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Background: Device-based measurements of physical behavior, using the current methods, place a large burden on participants. The Motus system could reduce this burden by removing the necessity for in-person meetings, replacing diaries written on paper with digital diaries, and increasing the automation of feedback generation. Objective: This study aims to describe the development of the Motus system and evaluate its potential to reduce participant burden in a two-phase usability evaluation. Methods: Motus was developed around (1) a thigh-worn accelerometer with Bluetooth data transfer; (2) a smartphone app containing an attachment guide, a digital diary, and facilitating automated data transfer; (3) a cloud infrastructure for data storage; (4) an analysis software to generate feedback for participants; and (5) a web-based app for administrators. We recruited 19 adults with a mean age of 45 (SD 11; range 27-63) years, of which 11 were female, to assist in the two-phase evaluation of Motus. A total of 7 participants evaluated the usability of mockups for a smartphone app in phase 1. Participants interacted with the app while thinking aloud, and any issues raised were classified as critical, serious, or minor by observers. This information was used to create an improved and functional smartphone app for evaluation in phase 2. A total of 12 participants completed a 7-day free-living measurement with Motus in phase 2. On day 1, participants attempted 20 system-related tasks under observation, including registration on the study web page, reading the information letter, downloading and navigating the smartphone app, attaching an accelerometer on the thigh, and completing a diary entry for both work and sleep hours. Task completion success and any issues encountered were noted by the observer. On completion of the 7-day measurement, participants provided a rating from 0 to 100 on the System Usability Scale and participated in a semistructured interview aimed at understandi

Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings., This research was partly financed by grants from: the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (1040232); FORTE, Swedish Research Council for Health, Working Life and Welfare (2021–01561); The Danish Work Environment Research Fund (November 03 2017); National Health and Medical Research Council Investigator Grant, Leadership second level (APP1194510); British Heart Foundation, Special Grant (SP/F/20/150002); National Health and Medical Research Council Ideas Grant (APP1180812); Swedish Heart Lung Foundation (20160343); Funding from Stockholm Stress Center – a centre of excellence for research on work-related stress and health Stress Research; AFA-insurance (150159).

Background: Device-based measurements of physical behavior, using the current methods, place a large burden on participants. The Motus system could reduce this burden by removing the necessity for in-person meetings, replacing diaries written on paper with digital diaries, and increasing the automation of feedback generation. Objective: This study aims to describe the development of the Motus system and evaluate its potential to reduce participant burden in a two-phase usability evaluation. Methods: Motus was developed around (1) a thigh-worn accelerometer with Bluetooth data transfer; (2) a smartphone app containing an attachment guide, a digital diary, and facilitating automated data transfer; (3) a cloud infrastructure for data storage; (4) an analysis software to generate feedback for participants; and (5) a web-based app for administrators. We recruited 19 adults with a mean age of 45 (SD 11; range 27-63) years, of which 11 were female, to assist in the two-phase evaluation of Motus. A total of 7 participants evaluated the usability of mockups for a smartphone app in phase 1. Participants interacted with the app while thinking aloud, and any issues raised were classified as critical, serious, or minor by observers. This information was used to create an improved and functional smartphone app for evaluation in phase 2. A total of 12 participants completed a 7-day free-living measurement with Motus in phase 2. On day 1, participants attempted 20 system-related tasks under observation, including registration on the study web page, reading the information letter, downloading and navigating the smartphone app, attaching an accelerometer on the thigh, and completing a diary entry for both work and sleep hours. Task completion success and any issues encountered were noted by the observer. On completion of the 7-day measurement, participants provided a rating from 0 to 100 on the System Usability Scale and participated in a semistructured interview aimed at understa

Background: There is increasing recognition of the need for more comprehensive surveillance data, including information on physical activity of all intensities, sedentary behavior, and sleep. However, meeting this need poses significant challenges for current surveillance systems, which are mainly reliant on self-report. Objective: The primary objective of this project is to develop and evaluate the feasibility of a sensor-based system for use in the surveillance of physical activity, sedentary behavior, and sleep (SurPASS) at a national level in Denmark. Methods: The SurPASS project involves an international, multidisciplinary team of researchers collaborating with an industrial partner. The SurPASS system consists of (1) a thigh-worn accelerometer with Bluetooth connectivity, (2) a smartphone app, (3) an integrated back end, facilitating the automated upload, analysis, storage, and provision of individualized feedback in a manner compliant with European Union regulations on data privacy, and (4) an administrator web interface (web application) to monitor progress. The system development and evaluation will be performed in 3 phases. These phases will include gathering user input and specifications (phase 1), the iterative development, evaluation, and refinement of the system (phase 2), and the feasibility evaluation (phase 3). Results: The project started in September 2020 and completed phase 2 in February 2022. Phase 3 began in March 2022 and results will be made available in 2023. Conclusions: If feasible, the SurPASS system could be a catalyst toward large-scale, sensor-based surveillance of physical activity, sedentary behavior, and sleep. It could also be adapted for cohort and interventional research, thus contributing to the generation of evidence for both interventions and public health policies and recommendations. International Registered Report Identifier (IRRID): DERR1-10.2196/35697

Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the ‘gold-standard’ measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.

Background: There is increasing recognition of the need for more comprehensive surveillance data, including information on physical activity of all intensities, sedentary behavior, and sleep. However, meeting this need poses significant challenges for current surveillance systems, which are mainly reliant on self-report. Objective: The primary objective of this project is to develop and evaluate the feasibility of a sensor-based system for use in the surveillance of physical activity, sedentary behavior, and sleep (SurPASS) at a national level in Denmark. Methods: The SurPASS project involves an international, multidisciplinary team of researchers collaborating with an industrial partner. The SurPASS system consists of (1) a thigh-worn accelerometer with Bluetooth connectivity, (2) a smartphone app, (3) an integrated back end, facilitating the automated upload, analysis, storage, and provision of individualized feedback in a manner compliant with European Union regulations on data privacy, and (4) an administrator web interface (web application) to monitor progress. The system development and evaluation will be performed in 3 phases. These phases will include gathering user input and specifications (phase 1), the iterative development, evaluation, and refinement of the system (phase 2), and the feasibility evaluation (phase 3). Results: The project started in September 2020 and completed phase 2 in February 2022. Phase 3 began in March 2022 and results will be made available in 2023. Conclusions: If feasible, the SurPASS system could be a catalyst toward large-scale, sensor-based surveillance of physical activity, sedentary behavior, and sleep. It could also be adapted for cohort and interventional research, thus contributing to the generation of evidence for both interventions and public health policies and recommendations.

This thesis explores the history of events in Rhode Island connected to the 1934 General Textile Strike. During the strike, two people were killed by soldiers of the Rhode Island National Guard in an event known as “The Saylesville Massacre.” The established historiography of the 1934 General Textile Strike does not tell the story of the Saylesville Massacre well. Despite claims to the contrary, the strike was poorly run and lost by the union. Through a careful reading of primary sources this thesis argues that only by understanding the 1934 General Textile Strike as a loss for the union can both Labor History and the Labor Movement learn from its example.

Background: The knowledge, from laboratory studies dating back to the 1950s on the importance of the association between cardiorespiratory fitness and aerobic workload for workers health, is fundamental for promoting sustainable healthy employability among ageing blue-collar workers today. However, the association between cardiorespiratory fitness and aerobic workload has not yet been documented during daily work, and we do not know if it applies to the normal work of blue-collar workers in different age groups. We aim to investigate the association between cardiorespiratory fitness and aerobic workload among blue-collar workers using measurements of 24-h heart rate collected over consecutive working days. Methods: We analyzed baseline cardiorespiratory fitness, assessed using a sub-maximal cycle ergometer test, and 1–4 days of 24-h heart rate measurement from 497 blue-collar workers participating in the DPHACTO study. We investigated the association between cardiorespiratory fitness and aerobic workload defined as the average percentage of heart rate reserve (%HRR), maximum %HRR and the duration time spent at a high HRR (> 30%) during working hours. The association was assessed using multivariate linear regression models adjusted for age, sex, self-rated health, shift-work, prescription medication and occupation, as well as for different age strata. Results: Higher cardiorespiratory fitness was significantly associated with decreased mean %HRR −0.32 [95% CI −0.39 to −0.25], maximum %HRR −0.35 [95% CI −0.45 to −0.25] and time spent at ≥ 30% HRR; −1.8% [95% CI −2.2 to −1.5%]. These associations were evident across age groups, with slightly stronger associations for workers aged 46–51 (total range 18–68). Conclusions: Higher cardiorespiratory fitness was associated with the decreased aerobic workload during normal work across all age groups and levels of work intensity. Our findings highlight the importance of cardiorespiratory fitness when considering the workl

Previous research has shown strong associations between occupational physical activity (OPA) and need for recovery (NFR). However this research has only utilized self-reported measures of OPA which may be biased. Thus, there is a need for investigating if the previously documented association between self-reported OPA and NFR can be found when using technical measures of OPA. There is also the need to investigate whether older workers are particularly susceptible to increased NFR, since age-related declines in physical capacity mean that it is likely these workers will have a higher NFR for a given physical activity. The aim of this study was to investigate the association between technically measured OPA and NFR, and whether this relationship is modified by age. Methods: This study utilized data from the Danish Physical Activity Cohort with Objective Measurements cohort - comprising Danish workers (n = 840) from the cleaning, manufacturing, and transportation sectors. OPA was measured by accelerometers attached to the thigh and upper back for at least one work day and classified into four physical behaviour categories (sedentary, standing, light, or moderate/vigorous). NFR was measured using a shortened version of the Danish NFR scale. Analysis was conducted using linear regression and isotemporal substitution analyses for compositional data. Results: The overall association between OPA and NFR was statistically significant in the unadjusted model (P < 0.001), but not when adjusted for age, sex, occupation, and shift work (P = 0.166). Isotemporal substitution showed small but significant reductions in NFR when increasing sedentary time relative to other behaviours (adjusted: ΔNFR = -0.010 [-0.019; -0.001]). There were no significant interactions between age and OPA (P = 0.409). Conclusions: This study found significant associations between OPA and NFR, but the effect sizes were small. Reallocating 30 min to sedentary behaviours from other behaviours was assoc

Introduction: The Prospective Physical Activity Sitting and Sleep consortium (ProPASS) is an international collaboration platform committed to harmonise thigh-worn accelerometry data. The aim of this paper is to (1) outline observational thigh-worn accelerometry studies and (2) summarise key strategic directions arising from the inaugural ProPASS meeting. Methods: (1) We performed a systematic scoping review for observational studies of thigh-worn triaxial accelerometers in free-living adults (n≥100, 24 hours monitoring protocols). (2)Attendees of the inaugural ProPASS meeting were sent a survey focused on areas related to developing ProPASS: important terminology (Q1); accelerometry constructs (Q2); advantages and distinct contribution of the consortium (Q3); data pooling and harmonisation (Q4); data access and sharing (Q5 and Q6). Results: (1) Eighty eligible articles were identified (22 primary studies; n~17 685). The accelerometers used most often were the ActivPAL3 and ActiGraph GT3X. The most commonly collected health outcomes were cardiometabolic and musculoskeletal. (2) None of the survey questions elicited the predefined 60% agreement. Survey responses recommended that ProPASS: use the term physical behaviour or movement behaviour rather than 'physical activity' for the data we are collecting (Q1); make only minor changes to ProPASS's accelerometry construct (Q2); prioritise developing standardised protocols/tools (Q4); facilitate flexible methods of data sharing and access (Q5 and Q6). Conclusions: Thigh-worn accelerometry is an emerging method of capturing movement and posture across the 24 hours cycle. In 2020, the literature is limited to 22 primary studies from high-income western countries. This work identified ProPASS's strategic directions-indicating areas where ProPASS can most benefit the field of research: use of clear terminology, refinement of the measured construct, standardised protocols/tools and flexible data sharing.

Galileo Galilei’s quote ‘measure what is measurable, and make measurable what is not so’ has particular relevance to health behaviours, such as physical activity (PA), sitting and sleep, whose measurement during free living is notoriously difficult. To date, much of what we know about how these behaviours affect our health is based on self-report by questionnaires which have limited validity, are prone to bias and inquire about selective aspects of these behaviours. Although self-reported evidence has made great contributions to shaping public health and exercise medicine policy and guidelines until now,1 the ongoing advancements of accelerometry-based measurement and evidence synthesis methods are set to change the landscape. The aim of this editorial is to outline new directions in PA and sleep-related epidemiology that open new horizons for guideline development and improvement; and to describe a new research collaboration platform: the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS).

Background Researchers applying compositional data analysis to time-use data (e.g., time spent in physical behaviors) often face the problem of zeros, that is, recordings of zero time spent in any of the studied behaviors. Zeros hinder the application of compositional data analysis because the analysis is based on log-ratios. One way to overcome this challenge is to replace the zeros with sensible small values. The aim of this study was to compare the performance of three existing replacement methods used within physical behavior time-use epidemiology: simple replacement, multiplicative replacement, and log-ratio expectation-maximization (lrEM) algorithm. Moreover, we assessed the consequence of choosing replacement values higher than the lowest observed value for a given behavior. Method Using a complete dataset based on accelerometer data from 1310 Danish adults as reference, multiple datasets were simulated across six scenarios of zeros (5-30% zeros in 5% increments). Moreover, four examples were produced based on real data, in which, 10 and 20% zeros were imposed and replaced using a replacement value of 0.5 min, 65% of the observation threshold, or an estimated value below the observation threshold. For the simulation study and the examples, the zeros were replaced using the three replacement methods and the degree of distortion introduced was assessed by comparison with the complete dataset. Results The lrEM method outperformed the other replacement methods as it had the smallest influence on the structure of relative variation of the datasets. Both the simple and multiplicative replacements introduced higher distortion, particularly in scenarios with more than 10% zeros; although the latter, like the lrEM, does preserve the ratios between behaviors with no zeros. The examples revealed that replacing zeros with a value higher than the observation threshold severely affected the structure of relative variation. Conclusions Given our findings, we encourage th

Aim: The aim of this study was to compare the association between count- and activity type–based definitions of light-intensity physical activity (LIPA) and adiposity markers. Methods: A total of 516 Danish workers participated in 1-4 days of hip- and thigh-based accelerometer measurements. Three definitions of average daily time spent in LIPA were derived: LIPA (1) time spent between 100 and 2029 CPM, LIPA (2) time spent moving and slow walking, and LIPA (3) time spent moving, walking slow, and standing. Adiposity markers were body mass index (BMI), body fat percentage, and waist circumference. The cross-sectional association between the three LIPA definitions and adiposity markers was analyzed and interpreted using compositional regression models followed by reallocation of time between LIPA, moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB), respectively. Results: The geometric means of daily time (min/day) spent in LIPA 1, LIPA 2, and LIPA 3 were 326, 102, and 274, respectively. We found the direction and strength of the association between the relative importance of daily time spent in LIPA and the adiposity markers to depend on the LIPA definition. For example, reallocating 30 minutes from MVPA to LIPA 1, LIPA 2 and LIPA 3 were associated with a 2.97 (95% CI: 0.68; 5.27), −0.71 (95% CI: −1.43; 0.02), and −0.45 (95% CI: −1.01; 0.11) difference in BMI, respectively. Conclusion: Our findings highlight the need for caution when comparing results from studies using different definitions of LIPA.

Drawn from the Well of the People is the first full-length history of the Living Stage Theatre Company. Founded in 1966 by Robert Alexander, Living Stage was the education and outreach arm of Arena Stage in Washington D.C. until their closing in 2002. A multi-racial, improvisational, and community-based company, Living Stage broke ground with many socially engaged theatre practices, and through their process-based approach they created theatrical engagements with, not just for their constituents. Famous for engaging the “forgotten” people of D.C. and beyond, Living Stage worked with young people besieged by poverty and segregation, seniors, the deaf and hard of hearing, disabled students, and inmates at correctional facilities like Lorton Prison and D.C. Jail. This project relies on the Living Stage Records at George Mason University Library’s Special Collections Research Center and is the first major work to do so. Additionally, long-tenured company member Jennifer Nelson donated her personal archive, which was gifted to her by Robert Alexander, to aid in the completion of this project. Oral histories from five company members were collected to supplement and enliven the written records. The dissertation also addresses the work of Haedicke and Biggs, the only extant scholarship on the group. Living Stage’s contributions force us to reconsider the intellectual history of socially engaged theatre in the United States, as they devised similar strategies to those found in Theatre of the Oppressed but did so before Augusto Boal created and published on his system. Similarly, how they obliterated the fourth wall and troubled the hierarchy between artists and audiences by engaging participants as co-creators expands the canon of radical and experimental theatre in the U.S. While their participatory approaches and commitment to marginalized communities radically democratized theatre practice, their institutional practices replicated systems of domination in important ways.

Background: Pooling data from thigh-worn accelerometers across multiple studies has great potential to advance evidence on the health benefits of physical activity. This requires harmonization of information on body postures, physical activity types, volumes and time patterns across different brands of devices. The aim of this study is to compare the physical behavior estimates provided by three different brands of thigh-worn accelerometers. Methods: Twenty participants volunteered for a 7-day free-living measurement. Three accelerometers - ActiGraph GT3X+, Axivity AX3 and ActivPAL Micro4 - were randomly placed in a vertical line on the midsection of the right thigh. Raw data from each accelerometer was processed and classified into 8 physical activities and postures using the Acti4 software. Absolute differences between estimates and the respective coefficient of variation (CV) were calculated. Results: We observed very minor differences between physical behavior estimates from three different accelerometer brands. When averaged over 24 h (1,440 min), the absolute difference (CV) between accelerometers were: 1.2 mins (0.001) for lying/sitting, 3.4 mins (0.02) for standing, 3.5 mins (0.06) for moving, 1.9 mins (0.03) for walking, 0.1 mins (0.19) for running, 1.2 mins (0.19) for stair climbing, 1.9 mins (0.07) for cycling. Moreover, there was an average absolute difference of 282 steps (0.03) per 24 h. Conclusions: Physical behaviors were classified with negligible difference between the accelerometer brands. These results support harmonization of data from different thigh-worn accelerometers across multiple cohorts when analyzed in an identical manner.

Chronic diseases such as diabetes are among the most widespread, expensive, and preventable of all health problems, accounting for approximately 86 percent of the United States’ $2.7 trillion annual health care expenditures. In the face of such staggering numbers, it is surprising that our current approach to chronic disease care management has remained largely unchanged for decades, where the care team evaluates the patient and related data infrequently and episodically. However, mobile care management (mCare) information system use is growing, whereby individuals with chronic medical conditions such as diabetes are taught to monitor and manage their disease through the use of a mobile application for tracking, education and feedback, along with monitoring of vital signs with “connected” medical devices, and the support of a remote health coach. These mCare systems offer promise, but many unanswered questions exist surrounding their effects on the health and healthcare of the users, and how user individual differences may influence these effects. Informed primarily by the mobile health systems and health behavior literatures, this study provided a deeper understanding of the effects of an mCare platform on health outcomes and health services utilization of chronic disease patients, principally those with diabetes mellitus, and the effects of a user’s social support on these outcomes. This study analyzed administrative claims, device readings, app usage, demographic and social determinant data of 163 diabetic mCare users from a 21-week observation period from mCare initiation, along with a well-matched control group of diabetic non-users, and a supplemental cohort of 127 non-diabetic mCare users with other chronic medical conditions. mCare had a significant positive effect on users’ adherence to physician’s office visits, suggesting greater continuity of care, chronic care management, and a possible reduction in inpatient use (1.2 fewer encounters over 5 months, on

Great Salt Lake is one of the most important and least understood ecosystems in Utah, and possibly North America. In its current form, it is of worldwide importance for migratory bird populations, and its shorelines represent some of the premier wetland areas in the United States. It is home to the most significant (largest) populations of Artemia franciscana (brine shrimp) in the Western hemisphere. It is influenced by an array of natural and human factors resulting in a dynamic and complex web of natural habitats and human uses. This project, commissioned by the Great Salt Lake Advisory Council, comprises a definition of health, an assessment of current health, and an identification of critical future stresses to Great Salt Lake health. In the context of this project, the term health refers to ecological health, in particular how well the lake functions to support significant bird populations, brine shrimp, and stromatolitic structures. Human uses of the lake for public health, recreation, minerals extraction, and brine shrimp cyst harvest were not considered. Ecological health was based on the lake's current physical form, including dikes and causeways that segment the lake into four bays and impounded wetlands created to increase habitat for waterfowl and other birds. This project does not attempt to define health as the "natural" pre-settlement condition of the lake, because this condition is not feasibly attainable and it is unknown to what extent it would support current populations of significant species. The project does not form any policy or management recommendations. Rather, the information provided in this document is objective, based on science, and is intended to be used to advise government officials on the sustainable use, protection, and development of Great Salt Lake. This project represents a first iteration of a definition and assessment of health for Great Salt Lake based on the best science available to the Panel as of December 2011. Ongoing

A large number of additives were checked for friction reducing ability in a turbulently flowing petroleum based fluid. Several pipelines of various lengths and diameters were used and the efficiency of effective additives was measured as a function of concentration. By subjecting the additives to a sever-shear environment, an estimate of the degradation characteristics was obtained. The most promising materials appear to be high molecular weight polymers, particularly polyisobutylene and polydimethylsiloxane. In the course of the present effort, it was demonstrated that these additives are effective in pipelines of the size and with the flow velocity of commercial and military pipelines and under conditions not detrimental to the fuel usage or equipment can enhance the flow rate by as much as 50%. (Author)