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ObjectivesThe use of online imagery by non-local observers to conduct remote, centralized collection of streetscape audit data in international studies has the potential to enhance efficiency of collection and comparability of such data for research on built environments and health. The objectives of the study were to measure (1) the consistency in responses between local in-field observers and non-local remote online observers and (2) the reliability between in-country online observers and non-local remote online observers using the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features along streets in five countries.MethodsConsistency and inter-rater reliability were analyzed between local and non-local observers on a pooled database of 200 routes in five study regions (Melbourne, Australia; Ghent, Belgium; Curitiba, Brazil; Hong Kong, China; and Valencia, Spain) for microscale environmental feature subscales and item-level variables using the intraclass correlation coefficient (ICC).ResultsA local in-field versus remote online comparison had an ICC of 0.75 (95 % CI: 0.68-0.80) for the grand total score. An ICC of 0.91 (95 % CI: 0.88-0.93) was found for the local online versus remote online comparison. Positive subscales yielded stronger results in comparison to negative subscales, except for the similarly poor-performing positive aesthetics/social characteristics.ConclusionsThis study demonstrated remote audits of microscale built environments using online imagery had good reliability with local in-field audits and excellent reliability with local online audits. Results generally supported remote online environmental audits as comparable to local online audits. This identification of low-cost and efficient data acquisition methods is important for expanding research on microscale built environments and physical activity globally.

BackgroundLeisure-time and transport activity domains are studied most often because they are considered more amenable to intervention, but to date evidence on these domains is limited. The aim of the present study was to examine patterns of socio-demographic correlates of adults' leisure-time and transport physical activity and how these associations varied across 17 cities in 12 countries.MethodsParticipants (N = 13,745) aged 18-66 years in the IPEN Adult study and with complete data on socio-demographic and self-reported physical activity characteristics were included. Participants reported frequency and duration of leisure-time and transport activities in the last 7 days using the self-administered International Physical Activity Questionnaire-Long Form. Six physical activity outcomes were examined in relation with age, education, and sex, and analyses explored variations by city and curvilinear associations.ResultsSex had the most consistent results, with five of six physical activity outcomes showing females were less active than males. Age had the most complex associations with self-report transport and leisure-time physical activity. Compared to older people, younger adults were less likely to engage in transport physical activity, but among those who did, younger people were likely to engage in more active minutes. Curvilinear associations were found between age and all three leisure-time physical activity outcomes, with the youngest and the oldest being more active. Positive associations with education were found for leisure-time physical activity only. There were significant interactions of city with sex and education for multiple physical activity outcomes.ConclusionsAlthough socio-demographic correlates of physical activity are widely studied, the present results provide new information. City-specific findings suggest there will be value in conducting more detailed case studies. The curvilinear associations of age with leisure-time physical activity as well as significant interactions of leisure-time activity with sex and education should be further investigated. The findings of lower leisure-time physical activity among females as well as people with low education suggest that greater and continued efforts in physical activity policies and programs tailored to these high-risk groups are needed internationally.

Aim: To test the association between sociodemographic and social characteristics with COVID-19 cases and deaths in small and large Brazilian cities. Methods: This ecological study included COVID-19 data available in State Health Secretaries (managed by brasil.io API) and three national databases (IBGE, DATASUS and Embrapa). Temporal spread of COVID-19 in Brazil during the first year considered as outcome: a) days until 1st case in each city since 1st in the country; b) days until 1,000 cases/100,000 inhabitants since 1st case in each city; c) days until 1st death until 50 deaths/100,000 inhabitants. Covariates included geographic region, city social and environmental characteristics, housing conditions, job characteristics, socioeconomic and inequalities characteristics, and health services and coverage. The analysis were stratified by city size into small (<100,000 inhabitants) and large cities (≥100,00 inhabitants). Multiple linear regressions were performed to test associations of all covariates to adjust to potential confounders. Results: In small cities, the first cases were reported after 82.2 days and 1,000 cases/100,000 were reported after 117.8 days, whereas in large cities these milestones were reported after 32.1 and 127.7 days, respectively. For first death, small and large cities took 121.6 and 36.0 days, respectively. However, small cities were associated with more vulnerability factors to first case arrival in 1,000 cases/100,000 inhabitants, first death and 50 deaths/100,000 inhabitants. North and Northeast regions positively associated with faster COVID-19 incidence, whereas South and Southeast were least. Conclusion: Social and built environment characteristics and inequalities were associated with COVID-19 cases spread and mortality incidence in Brazilian cities. [ABSTRACT FROM AUTHOR]

This study aimed to analyze ESBL-producing Escherichia coli prevalence in urine samples collected between 2011–2019 in Curitiba, a large city in Brazil, and relating it to antibiotic consumption and sanitary conditions. This is a longitudinal study correlating prevalence of ESBL-producing E. coli isolates from urine samples with district-level antibiotic consumption and sociodemographic data during 2011–2019. E. coli isolates were tested for antibiotic susceptibility and ESBL by an automated method. Statistical analysis applied linear regressions, pooled ordinary least squares, and fixed effects models for districts or years. The Chow and Hausman tests indicated that the fixed effects model for individual districts fitted best. Chi-square test was used for qualitative variables (statistical significance was set when P  < 0.05). Among the 886 535 urine sample cultures, 9.9% of isolates were ESBL-producing E. coli. Their prevalence increased from 4.7% in 2012 to 19.3% in 2019 (P  < 0.0001; R2 = 0.922). This progressive increase correlated with age (P  = 0.007; R2 = 0.8725) and male gender (P  < 0.001) and increased antibiotic consumption (P  = 0.0386; R2 = 0.47). The fixed effects model showed that district influences ESBL prevalence and that antibiotic consumption explains 20%–30% of this variation, with an increase of one defined daily dose accounting for an increase of 0.02084 percentage points of ESBL. The increasing prevalence of ESBL-producing E. coli can, to a considerable extent, be explained by increasing antibiotic consumption. [ABSTRACT FROM AUTHOR]

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Background: The aim of this study was to review the evidence to date on the association between physical activity and safety from crime. Methods: Articles with adult populations of 500+ participants investigating the association between physical activity and safety from crime were included. A methodological quality assessment was conducted using an adapted version of the Downs and Black checklist. Results: The literature search identified 15,864 articles. After assessment of titles, abstracts and full-texts, 89 articles were included. Most articles (84.3%) were derived from high-income countries and only 3 prospective articles were identified. Articles presented high methodological quality. In 38 articles (42.7%), at least one statistically significant association in the expected direction was reported (ie, safety from crime was positively associated with physical activity). Nine articles (10.1%) found an association in the unexpected direction and 42 (47.2%) did not find statistically significant associations. The results did not change when we analyzed articles separately by sex, age, type of measurement, or domains of physical activity evaluated. Conclusion: The current evidence, mostly based on cross-sectional studies, suggests a lack of association between physical activity and safety from crime. Prospective studies and natural experiments are needed, particularly in areas with wide crime variability. [ABSTRACT FROM AUTHOR]

Age-friendly cities and communities have emerged as a significant policy, participative and governance response to ageing and its spatial effects. This paper argues that it has important benefits in mobilizing older people, placing age on the urban agenda and building recognition across politicians, policy makers and programme managers. Based on the experience of Belfast (UK), the analysis suggests, however, that it needs to be understood within wider urban restructuring processes, the importance of the property economy and how planning practices favour particular groups and modes of development. Drawing on demographic data, policy documents and in-depth interviews, it evaluates the relationship between age and urban regeneration, research-based advocacy and central-local relations in health and place-based care. The paper concludes by highlighting the importance of knowledge in competitive policy arenas and the need to focus on the most excluded and isolated old and where and how they live. [ABSTRACT FROM AUTHOR]

Abstract Background Neighborhood safety is one of the environmental aspects that can influence physical activity. We analyzed the association between perceived neighborhood safety and physical inactivity (PI) in adults and examined effect modification according to sociodemographic variables. Methods A cross-sectional study was conducted with 1,261 adults (62% women), age 18–69 years from Curitiba, Brazil. Results The perception of unsafe neighborhood was higher among women, older participants, those classified in the high socioeconomic (SES) group, overweighed and also among those reporting to have PA equipments and children. The association between perception safety of walking during the day and walking for leisure (women PR = 1.12 CI95% = 1.02–1.22; men PR = 0.82 CI95% = 0.64–1.05; interaction term PR = 1.38 CI95% = 1.03–1.83) and safe perception was associated with PI, just in the highest SES group (PR = 1.09; CI95% = 1.00–1.19; p trend = 0.032) when compared with their counterparts (low SES PR = 0.99; CI95% = 0.90–1.04; p trend = 0.785; interaction term PR = 1.09; CI95% = 1.03–1.15; p trend = 0.007). Conclusion The perception of safety in the neighborhood was associated with PI in transport, but this association varies across of sociodemographic variables.