Cumming School of Medicine Research & Publications
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- ItemEmbargoPlace attachment and walking behaviour: mediation by perceived neighbourhood walkability(Elsevier, 2023-07) Koohsari, Mohammad Javad; Yasunaga, Akitomo; Oka, Koichiro; Nakaya, Tomoki; Nagai, Yukari; McCormack, Gavin R.The environmental features of a location are important for facilitating people’s attachment to places. Attachment to particular places, such as residential neighbourhoods, may encourage people to adopt and maintain physical activity routines. Moreover, the ways in which people perceive the built features in their neighbourhood (e.g., walkability) may mediate the relations between place attachment and physical activity. Therefore, this exploratory study examined the associations between place attachment and neighbourhood-specific physical activity and explored the extent to which perceived neighbourhood walkability mediates these associations. The study included survey data from 1,800 adults living in Calgary, Canada. Place attachment (including identity and dependence), physical activity, and neighbourhood walkability were self-reported using validated tools. Linear and logistic regression models were applied to estimate the associations between variables. Mediation was assessed using structural equation modelling. Place attachment dimensions were significantly positively associated (p < 0.05) with weekly participation (odds) and time spent walking for transport and recreation. The associations between place attachment and walking for transport were also mediated by perceived neighbourhood walkability. Together, these findings emphasize the crucial role of place attachment, particularly human bonding and relationships with the neighbourhood environment (i.e., place attachment), in supporting physically active lifestyles.
- ItemEmbargoUrban design and cardio-metabolic risk factors(Elsevier, 2023-05-19) Koohsari, Mohammad Javad; Oka, Koichiro; Nakaya, Tomoki; Vena, Jennifer; Williamson, Tyler; Quan, Hude; McCormack, Gavin R.Accumulating evidence suggests that the built environment may be associated with cardiovascular disease via its influence on health behaviours. The aim of this study was to estimate the associations between traditional and novel neighbourhood built environment metrics and clinically assessed cardio-metabolic risk factors among a sample of adults in Canada. A total of 7,171 participants from Alberta’s Tomorrow Project living in Alberta, Canada, were included. Cardio-metabolic risk factors were clinically measured. Two composite built environment metrics of traditional walkability and space syntax walkability were calculated. Among men, space syntax walkability was negatively associated with systolic and diastolic blood pressure (b=-0.87, 95% CI - 1.43, -0.31 and b=-0.45, 95% CI -0.86, -0.04, respectively). Space syntax walkability was also associated with lower odds of overweight/obese among women and men (OR=0.93, 95% CI 0.87, 0.99 and OR=0.88, 95% CI 0.79, 0.97, respectively). No significant associations were observed between traditional walkability and cardiometabolic outcomes. This study showed that the novel built environment metric based on the space syntax theory was associated with some cardio-metabolic risk factors.
- ItemEmbargoThe contribution of modifiable risk factors to socioeconomic inequities in cardiovascular disease morbidity and mortality: a nationally representative population-based cohort study(Elsevier, 2023-04-12) Nejatinamini, Sara; Campbell, David JT; Godley, Jenny; Minaker, Leia M; Sajobi, Tolulope T; McCormack, Gavin R; Olstad, Dana LeeThis study examined the individual and joint effects of modifiable risk factors mediating the associations between socioeconomic position (SEP) and morbidity and mortality from cardiovascular diseases (CVD) in a nationally representative sample of adults in Canada. Participants in the Canadian Community Health Survey (n=289,800) were followed longitudinally for CVD morbidity and mortality using administrative health and mortality data. SEP was measured as a latent variable consisting of household income and individual educational attainment. Mediators included smoking, physical inactivity, obesity, diabetes and hypertension. The primary outcome was CVD morbidity and mortality, defined as the first fatal/nonfatal CVD event during follow-up (median 6.2 years). Generalized structural equation modeling tested the mediating effects of modifiable risk factors in associations between SEP and CVD in the total population and stratified by sex. Lower SEP was associated with 2.5 times increased odds of CVD morbidity and mortality (OR: 2.52, 95% CI: 2.28, 2.76). Modifiable risk factors mediated 74% of associations between SEP and CVD morbidity and mortality in the total population and were more important mediators of associations in females (83%) than males (62%). Smoking mediated these associations independently and jointly with other mediators. The mediating effects of physical inactivity were through joint mediating effects with obesity, diabetes or hypertension. There were additional joint mediating effects of obesity through diabetes or hypertension in females. Findings point to modifiable risk factors as important targets for interventions along with interventions that target structural determinants of health to reduce socioeconomic inequities in CVD.
- ItemOpen AccessA Longitudinal Seroepidemiology Study to Evaluate Antibody Response to SARS-CoV-2 Virus and Vaccination in Children in Calgary, Canada from July 2020 to September 2022.(Canadian Immunization Conference, 2023-04-19) Doucette, Emily Jayne; Kellner, James DuncanIntroduction: Measurement of SARS-CoV-2 antibody seropositivity is important to accurately understand exposure to infection and/or vaccination in populations. Methods: A cohort of children with or without prior SARS-CoV-2 infections was enrolled in Calgary, Canada in 2020. Venous blood was sampled 4 times from July 2020 to April 2022 for SARS-CoV-2 nucleocapsid and spike antibodies, with an additional 5th visit in the fall of 2022. Demographic and clinical information was obtained including SARS-CoV-2 test results and vaccination records. Results and analysis: 1035 children were enrolled and 88.9% completed 4 visits; median age 9 years (IQR: 5,13); 519 (50.1%) female; and 815 (78.7%) Caucasian. 477 (46.1%) participants attended Visit 5. Before enrollment, 118 (11.4%) had confirmed or probable SARS-CoV-2 infection. By September 2022, the total cumulative percentage of previously uninfected participants diagnosed with COVID-19 was 53.9% by Visit 5. (0/917 (0%), 15/873 (1.7%), 31/837 (3.7%), 280/820 (34.1%), and 63/439 (14.4%) at Visits 1-5, respectively). Nucleocapsid antibody seropositivity declined to 18.0% after more than 200 days after diagnosis. In contrast, spike antibodies remained elevated in 97.6% of unvaccinated children after more than 400 days after diagnosis. By September 2022, 97.1% (232/239) of children 12 years and older, 85.9% (171/199) of children 5-11, and 15.4% (6/39) of children under 5 received at least 1 dose of vaccine. At that time, all 409 vaccinated children had spike antibodies, compared with 38/64 (59.4%) of unvaccinated children (P<0.001 for comparison of proportions). Conclusions: By September 2022, most children in the study had a serologic response against the SARS-CoV-2 virus from infection and/or vaccination, with unvaccinated children much less likely to have a serologic response. Ongoing studies of serologic status are needed to estimate population levels of virus exposure and durability of antibody response after infection and/or vaccination.
- ItemOpen AccessA scoping review of frameworks that address wellness in medical learners(2023-03-21) Hinds, Shannon; de Groot, Janet; Heirali, Alya; McClurg, Caitlin; Kassam, Aliya