Constructing a graphical model of the relationship between physical activity and cognitive function based on a systematic review of prospective evidence

2021 ◽  
Author(s):  
Thomas Campbell ◽  
Karl Ferguson ◽  
Jessica Whyte ◽  
Breda Cullen
Keyword(s):  
Physical Activity ◽  
Cognitive Function ◽  
Best Practice ◽  
Graphical Model ◽  
Included Study ◽  
Causal Inferences ◽  
Wide Range ◽  
Practice Method ◽  
Using Data ◽  
The Uk

Elucidating the factors that contribute to healthy ageing is an important research goal. Physical activity (PA) has been associated with benefits for cognitive function (CF). However, most of this evidence comes from longitudinal cohort studies which, in the absence of experimental design, have limited scope to make causal inferences regarding observed relationships. This review aimed to utilise recent methodological developments allowing researchers to formulate and answer stronger causal questions using observational data, by following a best-practice method for synthesising evidence to produce a graphical causal model known as a directed acyclic graph (DAG). Following a search of 3 databases (EMBASE, MEDLINE and PsycINFO), 21 observational studies on the PA-CF relationship were reviewed and their methodological quality, characteristics, and key findings were summarised. The outcomes of interest were the covariates and modelling practices employed in each study. The reported covariates were synthesised against a set of criteria to determine their role in the DAG as confounders or mediators of the PA-CF relationship. Every included study had some areas of methodological weakness. The resulting DAG included a wide range of biopsychosocial covariates spanning the entire life-course and indicated potential intermediate pathways between PA and CF via structural brain health. Strengths, limitations and implications of this review for modelling decisions are discussed, prior to the model being taken forward to inform an empirical analysis using data from the UK Biobank cohort, separate from this review.

scholarly journals Lockdown, slow down: impact of the COVID-19 pandemic on physical activity—an observational study

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001600
Author(s):  
Joanne Kathryn Taylor ◽  
Haarith Ndiaye ◽  
Matthew Daniels ◽  
Fozia Ahmed
Keyword(s):  
Physical Activity ◽  
New York ◽  
Heart Association ◽  
Evaluation Study ◽  
Activity Data ◽  
Cardiac Devices ◽  
Significant Difference ◽  
New York Heart Association ◽  
Using Data ◽  
The Uk

AimsIn response to the COVID-19 pandemic, the UK was placed under strict lockdown measures on 23 March 2020. The aim of this study was to quantify the effects on physical activity (PA) levels using data from the prospective Triage-HF Plus Evaluation study.MethodsThis study represents a cohort of adult patients with implanted cardiac devices capable of measuring activity by embedded accelerometery via a remote monitoring platform. Activity data were available for the 4 weeks pre-implementation and post implementation of ‘stay at home’ lockdown measures in the form of ‘minutes active per day’ (min/day).ResultsData were analysed for 311 patients (77.2% men, mean age 68.8, frailty 55.9%. 92.2% established heart failure (HF) diagnosis, of these 51.2% New York Heart Association II), with comorbidities representative of a real-world cohort.Post-lockdown, a significant reduction in median PA equating to 20.8 active min/day was seen. The reduction was uniform with a slightly more pronounced drop in PA for women, but no statistically significant difference with respect to age, body mass index, frailty or device type. Activity dropped in the immediate 2-week period post-lockdown, but steadily returned thereafter. Median activity week 4 weeks post-lockdown remained significantly lower than 4 weeks pre-lockdown (p≤0.001).ConclusionsIn a population of predominantly HF patients with cardiac devices, activity reduced by approximately 20 min active per day in the immediate aftermath of strict COVID-19 lockdown measures.Trial registration numberNCT04177199.

scholarly journals Diagnosis and management of bile acid diarrhoea: a survey of UK expert opinion and practice

2019 ◽  
Vol 11 (5) ◽  
pp. 358-363 ◽  
Author(s):  
Julian R F Walters ◽  
Ramesh Arasaradnam ◽  
H Jervoise N Andreyev ◽  
Keyword(s):  
Bile Acid ◽  
Expert Opinion ◽  
Best Practice ◽  
Online Survey ◽  
Design Method ◽  
Diagnosis And Management ◽  
Bile Acid Malabsorption ◽  
Presenting Symptoms ◽  
Wide Range ◽  
The Uk

ObjectiveBile acid diarrhoea (BAD), which includes bile acid malabsorption, causes a variety of digestive symptoms. Diagnostic rates and management vary considerably. We conducted a survey of current practice to review expert opinion and provide guidance on diagnosis and management.Design/methodAn online survey was conducted of clinical members of the UK Bile Acid Related Diarrhoea Network, who had all published research on BAD (n=21). Most were National Health Service consultants who had diagnosed over 50 patients with the condition.ResultsThe preferred terminology was to use BAD, with primary and secondary to classify causes. A wide range of presenting symptoms and associated conditions were recognised. SeHCAT (tauroselcholic acid) was the preferred diagnostic test, and 50% of respondents thought general practitioners should have access to this. Patients who met the Rome IV diagnostic criteria for functional diarrhoea, irritable bowel syndrome (IBS) with predominant diarrhoea or postcholecystectomy diarrhoea were usually investigated by SeHCAT, which was used sometimes in other types of IBS. Treatment with a bile acid sequestrant was offered to patients with low SeHCAT values, with expected response rates >70% in the most severe. Colestyramine was the usual sequestrant, starting between 2 g and 8 g daily; colesevelam was an alternative. In patients who had an incomplete response, increasing the dose, changing to an alternative sequestrant, use of loperamide and a low fat diet were suggested. Recommendations for follow-up and to improve the overall patient experience were made.ConclusionThis expert survey indicates current best practice in the diagnosis and management of BAD.

scholarly journals Methods for demonstrating the value of public libraries in the UK: a literature review

2011 ◽  
Vol 35 (109) ◽  
pp. 3-39 ◽  
Author(s):  
Christine Rooney-Browne
Keyword(s):  
Literature Review ◽  
Best Practice ◽  
Public Libraries ◽  
Social Research ◽  
Public Library ◽  
Local Authorities ◽  
Evaluation Methodologies ◽  
Wide Range ◽  
Information Professionals ◽  
The Uk

This paper summarises the findings of a report commissioned by the Chartered Institute of Library and Information Professionals' (CILIP) Library and Information Research Group (LIRG) to produce a comprehensive review of existing quantitative and qualitative evaluation methodologies for demonstrating the value of public libraries in the United Kingdom (UK). A thorough literature review of existing research was carried out and an investigation into best practices for evaluating impact was conducted. A wide range of journals and books published within the fields of library and information science and social research have been consulted. Relevant White Papers and Reviews; such as those published by the Chartered Institute of Library and Information Professionals (CILIP), the Scottish Library and Information Council (SLIC); the Museums, Libraries and Archives Council (MLA), the Department of Culture, Sport and Media (DCMS); and the American Library Association (ALA) have been analysed. Additional online searches helped to identify models of best practice; and the most up to date methods currently in use for measuring value outside of the UK. During the early stages of the literature review it became clear that a limited amount of research has been carried out in the UK field of public library valuation. Although academic researchers at Loughborough, Sheffield and Strathclyde University have published various journal articles and reports on this topic there is a lack of evidence that local authorities have been implementing the methodologies that the academics have recommended. Although it is possible that some local authorities may be working in isolation to implement bespoke evaluation methodologies it has been difficult to uncover examples of best practice in the UK. Therefore, as the literature review progressed the author expanded beyond the UK public library sector, and into the broader areas of economics, sociology and psychology. This enabled a more thorough understanding of the increase in evaluations, incentives, benchmarking, objective setting, accountability; and social and economic auditing. It is anticipated that the findings of this research will help the sector to develop more appropriate models for demonstrating the value of public libraries in the 21st century. The original report was compiled in June 2010.

Development, Calibration and Further Data Requirements of the Sewer Flow Quality Model Mosqito

1990 ◽  
Vol 22 (10-11) ◽  
pp. 103-109 ◽  
Author(s):  
J. A. Payne ◽  
G. D. Moys ◽  
C. J. Hutchings ◽  
R. J. Henderson
Keyword(s):  
Oxygen Demand ◽  
Flow Simulation ◽  
River Basin Management ◽  
Research Centre ◽  
Quality Model ◽  
Sewer Systems ◽  
Wide Range ◽  
Flow Quality ◽  
Using Data ◽  
The Uk

MOSQITO is the initial version of a sever flow quality model being developed by Hydraulics Research Ltd and the Water Research Centre as part of the UK River Basin Management programme. MOSQITO I simulates the time-varying behaviour of suspended solids, biochemical oxygen demand, chemical oxygen demand, ammoniacal nitrogen and hydrogen sulphide on catchment surfaces and in sewer systems. The model produces discharge pollutographs for these determinands which can be used as input to a river water quality model. MOSQITO consists of four sub-models which represent washoff from catchment surfaces, foul water inflow, pollutant behaviour in pipes and channels, and pollutant behaviour in ancillary structures within drainage systems. These sub-models are linked to the flow simulation model incorporated in the WALLRUS package which is the latest computer implementation of the Wallingford Procedure. The rationale behind the model, its structure and its operational basis have been discussed elsewhere (Moys and Henderson, 1988) and are therefore described briefly so that emphasis can be placed on the aspects which follow. Calibration and verification of the model are being carried out using data from a variety of experimental catchments in the UK. These catchments have been selected to exhibit a wide range of characteristics and include separate and combined sewer systems. Results of the calibration work are presented together with illustrations of the performance of the various sub-models and the overall model.

scholarly journals P82 Multi-centre cross-specialty recommendations for the investigation of suspected adult onset secondary haemophagocytic lymphohistiocytosis (HLH)

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Strachan Mackenzie ◽  
Ryan Low ◽  
Michael Brown ◽  
Emilie Sanchez ◽  
Kimberly Gilmour ◽  
...  
Keyword(s):  
Best Practice ◽  
Treatment Protocols ◽  
Missed Opportunities ◽  
National Network ◽  
Wide Range ◽  
The Creation ◽  
Multiple Challenges ◽  
Management Approaches ◽  
The Uk ◽  
Work Up

Abstract Background Secondary HLH (sHLH) in adults is a paradigm of a disorder with multiple challenges. It is rare and under-recognised, clinical features are non-specific and heterogeneous, it may present to a broad range of specialties and there is no single test which can unambiguously diagnose the condition. The investigation of such patients often occurs in a piecemeal fashion, which causes delays in establishing diagnosis leading to missed opportunities to start treatment early. Treatment protocols are extrapolated from mostly paediatric data from the primary, genetic form of HLH with insufficient clinical trials in adults to provide robust evidence-based management approaches. There is a resultant wide range in clinical practice and sHLH has a high mortality rate. Addressing these issues and improving knowledge about the disorder therefore requires cross-speciality, multi-centre working. Within the UK, these challenges have begun to be addressed over the past 24 months, resulting in the creation of local and regional HLH MDTs, the formation of a national network of interested specialists (HASC: the HLH across-specialty collaboration) as well as the creation of a national HLH registry as part of the UK Histiocytosis Registry (UKHR). Methods The aim of this project was to create a national guideline for the diagnosis and investigation of adult patients with suspected sHLH in order to start to standardise practice across the UK. Over 30 clinicians from a broad range of specialties, from both paediatric and adult practice, were consulted. These included sub-specialist input from rheumatology, haematology, infectious diseases, virology, nephrology, intensive care and immunology with collaborations from 15 centres around the UK. The HASC meetings were used as a forum to collaborate and develop the guidance. Results We created an investigation algorithm dividing tests for work-up into 3 sections: 1. Routine initial work 2. HLH-specific testing, comprehensive infection work-up, guidance on tissue biopsy 3. Identification and work-up of suspected adult cases of familial/genetic HLH (fHLH). The guidance also uses HASC multi-professional expertise to provide approaches to controversial areas including ferritin and sCD25 thresholds in adults, deep skin biopsies for suspected intravascular lymphoma and specific scenarios such as neurological presentations and CAR-T therapy. Clinicians from different specialties across the UK and specialist laboratories with an interest in HLH have been identified in order to make the HLH network more accessible. The aim is to have the guideline hosted by Histio UK, and freely available on their website. Conclusion This guideline is based on cross-specialty consensus expert opinion with reference to published literature in order to develop best practice. The coordinated investigation of patients with sHLH is key to improving early diagnosis and treatment and is just one part of the collaborative multi-faceted approach that is required to improve overall outcomes for patients with sHLH. Disclosures S. Mackenzie None. R. Low None. M. Brown None. E. Sanchez None. K. Gilmour None. T. Youngstein None. R. Tatersall None. B. Carpenter None. A. Patel None. C. Mcnamara None. J. Manson None.

scholarly journals The Shared Economy

2021 ◽  
Author(s):  
KC LOH
Keyword(s):  
Marginal Utility ◽  
National Income ◽  
Disposable Income ◽  
Allocation Of Resources ◽  
National Statistics ◽  
Wide Range ◽  
Household Disposable Income ◽  
Using Data ◽  
The Uk

Abstract: The theory of marginal utility describes how consumers choose between goods. However, marginal utility has also found application in a wide range of weightier subjects. For example, marginal utility can be used in the allocation of resources in healthcare programmes. This paper posits that marginal utility is also applicable in the allocation of the national income among corporations, government, and households. Using data from the UK Office for National Statistics, this paper finds that for the most part of the decade, from 2009 to 2018, household disposable income fell short of what might be considered an optimal share of the national income.

scholarly journals Phenome-Wide Association Study of Actigraphy in the UK Biobank

2021 ◽  
Author(s):  
Thomas G. Brooks ◽  
Nicholas F. Lahens ◽  
Gregory R. Grant ◽  
Yvette I. Sheline ◽  
Garret A. FitzGerald ◽  
...  
Keyword(s):  
Physical Activity ◽  
Airway Obstruction ◽  
Large Scale ◽  
Diurnal Rhythms ◽  
Uk Biobank ◽  
Daily Lives ◽  
Individualized Approach ◽  
Using Data ◽  
The Uk ◽  
Chronic Airway

AbstractWrist-worn accelerometer actigraphy devices present the opportunity for large-scale data collection from people during their daily lives. Using data from approximately 100,000 participants in the UK Biobank, actigraphy-derived measures of physical activity, sleep, and diurnal rhythms were associated in exploration and validation cohorts with a full phenome-wide set of diagnoses, biomarkers and metadata. Rhythmicity was captured by two independent models based on accelerometer and skin temperature harnessing behavioral (diurnal) and molecular (circadian) components. We found that robust rhythms significantly with biomarkers, survival, and phenotypes including diabetes, hypertension, mood disorders, and chronic airway obstruction; these associations were comparable to those with physical activity and sleep. Surprisingly, associations were mostly consistent between the sexes, while modulation by age was significant. More importantly, rhythms were found to be powerful predictors of future diseases: a two standard deviation difference in wrist temperature rhythms corresponded to increases in rate of diagnosis of 61% in diabetes, 38% in chronic airway obstruction, 27% in anxiety disorders, and 22% in hypertension. Our PheWAS of actigraphy data in the UK Biobank establishes that rhythmicity is fundamental to modeling disease trajectories, as are physical activity and sleep. Integration of long-term remote biosensing into patient care could thus afford an individualized approach to risk management.

scholarly journals Shared brain and genetic architectures between mental health and physical activity

2022 ◽  
Author(s):  
Wei Zhang ◽  
Sarah E Paul ◽  
Anderson M. Winkler ◽  
Ryan Bogdan ◽  
Janine D Bijsterbosch
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Network Architecture ◽  
Brain Network ◽  
Potential Candidate ◽  
Causal Relationships ◽  
Beneficial Effects ◽  
Using Data ◽  
The Uk ◽  
Connectivity Strength

Physical activity is correlated with, and effectively treats various forms of psychopathology. However, whether biological correlates of physical activity and psychopathology are shared remains unclear. Here, we examined the extent to which the neural and genetic architecture of physical activity and mental health are shared. Using data from the UK Biobank (N=6,389), canonical correlation analysis was applied to estimate associations between the amplitude and connectivity strength of sub-networks of three major neurocognitive networks (default mode, DMN; salience, SN; central executive networks, CEN) with accelerometer-derived measures of physical activity and self-reported mental health. We estimated the genetic correlation between mental health and physical activity measures, as well as putative causal relationships by applying linkage disequilibrium score regression, genomic structural equational modeling, and latent causal variable analysis to genome-wide association summary statistics (GWAS N=91,105-500,199). Physical activity and mental health were associated with connectivity strength and amplitude of the DMN, SN, and CEN (all r>0.13, all p<0.048). These neural correlates exhibited highly similar loading patterns across mental health and physical activity models even when accounting for their shared variance. This suggests a largely shared brain network architecture between mental health and physical activity. Mental health and physical activity were also genetically correlated (|rg|=0.085-0.121), but we found no evidence for causal relationships between them. Collectively, our findings provide empirical evidence that mental health and physical activity have shared brain and genetic architectures and suggest potential candidate sub-networks for future studies on brain mechanisms underlying beneficial effects of physical activity on mental health.

scholarly journals THE APPLICATION OF MASS OBSERVATION DATA IN SOCIAL RESEARCH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S756-S757
Author(s):  
Paul Kingston
Keyword(s):  
Older People ◽  
Social Issues ◽  
Social Research ◽  
Personal Narratives ◽  
Health Impact ◽  
Observation Data ◽  
Health And Social Care ◽  
Wide Range ◽  
Using Data ◽  
The Uk

Abstract Responding to the opportunities and challenges of an ageing world the University of Chester established the Centre for Ageing, Mental Health and Veterans’ Studies in 2013 to provide research, consultancy and education, with the aim of promoting innovation in health and social care services for older people. This symposium brings together researchers from a wide range of disciplines and career stages, to explore the utility of Mass observation data in social research in the field of gerontology. The Mass Observation Project, established in 1937, documents the lives of ordinary people living in the UK, and explores a wide range of social issues. The symposium comprises four separate papers. The Methodological Relevance of Mass Observation Data: This preliminary overview will outline the mass observation archive, highlighting challenges and issues encountered utilising the data produced in social research. Personal Narratives of Ageing: This paper presents personal narratives reflecting on the ageing process, and growing older in the UK. The Health Impact of Scams: This presentation will offer new and alternate insights into ‘scams’ and the health effects of fraud on older people, using data from the mass observation directive commissioned by the centre. Perceptions of Dementia: This paper presents a perspective on the public knowledge and understanding about dementia not previously considered, where respondents have written openly about their own experiences, and reflected on their perception of the wider public’s knowledge and understanding about dementia.

A survey of CBT supervision in the UK: methods, satisfaction and training, as viewed by a selected sample of CBT supervision leaders

2016 ◽  
Vol 9 ◽  
Author(s):  
Robert P. Reiser ◽  
Derek L. Milne
Keyword(s):  
Clinical Supervision ◽  
Clinical Training ◽  
Best Practice ◽  
Core Competency ◽  
Small Sample ◽  
Internet Survey ◽  
Current Status ◽  
Wide Range ◽  
Training Resources ◽  
The Uk

AbstractInternationally, clinical supervision has been increasingly recognized as a core competency and an essential requirement for clinical training. Over the past 10 years, frameworks for supervision competencies have been developed and promulgated in several countries, notably the UK, USA and Australia. But what is the current status of the actual practice of CBT supervision in the UK? We conducted an internet survey with a purposive sample of n=110 accredited British Association for Behavioural and Cognitive Psychotherapy (BABCP) supervisors and trainers (a 44% response rate), selected for their assumed expertise. The results were consistent with past surveys of Townend et al., indicating that the most frequently reported supervision methods tended to reflect many of the recommendations in widely disseminated supervision competency frameworks and recognized best practice statements. Overall, these CBT supervision leaders reported using an impressively wide range of methods, including much more frequent use of role-play, therapy recordings, and direct observation than reported in the Townend et al. surveys or in observational studies. Although satisfied in their supervisory role, respondents indicated the need for improved CBT supervisor training resources, with significant interest in developing competence instruments and group supervision methods. In conclusion, at least for this small sample of CBT supervision leaders in the UK, practice reflects international progress, but training resources are sought to maintain momentum.

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