Methods: This was an exploratory qualitative research study. Participants were African American, Hispanic, Asian, and American Indian women, between the ages of 26 and 38, who have experienced stillbirth within the past 3 years. Participants completed a 20-30 minute phone interview.
Results: Fourteen women participated in the study (M age = 31.02 ± 5.97 years; M time since stillbirth = 1.47 ± 0.94 years). Women’s perceptions about physical activity and mindfulness to cope with grief were coded into the following major themes: perception of health care after stillbirth (satisfaction with the level of care provided), recommendations about inter-conception health care from physician (relating to mental, emotional, and physical health), grief (comfort with communicating with the physician), coping mechanisms, perception of the relationship between physical activity and mood, barriers to participating in physical activity (social and behavioral), pre-pregnancy physical activity, and perception of mindful approach (e.g., yoga) as a coping mechanism.
Conclusion: This was the first study to explore perceptions of health care and the use of physical activity and/or mindful approaches (e.g., yoga) to cope with grief after stillbirth in women of racial/ethnic minority. Findings from this study may help inform health care professionals alter their care practices and introduce physical activity and mindfulness based approaches as coping mechanisms to mothers of stillborn babies.
Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.
Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.
Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.
Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.
Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.
Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables.
Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983–2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (− 95%) to an increase of 339 deaths per year (+ 359%).
Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.
Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53 cooling centers were evaluated to assess facility and visitor characteristics. Maricopa County staff collected data by directly observing daily operations and by surveying managers and visitors. The cooling centers in Maricopa County were often housed within community, senior, or religious centers, which offered various services for at least 1500 individuals daily. Many visitors were unemployed and/or homeless. Many learned about a cooling center by word of mouth or by having seen the cooling center’s location. The cooling centers provide a valuable service and reach some of the region’s most vulnerable populations. This project is among the first to systematically evaluate cooling centers from a public health perspective and provides helpful insight to community leaders who are implementing or improving their own network of cooling centers.
The purpose of this study is to determine the feasibility of three widely used wearable sensors in research settings for 24 h monitoring of sleep, sedentary, and active behaviors in middle-aged women.
Methods
Participants were 21 inactive, overweight (M Body Mass Index (BMI) = 29.27 ± 7.43) women, 30 to 64 years (M = 45.31 ± 9.67). Women were instructed to wear each sensor on the non-dominant hip (ActiGraph GT3X+), wrist (GENEActiv), or upper arm (BodyMedia SenseWear Mini) for 24 h/day and record daily wake and bed times for one week over the course of three consecutive weeks. Women received feedback about their daily physical activity and sleep behaviors. Feasibility (i.e., acceptability and demand) was measured using surveys, interviews, and wear time.
Results
Women felt the GENEActiv (94.7 %) and SenseWear Mini (90.0 %) were easier to wear and preferred the placement (68.4, 80 % respectively) as compared to the ActiGraph (42.9, 47.6 % respectively). Mean wear time on valid days was similar across sensors (ActiGraph: M = 918.8 ± 115.0 min; GENEActiv: M = 949.3 ± 86.6; SenseWear: M = 928.0 ± 101.8) and well above other studies using wake time only protocols. Informational feedback was the biggest motivator, while appearance, comfort, and inconvenience were the biggest barriers to wearing sensors. Wear time was valid on 93.9 % (ActiGraph), 100 % (GENEActiv), and 95.2 % (SenseWear) of eligible days. 61.9, 95.2, and 71.4 % of participants had seven valid days of data for the ActiGraph, GENEActiv, and SenseWear, respectively.
Conclusion
Twenty-four hour monitoring over seven consecutive days is a feasible approach in middle-aged women. Researchers should consider participant acceptability and demand, in addition to validity and reliability, when choosing a wearable sensor. More research is needed across populations and study designs.
This study aims to examine the relationship between urban densification and pedestrian thermal comfort at different times of the year, and to understand how this can impact patterns of activity in downtown areas. The focus of the research is on plazas in the urban core of downtown Tempe, given their importance to the pedestrian landscape. With that in mind, the research question for the study is: how does the microclimate of a densifying urban core affect thermal comfort in plazas at different times of the year? Based on the data, I argue that plazas in downtown Tempe are not maximally predisposed to pedestrian thermal comfort in the summer or the fall. Thus, the proposed intervention to improve thermal comfort in downtown Tempe’s plazas is the implementation of decision support tools focused on education, community engagement, and thoughtful building designs for heat safety.
The positive impacts of yoga on stress, pain, and chronic disease has recently led to the integration of yoga as part of physical therapy (PT) treatment. Due to the lack of training for PTs related to yoga, there is currently a need to provide knowledge and education about how to safely and easily implement therapeutic yoga (TY) as a complementary treatment approach.
Objective:
The purpose of this study was to assess the readiness of PTs (those who do not currently prescribe TY to patients) to integrate TY into treatment, and secondly, the feasibility (i.e., acceptability, demand, and practicality) of a 5-week online TY training to improve the readiness of PT’s to utilize TY in their practice.
Methods:
Licensed Physical Therapist’s (n=103) were recruited nationally through social media and email. Eligible and consented participants were asked to register in a 5-week online TY training course, Readiness for Integrating Yoga Therapeutics into Rehabilitation for PTs (intervention). PTs perceptions of TY and the role of safety and confidence in prescribing TY to patients were measured at baseline and post-intervention using a customized survey. Feasibility outcomes were measured after completion of the 5-week online training course with a survey. Feasibility was measured with acceptability, demand, and practicality. Our benchmarks included: (1) at least 70% of PTs would find the course acceptable, (2) at least 60% would finish the course (i.e., demand) and (3) there would be significant improvements in PTs perceptions of TY.
Results:
A total of 95 licensed PTs registered in the 5-week online TY training course, with 60 PTs (63%) completing the intervention and surveys. Of the PTs who completed the 5-week online training course, most PTs felt they were not ready (n=19/60, 31.7%) or somewhat ready (n=25/60, 41.7%) to integrate TY prior to taking the online training. Over half of PTs thought the online training was acceptable (n= 50/60, 83.3%) and finished the course (n=60/95, 63%). There were significant improvements in personal readiness to prescribe TY, safety prescribing TY, confidence to prescribe TY, current understanding/knowledge of TY and feeling adequately trained and educated to use some form of TY techniques with patients.
Conclusion:
Findings suggest a 5-week online TY training course is feasible in improving PTs readiness to prescribe TY, safety prescribing TY, confidence to prescribe TY, current understanding/knowledge of TY and feeling adequately trained and educated to use some form of TY techniques with patients. Future studies are proposed to test the effectiveness of TY training and education opportunities with PTs to further advance the adoption of TY into PT practice.