answered the Active Australia (AA) and National Health Surveys, 427 answered the AA and CDC Behavioural Risk Factor Surveillance System surveys (BRFSS), and 425 answered the AA survey and the short International Physical Activity Questionnaire (IPAQ). Results Among the three pairs of survey items, the difference in mean total PA time was lowest when the AA and NHS items were asked (difference=24) (SE:17) minutes, compared with 144 (SE:21) mins for AA/BRFSS and 406 (SE:27) mins for AA/IPAQ). Correspondingly, prevalence estimates for 'sufficiently active' were similar for AA and NHS (56% and 55% respectively), but about 10% higher when BRFSS data were used, and about 26% higher when the IPAQ items were used, compared with estimates from the AA survey. Conclusions The findings clearly demonstrate that there are large differences in reported PA times and hence in prevalence estimates of 'sufficient activity' from these four measures. Implications It is important to consistently use the same survey for population monitoring purposes. As the AA survey has now been used three times in national surveys, its continued use for population surveys is recommended so that trend data ever a longer period of time can be established.

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.

Thesis Eleven festival and cultural sociology public event : a report

From June 7th to 15th the Thesis Eleven Centre for Cultural Sociology at La Trobe University directed by Peter Beilharz put together a programme of public lectures, cultural events and master classes under the theme ‘Word, Image, Action: Popular Print and Visual Cultures’. This article reports on the highlights of the festival, including a forum titled ‘Does WikiLeaks Matter?, a half-day event ‘On Bauman’, and a public lecture by Ron Jacobs on ‘Media Narratives of Economic Crisis’.

Meta-analyses identify 13 loci associated with age at menopause and highlight DNA repair and immune pathways

To newly identify loci for age at natural menopause, we carried out a meta-analysis of 22 genome-wide association studies (GWAS) in 38,968 women of European descent, with replication in up to 14,435 women. In addition to four known loci, we identified 13 loci newly associated with age at natural menopause (at P < 5 x 10(-8)). Candidate genes located at these newly associated loci include genes implicated in DNA repair (EXO1, HELQ, UIMC1, FAM175A, FANCI, TLK1, POLG and PRIM1) and immune function (IL11, NLRP11 and PRRC2A (also known as BAT2)). Gene-set enrichment pathway analyses using the full GWAS data set identified exoDNase, NF-kappaB signaling and mitochondrial dysfunction as biological processes related to timing of menopause.

Comparing population attributable risks for heart disease across the adult lifespan in women

Background Recent estimates suggest that high body mass index (BMI), smoking, high blood pressure (BP) and physical inactivity are leading risk factors for the overall burden of disease in Australia. The aim was to examine the population attributable risk (PAR) of heart disease for each of these risk factors, across the adult lifespan in Australian women. Methods PARs were estimated using relative risks (RRs) for each of the four risk factors, as used in the Global Burden of Disease Study, and prevalence estimates from the Australian Longitudinal Study on Women's Health, in 15 age groups from 22–27 (N=9608) to 85–90 (N=3901). Results RRs and prevalence estimates varied across the lifespan. RRs ranged from 6.15 for smoking in the younger women to 1.20 for high BMI and high BP in the older women. Prevalence of risk exposure ranged from 2% for high BP in the younger women to 79% for high BMI in mid-age women. In young adult women up to age 30, the highest population risk was attributed to smoking. From age 31 to 90, PARs were highest for physical inactivity. Conclusions From about age 30, the population risk of heart disease attributable to inactivity outweighs that of other risk factors, including high BMI. Programmes for the promotion and maintenance of physical activity deserve to be a much higher public health priority for women than they are now, across the adult lifespan.

Does vigorous physical activity provide additional benefits beyond those of moderate?

Background Although guidelines suggest that vigorous physical activity (PA) confers “extra” benefits compared with those from moderate-intensity activity alone, the magnitude of this additional benefit is unclear. The aim was to compare the reduction in risk of hypertension (HT) and depressive symptoms (DS) for 12 yr in middle-age women who reported (a) only moderate-intensity PA (MOPA) and (b) a combination of moderate and vigorous PA (MVPA), after controlling for overall volume of activity. Methods The study involved 11,285 participants in the Australian Longitudinal Study on Women’s Health, who completed surveys in 1998 (age = 46–52 yr), 2001, 2004, 2007, and 2010. Generalized estimating equation models (with 3-yr time lag) were used to examine the relationship between PA in seven categories from 0 to >2000 MET·min·wk−1 and occurrence of HT and DS for women who reported MOPA or MVPA. Results For HT, risk was slightly lower for MVPA than for MOPA across the entire range of PA levels, but this difference was only significant at the highest PA level (>2000; odds ratio [OR] = 0.80 MOPA and 0.56 MVPA). For DS, OR values were similar in both groups up to 500 MET·min·wk−1, then slightly lower for MVPA than for MOPA at higher PA levels. Again, this difference was only significant at the highest PA level (>2000; OR = 0.57 MOPA and 0.42 MVPA). OR values were slightly attenuated in adjusted models. Conclusions Doing both vigorous and moderate activity does not have significant additional benefits in terms of HT and DS, above those from moderate-intensity activity alone, except at very high levels of PA.

Response: Special communication: Letters to the Editor-in-Chief [Vigorous exercise in clinical practice: balancing risks and benefits]

The effects of different exercise intensities on health have been investigated in several studies in recent years, in which some authors showed greater benefits for vigorous exercise (6) while others did not find any differences (8). An important issue regarding these conflicting results could be the fact that only a few of the studies controlled the effects of different exercise intensities for the overall volume of physical activity, making the evaluation of the available data difficult.

"Onko yhteisöllisyydellä väliä?" : identiteettiprosessi ja sosiaalinen pääoma epävarmuuden sietämisen merkityksellisinä elementteinä

”Does the community really count? – identity process and social capital as elements in surviving in insecurity and uncertainty” is a combination of five articles. The aim of this study is to answer the question: how or in which ways is it possible to find the role of identity process and social capital in surviving in insecurity and uncertainty? In the introduction part the concepts of community and social capital are examined. Then I will study the articles and try to find out what kinds of elements of identity process and social capital in them can be found in order to survive in the societal change. The study consists of the introduction part and the articles. The articles are: 1. “Is Becoming a Researcher Some Kind of Role-playing” - Roles of the Researcher in the Process of Forming the Identity 2. What Composes Collective Identity in the Polytechnic Community? 3. Opportunities to Succeed or Fear of Failure? -Entrepreneurship from the Youngsters` Point of View 4. Learning Risk-taking Competences 5. “Bricolage”, or Just Putting Things Together? The starting point for the study is the feeling of insecurity that surrounds a person living in the present society: you cannot be sure with whom you are going to co-operate tomorrow. In the “Good Old Days” the harmonious communities “protected” their members and worked strongly toward common aims. Nowadays, partly because of urbanisation, we are so busy that we only have time to take care of ourselves, or rather to say: just of myself. As Bauman (2001) puts it: people turn to communities in which they feel like home. They still long for communality. For Mead (1962) the group and the communality plays a big role: a person needs others to become the whole ”Self.” In acting with others a person can gain much more than working alone (Field 2003). But, as Day (2006) puts it, the reality of community as discovered by empirical reserach is a great deal messier than the abstract and idealized versions used by theorists. Keywords: uncertainty, insecurity, communality, identity process, social capital, significant groups, survival.

Julkisen tilan kontrollin ulottuvuuksia : tapaustutkimus Stop Töhryille -projektista.

Tämä tutkielma keskittyy julkisen kaupunkitilan kontrollin eri muotoihin. Ihmiset käyttävät kaupunkitilaa eri tavoin ja eri tarkoituksiin. Tilan sallitut ja kielletyt käyttömuodot ovat aina erilaisten toiveiden yhteensovittamista: yhteisen neuvottelun tulos. Tilaa myös kontrolloidaan vastaamaan erilaisia toiveita ja odotuksia. Tutkielmassa julkisen tilan kontrollin muodot on jaettu kolmeen: tilan fyysinen muokkaaminen, tilan valvonta ja asenteisiin vaikuttaminen esimerkiksi politiikkaohjelmilla. Tärkeimpänä kiinnostuksen kohteena on tilanne, jossa jokin toiminta kielletään kokonaisuudessaan. Tutkielmassa käytetään konkreettisena esimerkkinä yrityksestä kontrolloida tilaa Helsingin kaupungin Stop Töhryille -projektia: kyseessä on tapaustutkimus em. projektista. Projekti toteutettiin vuosina 1998–2008 Helsingin kaupungin rakennusviraston sekä yleisten töiden lautakunnan alaisuudessa. Projektin tavoitteena oli vähentää ja poistaa kaupunkitilassa näkyviä graffiteja. Keinoina tähän oli tekninen siivous, valvonta ja viestintä. Graffitit voidaan nähdä yhtenä keinona vallata tilaa itselle. Tutkimuksen ongelmanasettelun taustalla on pohdinta siitä, kohdistuuko julkisen tilan kontrolli jonkin tietyn toiminnon ei-toivottavuuteen vai kohdistuuko kontrolli tiettyjen toimijoiden ei-toivottavuuteen. Tavoitteena on selvittää, minkälainen tilan kontrolliin tähtäävä ohjelma Stop Töhryille -projekti oli. Tutkimuskysymykset liittyvät siihen, miksi projekti toteutettiin, mihin projektin toimenpiteet kohdistuivat ja miten nollatoleranssi määriteltiin projektissa. Tutkielman teoreettinen viitekehys pohjautuu Jock Youngin määritelmälle nollatoleranssista, nollatoleranssin kritiikille sekä Henri Lefebvren, Don Mitchellin, Andrea Sharkeyn ja Rob Shieldsin kirjoituksiin oikeudesta tilaan. Aineistona käytetään yleisten töiden lautakunnan kokousten esityslista- ja pöytäkirjamateriaalia sekä haastatteluja projektissa mukana olleille tai projektiin vaikuttaneille tahoille (N=4). Analyysin menetelmänä sovelletaan diskurssianalyysiä. Aineiston perusteella voidaan todeta, että projektissa hyödynnettiin laajasti erilaisia kontrollin keinoja. Projektin toimenpiteet keskittyivät alussa enemmän toimintoon (graffitien puhdistamiseen ja ehkäisyyn), mutta viimeisinä vuosina painopiste siirtyi enemmän toimijaan (graffitintekijään). Aineiston analyysissä yhtenä olennaisena toimijaryhmänä esille nousivat nuoret ja nuoriso, jotka mainittiin useaan otteeseen graffitintekijöinä. Tutkielmassa tätä ilmiötä pohditaan Mike Presdeen nuoruuden kriminalisointi -käsitteen sekä Zygmunt Baumanin ulossulkemisen paradigman kautta. Nollatoleranssiretoriikka on löydettävissä projektista kolmella tasolla: ideologisella, toiminnallisella sekä viestinnällisellä. Nollatoleranssia perusteltiin ideologisella tasolla rikottujen ikkunoiden teesillä: pieniä sosiaalisia häiriöitä poistamalla voidaan ehkäistä suuria rikoksia. Tämä perustelu vietiin toiminnalliselle tasolle, jossa häiriökäyttäytyjiä valvottiin ja heille vaadittiin kovia rangaistuksia. Viestinnällä pyrittiin madaltamaan kansalaisten sietokykyä graffiti-ilmiöön ja edesautettiin mahdollisimman laajan kansalais- ja asukasyhteistyön syntymistä. Lisäksi projektissa luotiin aktiivisesti tiedon ja kielen politiikkaa, joissa tuotetaan käsitystä siitä että graffitit lisäävät turvattomuutta ja konstruoidaan sellainen kieli, jossa graffitit nähdään ongelmana.

Julkisen tilan kontrollin ulottuvuuksia. Tapaustutkimus Stop Töhryille -projektista.

Tämä tutkielma keskittyy julkisen kaupunkitilan kontrollin eri muotoihin. Ihmiset käyttävät kaupunkitilaa eri tavoin ja eri tarkoituksiin. Tilan sallitut ja kielletyt käyttömuodot ovat aina erilaisten toiveiden yhteensovittamista: yhteisen neuvottelun tulos. Tilaa myös kontrolloidaan vastaamaan erilaisia toiveita ja odotuksia. Tutkielmassa julkisen tilan kontrollin muodot on jaettu kolmeen: tilan fyysinen muokkaaminen, tilan valvonta ja asenteisiin vaikuttaminen esimerkiksi politiikkaohjelmilla. Tärkeimpänä kiinnostuksen kohteena on tilanne, jossa jokin toiminta kielletään kokonaisuudessaan. Tutkielmassa käytetään konkreettisena esimerkkinä yrityksestä kontrolloida tilaa Helsingin kaupungin Stop Töhryille -projektia: kyseessä on tapaustutkimus em. projektista. Projekti toteutettiin vuosina 1998–2008 Helsingin kaupungin rakennusviraston sekä yleisten töiden lautakunnan alaisuudessa. Projektin tavoitteena oli vähentää ja poistaa kaupunkitilassa näkyviä graffiteja. Keinoina tähän oli tekninen siivous, valvonta ja viestintä. Graffitit voidaan nähdä yhtenä keinona vallata tilaa itselle. Tutkimuksen ongelmanasettelun taustalla on pohdinta siitä, kohdistuuko julkisen tilan kontrolli jonkin tietyn toiminnon ei-toivottavuuteen vai kohdistuuko kontrolli tiettyjen toimijoiden ei-toivottavuuteen. Tavoitteena on selvittää, minkälainen tilan kontrolliin tähtäävä ohjelma Stop Töhryille -projekti oli. Tutkimuskysymykset liittyvät siihen, miksi projekti toteutettiin, mihin projektin toimenpiteet kohdistuivat ja miten nollatoleranssi määriteltiin projektissa. Tutkielman teoreettinen viitekehys pohjautuu Jock Youngin määritelmälle nollatoleranssista, nollatoleranssin kritiikille sekä Henri Lefebvren, Don Mitchellin, Andrea Sharkeyn ja Rob Shieldsin kirjoituksiin oikeudesta tilaan. Aineistona käytetään yleisten töiden lautakunnan kokousten esityslista- ja pöytäkirjamateriaalia sekä haastatteluja projektissa mukana olleille tai projektiin vaikuttaneille tahoille (N=4). Analyysin menetelmänä sovelletaan diskurssianalyysiä. Aineiston perusteella voidaan todeta, että projektissa hyödynnettiin laajasti erilaisia kontrollin keinoja. Projektin toimenpiteet keskittyivät alussa enemmän toimintoon (graffitien puhdistamiseen ja ehkäisyyn), mutta viimeisinä vuosina painopiste siirtyi enemmän toimijaan (graffitintekijään). Aineiston analyysissä yhtenä olennaisena toimijaryhmänä esille nousivat nuoret ja nuoriso, jotka mainittiin useaan otteeseen graffitintekijöinä. Tutkielmassa tätä ilmiötä pohditaan Mike Presdeen nuoruuden kriminalisointi -käsitteen sekä Zygmunt Baumanin ulossulkemisen paradigman kautta. Nollatoleranssiretoriikka on löydettävissä projektista kolmella tasolla: ideologisella, toiminnallisella sekä viestinnällisellä. Nollatoleranssia perusteltiin ideologisella tasolla rikottujen ikkunoiden teesillä: pieniä sosiaalisia häiriöitä poistamalla voidaan ehkäistä suuria rikoksia. Tämä perustelu vietiin toiminnalliselle tasolle, jossa häiriökäyttäytyjiä valvottiin ja heille vaadittiin kovia rangaistuksia. Viestinnällä pyrittiin madaltamaan kansalaisten sietokykyä graffiti-ilmiöön ja edesautettiin mahdollisimman laajan kansalais- ja asukasyhteistyön syntymistä. Lisäksi projektissa luotiin aktiivisesti tiedon ja kielen politiikkaa, joissa tuotetaan käsitystä siitä että graffitit lisäävät turvattomuutta ja konstruoidaan sellainen kieli, jossa graffitit nähdään ongelmana.