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      Physical Activity and Transitioning to Retirement : A Systematic Review

      review-article
      , , *
      American Journal of Preventive Medicine
      Elsevier Science

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          Abstract

          Context

          The transition to retirement has been recognized as a turning point in determining physical activity and may present a critical “window” for promoting physical activity. This systematic review examined changes in physical activity across the retirement transition, whether these changes vary by SES, and what is known about predictors of these changes.

          Evidence acquisition

          Peer-reviewed articles and gray research literature, published between January 1980 and July 2010 in any country or language, were identified. Longitudinal and cross-sectional observational studies were included. Study selection, quality assessment, data extraction, and synthesis were performed between July 2010 and March 2011. A harvest plot approach to visualizing the findings was combined with a narrative synthesis.

          Evidence synthesis

          Of the 19 included studies, 11 examined changes in exercise, or leisure-time physical activity, or both; seven, changes in total physical activity; and one study, both. Most studies used single-item measures of physical activity ( n=9) or custom questionnaires ( n=6). Results suggested that exercise and leisure-time physical activity increased after the retirement transition, whereas findings regarding total physical activity were inconsistent. SES moderated the association, with low SES being associated with a decrease and high SES with an increase in physical activity. Evidence on predictors of change was scarce and methodologically weak.

          Conclusions

          Evidence suggests that exercise and leisure-time physical activity increases after the retirement transition, but whether and how total physical activity changes is unclear. Imprecise physical activity measures used in primary studies limit conclusions, and this highlights the need for further research.

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          Most cited references46

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          Limits to the measurement of habitual physical activity by questionnaires.

          Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.
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            Assessment of physical activity - a review of methodologies with reference to epidemiological research: a report of the exercise physiology section of the European Association of Cardiovascular Prevention and Rehabilitation.

            Physical activity has a fundamental role in the prevention and treatment of chronic disease. The precise measurement of physical activity is key to many surveillance and epidemiological studies investigating trends and associations with disease. Public health initiatives aimed at increasing physical activity rely on the measurement of physical activity to monitor their effectiveness. Physical activity is multidimensional, and a complex behaviour to measure; its various domains are often misunderstood. Inappropriate or crude measures of physical activity have serious implications, and are likely to lead to misleading results and underestimate effect size. In this review, key definitions and theoretical aspects, which underpin the measurement of physical activity, are briefly discussed. Methodologies particularly suited for use in epidemiological research are reviewed, with particular reference to their validity, primary outcome measure and considerations when using each in the field. It is acknowledged that the choice of method may be a compromise between accuracy level and feasibility, but the ultimate choice of tool must suit the stated aim of the research. A framework is presented to guide researchers on the selection of the most suitable tool for use in a specific study.
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              Is Open Access

              An administrative data merging solution for dealing with missing data in a clinical registry: adaptation from ICD-9 to ICD-10

              Background We have previously described a method for dealing with missing data in a prospective cardiac registry initiative. The method involves merging registry data to corresponding ICD-9-CM administrative data to fill in missing data 'holes'. Here, we describe the process of translating our data merging solution to ICD-10, and then validating its performance. Methods A multi-step translation process was undertaken to produce an ICD-10 algorithm, and merging was then implemented to produce complete datasets for 1995–2001 based on the ICD-9-CM coding algorithm, and for 2002–2005 based on the ICD-10 algorithm. We used cardiac registry data for patients undergoing cardiac catheterization in fiscal years 1995–2005. The corresponding administrative data records were coded in ICD-9-CM for 1995–2001 and in ICD-10 for 2002–2005. The resulting datasets were then evaluated for their ability to predict death at one year. Results The prevalence of the individual clinical risk factors increased gradually across years. There was, however, no evidence of either an abrupt drop or rise in prevalence of any of the risk factors. The performance of the new data merging model was comparable to that of our previously reported methodology: c-statistic = 0.788 (95% CI 0.775, 0.802) for the ICD-10 model versus c-statistic = 0.784 (95% CI 0.780, 0.790) for the ICD-9-CM model. The two models also exhibited similar goodness-of-fit. Conclusion The ICD-10 implementation of our data merging method performs as well as the previously-validated ICD-9-CM method. Such methodological research is an essential prerequisite for research with administrative data now that most health systems are transitioning to ICD-10.
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                Author and article information

                Contributors
                Journal
                Am J Prev Med
                Am J Prev Med
                American Journal of Preventive Medicine
                Elsevier Science
                0749-3797
                1873-2607
                1 September 2012
                September 2012
                : 43
                : 3
                : 329-336
                Affiliations
                MRC Epidemiology Unit and UK Clinical Research Collaboration Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
                Author notes
                [* ]Address correspondence to: David Ogilvie, PhD, MRC Epidemiology Unit and UKCRC Centre for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR, UK david.ogilvie@ 123456mrc-epid.cam.ac.uk
                Article
                S0749-3797(12)00394-7
                10.1016/j.amepre.2012.05.026
                3830178
                22898127
                1ff35e6d-a167-421b-8e06-2958159e4124
                © 2012 Elsevier Inc.

                This document may be redistributed and reused, subject to certain conditions.

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                Review and Special Article

                Medicine
                Medicine

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