scholarly journals What is the Minimum Step Rate Required to Achieve Moderate-Intensity Walking Overground in Adolescent Girls?

2020 ◽  
Vol 32 (4) ◽  
pp. 197-203
Author(s):  
Mhairi J. MacDonald ◽  
Samantha G. Fawkner ◽  
Ailsa G. Niven
Keyword(s):  
Adolescent Girls ◽  
Mixed Model ◽  
Small Sample Size ◽  
Resting Metabolic Rate ◽  
Population Level ◽  
Small Sample ◽  
Moderate Intensity ◽  
Anthropometric Measures ◽  
Step Rate ◽  
Metabolic Equivalents

Background: In order to promote walking, researchers have sought to identify the required step rate to maintain a health-enhancing walking intensity However, there is limited evidence regarding the stepping rate required to promote moderate-intensity walking in adolescent girls. Purpose: To identify the step rate equivalent to moderate-intensity physical activity (MPA) in adolescent girls and to explore the influence that different anthropometric measures may have on the step rate equating to MPA in this population. Methods: A total of 56 adolescent girls (mean age = 13.8[0.7] y) were recruited to the study. Anthropometric variables and resting metabolic rate were assessed, followed by 3 overground walking trials on a flat surface at approximately 2, 3, and 4 mph, each lasting a minimum of 4 minutes. Oxygen uptake was assessed using a portable gas analyzer and subsequently converted into metabolic equivalents (METs). Step count was assessed by real-time direct observation hand tally. Results: Employing the linear regression between step rate and METs (r2 = .20, standard error of estimates = 0.003) suggests that 120 steps per minute was representative of an MPA (3 METs) equating to 7200 steps in 60 minutes. Multiple regression and mixed-model regression confirmed weight-related variables and maturity were significant predictors of METs (P < .01). Conclusion: The results suggest that, at population level, a step rate of 120 steps per minute may be advocated to achieve MPA in adolescent girls; although, due to the small sample size used, caution should be applied. At an individual level, other factors, such as age and weight, should be considered.

scholarly journals How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: a narrative review

2018 ◽  
Vol 52 (12) ◽  
pp. 776-788 ◽  
Author(s):  
Catrine Tudor-Locke ◽  
Ho Han ◽  
Elroy J Aguiar ◽  
Tiago V Barreira ◽  
John M Schuna Jr ◽  
...  
Keyword(s):  
Population Level ◽  
Strong Relationship ◽  
Epidemiological Studies ◽  
Moderate Intensity ◽  
Current Evidence ◽  
Free Living ◽  
Metabolic Equivalents ◽  
Registration Number ◽  
Comprehensive Search ◽  
Comprehensive Search Strategy

BackgroundCadence (steps/min) may be a reasonable proxy-indicator of ambulatory intensity. A summary of current evidence is needed for cadence-based metrics supporting benchmark (standard or point of reference) and threshold (minimums associated with desired outcomes) values that are informed by a systematic process.ObjectiveTo review how fast, in terms of cadence, is enough, with reference to crafting public health recommendations in adults.MethodsA comprehensive search strategy was conducted to identify relevant studies focused on walking cadence and intensity for adults. Identified studies (n=38) included controlled (n=11), free-living observational (n=18) and intervention (n=9) designs.ResultsThere was a strong relationship between cadence (as measured by direct observation and objective assessments) and intensity (indirect calorimetry). Despite acknowledged interindividual variability, ≥100 steps/min is a consistent heuristic (e.g, evidence-based, rounded) value associated with absolutely defined moderate intensity (3 metabolic equivalents (METs)). Epidemiological studies report notably low mean daily cadences (ie, 7.7 steps/min), shaped primarily by the very large proportion of time (13.5 hours/day) spent between zero and purposeful cadences (<60 steps/min) at the population level. Published values for peak 1-min and 30-min cadences in healthy free-living adults are >100 and >70 steps/min, respectively. Peak cadence indicators are negatively associated with increased age and body mass index. Identified intervention studies used cadence to either prescribe and/or quantify ambulatory intensity but the evidence is best described as preliminary.ConclusionsA cadence value of ≥100 steps/min in adults appears to be a consistent and reasonable heuristic answer to ’How fast is fast enough?' during sustained and rhythmic ambulatory behaviour.Trial registration numberNCT02650258

Dietary intakes and anthropometric measures of Indigenous Australian women and their infants in the Gomeroi gaaynggal cohort

2016 ◽  
Vol 7 (5) ◽  
pp. 481-497 ◽  
Author(s):  
A. M. Ashman ◽  
C. E. Collins ◽  
L. J. Weatherall ◽  
L. Keogh ◽  
L. J. Brown ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Saturated Fat ◽  
Small Sample ◽  
Indigenous Australians ◽  
Breastfeeding Initiation ◽  
Dietary Intakes ◽  
Nutrient Intakes ◽  
Indigenous Australian ◽  
Anthropometric Measures ◽  
Cross Sectional

Indigenous Australians continue to experience disparities in chronic diseases, many of which have nutrition-related trajectories. Optimal nutrition throughout the lifespan is protective for a number of adverse health outcomes, however little is known about current dietary intakes and related anthropometric outcomes of Indigenous women and their infants. Research is required to identify nutrition issues to target for health promotion activities. The Gomeroi gaaynggal programme is an ongoing, prospective cohort of pregnant Indigenous Australian women and their children. A cross-sectional examination of postnatal dietary intakes and anthropometric outcomes of mothers and children are reported. To date, 73 mother–child dyads have participatedpostpartum. Breastfeeding initiation was 85.9% and median (interquartile range) duration of any breastfeeding was 1.4 (0.5–4.0) months. Infants were introduced to solid foods at 5.0 months (4.0–6.0) and cow’s milk at 12.0 (10.0–13.0) months. At 12 monthspostpartum, 66.7% of women were overweight or obese, 63.7% at 2 years. Compared with recommendations, reported median maternal nutrient intakes from 24-h recall were low in fibre, folate, iodine, calcium, potassium and vitamin D and high in proportions of energy from total and saturated fat. Limitations of this study include a small sample size and incomplete data for the cohort at each time point. Preliminary data from this ongoing cohort of Indigenous Australian women and children suggest that women may need support to optimize nutrient intakes and to attain a healthy body weight for themselves and their children.

scholarly journals Longitudinal Variation of Amino Acid Levels in Human Milk and Their Associations with Infant Gender

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1233 ◽  
Author(s):  
Joris van Sadelhoff ◽  
Bert van de Heijning ◽  
Bernd Stahl ◽  
Sonia Amodio ◽  
Edmond Rings ◽  
...  
Keyword(s):  
Human Milk ◽  
Mixed Model ◽  
Small Sample Size ◽  
Male Infant ◽  
Small Sample ◽  
Functional Roles ◽  
Protein Levels ◽  
Infant Gender ◽  
Amino Acid Levels ◽  
Time Specific

It is discussed that specific amino acids (AAs) have functional roles in early life. Understanding the AA composition in human milk (HM) during lactation assists in specifying these roles. To this end we assessed the levels of free AAs (FAAs), total AAs (free and bound, TAAs) and protein levels in HM in the first 6 months of lactation, and evaluated possible associations with infant gender. HM samples of 25 healthy Dutch mothers participating in the PreventCD study were collected monthly during the first 6 months of lactation. Of the participating mothers, 12 gave birth to a boy and 13 gave birth to a girl. Analyses of the HM samples revealed that levels of free glutamate, glutamine, aspartate, glycine, and serine significantly increased during months 1–3 of lactation, both in absolute sense and relative to TAA levels. Evaluation of gender differences by mixed model analyses revealed an association between female infant gender and higher protein content (p = 0.0465) and TAA content (p = 0.0362) in HM during the first 3 months of lactation. Furthermore, there was a tendency for an association of male infant gender with higher levels of free glutamine (p = 0.0948) in HM during the first 3 months of lactation. These results show that FAA, TAA and protein levels in HM display a time-specific occurrence during lactation. Moreover, although confirmation is necessary in view of the small sample size, this study indicates that the AA composition in HM shows differential effects of the infant’s sex.

scholarly journals Brief telephone intervention for caregivers of medically complex patients during COVID-19

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 935-935
Author(s):  
Mary Stevens-Carr ◽  
Kevin Sethi ◽  
Channing Cochran ◽  
Margaret Bencomo-Rivera ◽  
Janice Marceaux
Keyword(s):  
Mixed Model ◽  
Small Sample Size ◽  
Small Sample ◽  
Adult Day Care ◽  
Telephone Intervention ◽  
Post Intervention ◽  
Home Based Primary Care ◽  
Home Based ◽  
Complex Patients ◽  
Mixed Model Anova

Abstract The VA Home Based Primary Care (HBPC) program consists of an interdisciplinary team, including psychology, serving veterans with complex medical conditions who are supported by live-in caregiver(s). HBPC psychologists may work with caregivers to address caregiver stress. Some veterans enrolled in HBPC attend Adult Day Care (ADC) programs, allowing respite for caregivers. At the onset of COVID19 pandemic, ADC centers closed to minimize spread of the virus. The authors identified these caregivers to be at high risk for burnout and sought to develop a protocol to assist these caregivers via telephone and evaluate outcomes. PreCOVID-19 caregiver stress was known via a 4-item Zarit Caregiver Burden annual screening (Bédard et al., 2001). Following ADC closures, caregivers of veterans enrolled in ADC programs were contacted and re-administered the Zarit to determine impact of COVID-19 on caregiver stress. Caregivers of veterans not attending ADC were also contacted for comparison. Contacted caregivers were provided a brief CBT-based intervention via telephone, and post-intervention Zarit screening was administered after two weeks. Ultimately, 4 ADC caregivers and 4 non-ADC caregivers were contacted and provided with services before ADC centers reopened. Statistical analysis via mixed model ANOVA did not yield significant results, likely due to small sample size, although there was a large effect size (η_p^2 =.566). ADC caregivers generally reported increased stress from baseline following ADC closure and reduced stress following provision of intervention. The authors will present caregiver feedback about aspects of telephone intervention that were helpful, and not helpful, as well as authors impression.

scholarly journals Absolute Accelerometer-Based Intensity Prescription Compared to Physiological Variables in Pregnant and Nonpregnant Women

2020 ◽  
Vol 17 (16) ◽  
pp. 5651
Author(s):  
Philipp Birnbaumer ◽  
Pavel Dietz ◽  
Estelle Dorothy Watson ◽  
Gudani Mukoma ◽  
Alexander Müller ◽  
...  
Keyword(s):  
Ventilatory Threshold ◽  
Resting Metabolic Rate ◽  
Moderate Intensity ◽  
Cut Points ◽  
Physiological Variables ◽  
Metabolic Equivalents ◽  
Ventilatory Equivalent ◽  
Ventilatory Parameters ◽  
Accelerometer Cut Points ◽  
The Relationship

Estimation of the intensity of physical activity (PA) based on absolute accelerometer cut points (Cp) likely over- or underestimates intensity for a specific individual. The purpose of this study was to investigate the relationship between absolute moderate intensity Cp and the first ventilatory threshold (VT1). A group of 24 pregnant and 15 nonpregnant women who performed a submaximal incremental walking test with measures of ventilatory parameters and accelerations from three different accelerometers on the wrist (ActiGraph wGT3X-BT, GENEActiv, Axivity AX3) and one on the hip (Actigraph wGT3X-BT) were analyzed. Cp were determined corresponding to 3 metabolic equivalents of task (MET), using the conventional MET definition (Cp3.5) (3.5 mL/kg×min) and individual resting metabolic rate (Cpind). The ventilatory equivalent (VE/VO2) was used to determine VT1. Accelerations at VT1 were significantly higher (p < 0.01) compared to Cp3.5 and Cpind in both groups. Cp3.5 and Cpind were significantly different in nonpregnant (p < 0.01) but not in pregnant women. Walking speed at VT1 (5.7 ± 0.5/6.2 ± 0.8 km/h) was significantly lower (p < 0.01) in pregnant compared to nonpregnant women and correspondent to 3.8 ± 0.7/4.9 ± 1.4 conventional METs. Intensity at absolute Cp was lower compared to the intensity at VT1 independent of the device or placement in pregnant and nonpregnant women. Therefore, we recommend individually tailored cut points such as the VT1 to better assess the effect of the intensity of PA.

A Steps/Minute Value for Moderate Intensity Physical Activity in Adolescent Females

2012 ◽  
Vol 24 (3) ◽  
pp. 399-408 ◽  
Author(s):  
Deirdre M. Harrington ◽  
Kieran P. Dowd ◽  
Catrine Tudor-Locke ◽  
Alan E. Donnelly
Keyword(s):  
Physical Activity ◽  
Mixed Model ◽  
Adolescent Females ◽  
Moderate Intensity ◽  
Moderate Intensity Physical Activity ◽  
Metabolic Equivalents ◽  
Intensity Physical Activity ◽  
Analytical Approaches ◽  
The Relationship ◽  
Over Ground Walking

The number of steps/minute (i.e., cadence) that equates to moderate intensity in adolescents is not known. To that end, 31 adolescent females walked on a treadmill at 5 different speeds while wearing an ActivPAL accelerometer and oxygen uptake was recorded by indirect calorimetry. The relationship between metabolic equivalents (METs) and cadence was explored using 3 different analytical approaches. Cadence was a significant predictor of METs (r=.70; p<.001). Moderate intensity (3 METs) corresponded to 94 or 114 steps/minute based on the mixed model and ROC analysis, respectively. These two values, and a practical value of 100 steps/minute, were cross-validated on an independent sample of 33 adolescent females during over-ground walking at 3 speeds. The sensitivity and specificity of each value correctly identifying 3 METs were 98.5% and 87.2% for 94 steps/minute, 72.9% and 98.8 for 114 steps/minute and 96.5% and 95.7% for 100 steps/minute. Compromising on a single cadence of 100 steps/minute would be a practical value that approximates moderate intensity in adolescent females and can be used for physical activity interpretation and promotion.

Step-Rate Recommendations for Moderate-Intensity Walking in Overweight/Obese and Healthy Weight Children

2015 ◽  
Vol 12 (3) ◽  
pp. 370-375 ◽  
Author(s):  
Charles F. Morgan ◽  
Allison R. Tsuchida ◽  
Michael William Beets ◽  
Ronald K. Hetzler ◽  
Christopher D. Stickley
Keyword(s):  
Physical Activity ◽  
Hierarchical Linear Modeling ◽  
Indirect Calorimetry ◽  
Weight Status ◽  
Moderate Intensity ◽  
Moderate Physical Activity ◽  
Healthy Weight ◽  
Step Rate ◽  
Metabolic Equivalents ◽  
Moderate Intensity Activity

Background:Physical activity guidelines for youth and adults include recommendations for moderate intensity activity to attain health benefits. Indirect calorimetry studies have consistently reported a 100 ste·min−1 threshold for moderate intensity walking in adults. No indirect calorimetry studies have investigated step-rate thresholds in children and therefore the primary purpose of the study was to determine preliminary step-rate thresholds for moderate physical activity walking in children.Methods:Oxygen consumption was measured at rest and used to determine 3 and 4 age-adjusted metabolic equivalents (A-AMETs) for 4 treadmill trials (self-selected, 2.5, 3.0, and 3.5 MPH). Two trained observers simultaneously counted children’s steps during each walking trial. Step-rate thresholds associated with moderate-intensity activity, defined as 3 and 4 A-AMETs, were determined using hierarchical linear modeling.Results:Regression analysis determined an overall step rate of 112 and 134 step·min-1 for 3 and 4 A-AMETs respectively. Body mass index (BMI) weight status and age were positively related to A-AMETs.Conclusions:We suggest age and BMI weight status specific recommendations that range from a low of 100 step·min-1 threshold (3 A-AMETs) for overweight/obese 11- to 12-year-olds to a high of 140 step·min-1 threshold (4 A-AMETs) for healthy weight 9- to 10-year-old children.

scholarly journals Expression of Prostanoid EP3 Receptors in Oral Squamous Epithelium and Oral Squamous Cell Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Muhammad Kashif ◽  
Muhammad Ishfaq ◽  
A. H. Nagi
Keyword(s):  
Small Sample Size ◽  
Descriptive Analysis ◽  
Maxillofacial Surgery ◽  
Small Sample ◽  
Moderate Intensity ◽  
Normal Epithelium ◽  
Receptor Antibody ◽  
Antibody Staining ◽  
Well Differentiated ◽  
Ep3 Receptor

Objectives. To carry out a descriptive analysis of the expression of the EP3 receptors of PGE2 in different histological grades of OSCC and adjacent normal epithelium. Material and Methods. A total of 46 patients presenting with various histological subtypes and grades of OSCC were recruited from Maxillofacial Surgery Department of Nishtar Institute of Dentistry Multan. Microscopically tumour subtyping and histological grading according to Anneroth’s grading system were carried out. Immunohistochemical staining with rabbit polyclonal EP3 receptor antibody was performed and sections were scored for intensity and proportion of positive adjacent squamous epithelial and tumour cells. Results. Out of 46 patients n=28 (60.9%) were well differentiated, n=15 (32.6%) were moderately differentiated, and only n=3 (6.5%) were poorly differentiated. All n=46 cases of OSCC were positive for EP3 receptor antibody, n=14 (30.4%) cases had strong intensity of anti EP3 antibody staining in tumour tissue, n=17 (37%) cases showed moderate intensity, and n=15 (32.6%) cases showed weak intensity. Conclusion. Prostanoid EP3 receptors are widely but variably expressed in OSCC. Most of well differentiated OSCC cases show a moderate to strong expression of EP3 receptors. However, insignificant statistical relation to histological grades of OSCC has been observed. This might be due to small sample size of the study.

Change in Neurocognitive Functioning After Treatment With Cranial Radiation in Childhood

2004 ◽  
Vol 22 (4) ◽  
pp. 706-713 ◽  
Author(s):  
Brenda J. Spiegler ◽  
Eric Bouffet ◽  
Mark L. Greenberg ◽  
James T. Rutka ◽  
Donald J. Mabbott
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Mixed Model ◽  
Standard Dose ◽  
Small Sample Size ◽  
Small Sample ◽  
Rate Of Change ◽  
Receptive Vocabulary ◽  
Cranial Radiation ◽  
Intelligence Scores

Purpose To evaluate the pattern of stability and change over time across multiple domains of neurocognitive function in radiated survivors of posterior fossa (PF) tumors. Patients and Methods Thirty-four children (25 males) treated for malignant PF tumors were observed with serial clinical neuropsychologic assessments. Thirty patients were treated for medulloblastoma and four patients were treated for ependymoma. Twelve patients were treated with reduced-dose and 21 patients were treated with standard-dose cranial radiation. All patients received an additional boost to the PF. One patient was treated with PF radiation only. Standardized neuropsychologic tests were administered at different times after diagnosis for each child. The rate of change in scores was determined using a mixed model regression. Results Results showed a 2- to 4-point decline per year in intelligence scores. For our relatively young sample, intellectual function declined quickly in the first few years after treatment, and then more gradually. Significant declines in visual-motor integration, visual memory, verbal fluency, and executive functioning were also documented. No decline was evident for verbal memory and receptive vocabulary. Conclusion Cranial radiation is associated with a decline in multiple neurocognitive domains, with a few notable exceptions. Our results must be interpreted in the context of common limitations of clinical research, including patient variability, changes in test versions, small sample size, and clinical referral bias.

scholarly journals Patient and Payer Preferences for Additional Value Criteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Ivett Jakab ◽  
Melanie D. Whittington ◽  
Elizabeth Franklin ◽  
Susan Raiola ◽  
Jonathan D. Campbell ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Treatment Options ◽  
Unmet Need ◽  
Population Level ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Small Sample ◽  
Decision Context ◽  
Definition Of ◽  
Additional Value

Background: Defining the value of healthcare is an elusive target, and depends heavily on the decision context and stakeholders involved. Cost-utility analysis and the quality-adjusted life year (QALY) have become the method and value definition of choice for traditional value judgements in coverage and pricing decisions. Other criteria that may influence value are often not measured and therefore omitted from value assessments, or are only used to qualitatively contextualize assessments. The objective of this study was to engage two key stakeholders; patients and payers to elicit and rank the importance of additional value criteria, potentially assessed in Multiple Criteria Decision Analysis (MCDA).Methods: This study consisted of a focus group with cancer patients (n = 7), including follow-up questions through an electronic survey, and in-depth phone interviews with payers (n = 5).Results: For payers, value equated either with criteria that provided tangible benefits (from their perspective) such as new treatment options that respond to serious unmet need. For patients, population-level value equated to options that would potentially benefit them in the future and the value of hope. However, these criteria were seen by payers as difficult to measure and incorporate into objective decision making.Limitations: The findings from this study are primarily limited due to generalizability. Due to the small sample size, it was outside the scope of this study to calculate a weight for each criterion that could be used as part of a quantitative MCDA.Conclusion: MCDA, with particular attention to qualitative aspects, is an avenue to incorporate these additional criteria into value assessments, as well as provide an opportunity for reflecting the patient’s preferences in assessing the value of a treatment.

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