Quantified Kinematics to Evaluate Patient Chemotherapy Risks in Clinic

PURPOSE Performance status (PS) is a key factor in oncologic decision making, but conventional scales used to measure PS vary among observers. Consumer-grade biometric sensors have previously been identified as objective alternatives to the assessment of PS. Here, we investigate how one such biometric sensor can be used during a clinic visit to identify patients who are at risk for complications, particularly unexpected hospitalizations that may delay treatment or result in low physical activity. We aim to provide a novel and objective means of predicting tolerability to chemotherapy. METHODS Thirty-eight patients across three centers in the United States who were diagnosed with a solid tumor with plans for treatment with two cycles of highly emetogenic chemotherapy were included in this single-arm, observational prospective study. A noninvasive motion-capture system quantified patient movement from chair to table and during the get-up-and-walk test. Activity levels were recorded using a wearable sensor over a 2-month period. Changes in kinematics from two motion-capture data points pre- and post-treatment were tested for correlation with unexpected hospitalizations and physical activity levels as measured by a wearable activity sensor. RESULTS Among 38 patients (mean age, 48.3 years; 53% female), kinematic features from chair to table were the best predictors for unexpected health care encounters (area under the curve, 0.775 ± 0.029) and physical activity (area under the curve, 0.830 ± 0.080). Chair-to-table acceleration of the nonpivoting knee ( t = 3.39; P = .002) was most correlated with unexpected health care encounters. Get-up-and-walk kinematics were most correlated with physical activity, particularly the right knee acceleration ( t = −2.95; P = .006) and left arm angular velocity ( t = −2.4; P = .025). CONCLUSION Chair-to-table kinematics are good predictors of unexpected hospitalizations, whereas the get-up-and-walk kinematics are good predictors of low physical activity.

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Effects of trees, gardens, and nature trails on heat index and child health: design and methods of the Green Schoolyards Project

BMC Public Health ◽

10.1186/s12889-020-10128-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kevin Lanza ◽

Melody Alcazar ◽

Deanna M. Hoelscher ◽

Harold W. Kohl

Keyword(s):

Physical Activity ◽

United States ◽

Relative Humidity ◽

Air Temperature ◽

The United States ◽

Heat Index ◽

Activity Levels ◽

Natural Setting ◽

Physical Activity Levels ◽

Nature Trails

Abstract Background Latinx children in the United States are at high risk for nature-deficit disorder, heat-related illness, and physical inactivity. We developed the Green Schoolyards Project to investigate how green features—trees, gardens, and nature trails—in school parks impact heat index (i.e., air temperature and relative humidity) within parks, and physical activity levels and socioemotional well-being of these children. Herein, we present novel methods for a) observing children’s interaction with green features and b) measuring heat index and children’s behaviors in a natural setting, and a selection of baseline results. Methods During two September weeks (high temperature) and one November week (moderate temperature) in 2019, we examined three joint-use elementary school parks in Central Texas, United States, serving predominantly low-income Latinx families. To develop thermal profiles for each park, we installed 10 air temperature/relative humidity sensors per park, selecting sites based on land cover, land use, and even spatial coverage. We measured green features within a geographic information system. In a cross-sectional study, we used an adapted version of System for Observing Play and Recreation in Communities (SOPARC) to assess children’s physical activity levels and interactions with green features. In a cohort study, we equipped 30 3rd and 30 4th grade students per school during recess with accelerometers and Global Positioning System devices, and surveyed these students regarding their connection to nature. Baseline analyses included inverse distance weighting for thermal profiles and summing observed counts of children interacting with trees. Results In September 2019, average daily heat index ranged 2.0 °F among park sites, and maximum daily heat index ranged from 103.4 °F (air temperature = 33.8 °C; relative humidity = 55.2%) under tree canopy to 114.1 °F (air temperature = 37.9 °C; relative humidity = 45.2%) on an unshaded playground. 10.8% more girls and 25.4% more boys interacted with trees in September than in November. Conclusions We found extreme heat conditions at select sites within parks, and children positioning themselves under trees during periods of high heat index. These methods can be used by public health researchers and practitioners to inform the redesign of greenspaces in the face of climate change and health inequities.

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Accuracy of Accelerometers for Measuring Physical Activity and Levels of Sedentary Behavior in Children: A Systematic Review

Journal of Primary Care & Community Health ◽

10.1177/2150132719874252 ◽

2019 ◽

Vol 10 ◽

pp. 215013271987425 ◽

Cited By ~ 1

Author(s):

Brian A. Lynch ◽

Tara K. Kaufman ◽

Tamim I. Rajjo ◽

K. Mohammed ◽

Seema Kumar ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Sedentary Behavior ◽

Indirect Calorimetry ◽

Area Under The Curve ◽

Current Evidence ◽

Activity Levels ◽

Light Physical Activity ◽

Accuracy Measures ◽

Median Area

Objectives: This systematic review evaluated the accuracy of triaxial and omnidirectional accelerometers for measuring physical activity and sedentary behavior in children. Design: Systematic review of the literature. Methods: We comprehensively searched several databases for studies published from January 1996 through June 2018 that reported diagnostic accuracy measures in children and adolescents (age 3-18 years) and compared accelerometers with energy expenditure using indirect calorimetry. Results: We included 11 studies that enrolled 570 participants. All studies used indirect calorimetry as the reference standard. Across the studies, median sensitivity ranged from 46% to 96% and median specificity ranged from 71% to 96%. Median area under the curve ranged from 69% to 98%. Conclusions: Accuracy measures were greatest when detecting sedentary behavior and lowest when detecting light physical activity. Accuracy was higher when the accelerometer was placed on the hip compared with the wrist. The current evidence suggests that triaxial and omnidirectional accelerometers are accurate in measuring sedentary behavior and physical activity levels in children.

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Results from the United States’ 2014 Report Card on Physical Activity for Children and Youth

Journal of Physical Activity and Health ◽

10.1123/jpah.2014-0184 ◽

2014 ◽

Vol 11 (s1) ◽

pp. S105-S112 ◽

Cited By ~ 44

Author(s):

Kara N. Dentro ◽

Kim Beals ◽

Scott E. Crouter ◽

Joey C. Eisenmann ◽

Thomas L. McKenzie ◽

...

Keyword(s):

Physical Activity ◽

United States ◽

Sport Participation ◽

Comprehensive Evaluation ◽

The United States ◽

Report Card ◽

Children And Youth ◽

Activity Levels ◽

Sedentary Behaviors ◽

Physical Activity Levels

Background:The National Physical Activity Plan Alliance partnered with physical activity experts to develop a report card that provides a comprehensive assessment of physical activity among United States children and youth.Methods:The 2014 U.S. Report Card on Physical Activity for Children and Youth includes 10 indicators: overall physical activity levels, sedentary behaviors, active transportation, organized sport participation, active play, health-related fitness, family and peers, school, community and the built environment, and government strategies and investments. Data from nationally representative surveys were used to provide a comprehensive evaluation of the physical activity indicators. The Committee used the best available data source to grade the indicators using a standard rubric.Results:Approximately one-quarter of children and youth 6 to 15 years of age were at least moderately active for 60 min/day on at least 5 days per week. The prevalence was lower among youth compared with younger children, resulting in a grade of D- for overall physical activity levels. Five of the remaining 9 indicators received grades ranging from B- to F, whereas there was insufficient data to grade 4 indicators, highlighting the need for more research in some areas.Conclusions:Physical activity levels among U.S. children and youth are low and sedentary behavior is high, suggesting that current infrastructure, policies, programs, and investments in support of children’s physical activity are not sufficient.

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Physical Activity, Sedentary Behaviors, and Risk of Cancer

10.1093/oso/9780190238667.003.0021 ◽

2017 ◽

Author(s):

Steven C. Moore ◽

Charles E. Matthews ◽

Sarah Keadle ◽

Alpa V. Patel ◽

I-Min Lee

Keyword(s):

Physical Activity ◽

The United States ◽

Moderate Intensity ◽

Activity Levels ◽

Breast Cancers ◽

Sedentary Behaviors ◽

Moderate Intensity Physical Activity ◽

Non Hodgkin Lymphoma ◽

Increased Risk ◽

Risk Of Cancer

Current physical activity guidelines recommend that adults perform at least 150 minutes per week of moderate-intensity physical activity (e.g., brisk walking), or 75 minutes per week of vigorous-intensity activity (e.g., jogging), or an equivalent combination of these. In the United States and worldwide, many adults fail to meet these recommended activity levels, with deleterious consequences for health, including increased risk of some cancers. This chapter reviews the epidemiologic evidence for links between physical activity and cancer, emphasizing published meta-analyses and the results of a recent large consortium-based study. The authors find the evidence to be convincing that physical activity reduces risk of colon and female breast cancers, and probable that it reduces risk of kidney and endometrial cancers. Moreover, physical activity has been associated with lower risk of cancers of the bladder, liver, gastric cardia, head and neck, esophagus (adenocarcinoma), and myeloma, myeloid leukemia, and non-Hodgkin lymphoma.

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Physical Activity on Prescription in Routine Health Care: 1-Year Follow-Up of Patients with and without Counsellor Support

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165679 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5679

Author(s):

Pia Andersen ◽

Sara Holmberg ◽

Kristofer Årestedt ◽

Lena Lendahls ◽

Per Nilsen

Keyword(s):

Physical Activity ◽

Health Care ◽

Health Care Professionals ◽

Routine Care ◽

Interquartile Range ◽

Activity Levels ◽

Everyday Activity ◽

Significant Difference ◽

One Year

The effectiveness of counsellor support in addition to physical activity on prescription (PAP) from health care professionals has rarely been evaluated. This observational follow-up study investigated differences in physical activity levels and health-related quality of life (HRQoL) one year after PAP regarding patients’ use of counsellor support in addition to PAP in routine care. The study was conducted in a Swedish health care region in which all patients receiving PAP from health care professionals were offered counsellor support. Data were collected from medical records and questionnaires (baseline and follow-up). Of the 400 study participants, 37% used counsellor support. The group of counsellor users attained a higher level of physical activity one year after receiving PAP compared to the group of non-users (p < 0.001). The level of physical activity was measured by a validated index (score 3–19) calculated from weekly everyday activity and exercise training. Comparison of the change in scores between baseline and follow-up showed a significant difference between the two groups, (p < 0.001). The median difference in the PAP + C group was 2.0 (interquartile range, 7.0) and 0.0. among non-users (interquartile range, 4.0). Significant differences in HRQoL were due to positive improvements among counsellor users, with the main improvement in general health. The conclusion is that patients using counsellor support after receiving PAP from health care professionals had higher physical activity and better HRQoL one year after compared with patients who did not use this support.

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The right to medical care and its economic consequences: an American dilemma

Revista de Saúde Pública ◽

10.1590/s0034-89101972000400002 ◽

1972 ◽

Vol 6 (4) ◽

pp. 317-327

Author(s):

José Duarte de Araújo

Keyword(s):

United States ◽

Health Care ◽

United States Of America ◽

The United States ◽

Right To Health ◽

Economic Consequences ◽

Right To Health Care ◽

Modern Times ◽

The Right

The concepts of "rights" and of "right to health care" including its evolution in modern times are discussed. The consequences of implementing this right are discussed in economic terms, regarding the situation in the United States of America. A discussion is also included on the limitations of the role of Health Insurance as a measure to solve the problem of providing health care for all individuals.

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The health capability paradigm and the right to health care in the United States

Theoretical Medicine & Bioethics ◽

10.1007/s11017-016-9371-y ◽

2016 ◽

Vol 37 (4) ◽

pp. 275-292 ◽

Cited By ~ 6

Author(s):

Jennifer Prah Ruger

Keyword(s):

United States ◽

Health Care ◽

The United States ◽

Right To Health ◽

Right To Health Care ◽

Health Capability Paradigm ◽

The Right

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America's health care dilemma: not a pretty sight

Health Economics Policy and Law ◽

10.1017/s1744133107004203 ◽

2007 ◽

Vol 2 (3) ◽

pp. 341-346

Author(s):

DAVID WILSFORD

Keyword(s):

Health Care ◽

Local Politics ◽

Max Weber ◽

The United States ◽

Policy Debate ◽

Us Congress ◽

Critical Junctures ◽

The Us ◽

The Uk ◽

The Right

As the American right wing’s control of national (and local) politics implodes in the United States, there is the inevitable hope wafting in the air as policy specialists and other political activists on the other side of the divide anticipate capturing the US presidency at the end of 2008 to go with the center-left’s majorities won in the US Congress at the end of 2006. And so, health care reform is once again on the march! Alas, if Max Weber was wise to have observed that ideas run upon the tracks of interests, implying clearly that some good ideas die their death because they do not find the right track of interests, while some tracks of interests go nowhere for lack of the right idea, the health policy debate still provides a Technicolor demonstration that the mish and mash of this and that is not yet pointing the country in any particular direction, regardless of election outcomes in 2006 and 2008. Worse yet, in spite of the great sociologist Reinhard Bendix’s demonstration in his masterwork Kings orPeople (1978) that non-incremental transformations often occur at critical junctures of a nation’s history due to the diffusion effects of ideas from abroad, there is no evidence in the current (or past) American debate that the country has ever learned anything at all or thinks it has anything at all to learn from the way these problems are grappled with, and more successfully, elsewhere. (Oh, let’s just take Japan, France, Germany, Spain, Canada, the UK, and a handful of other countries as quick examples.)

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