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Objective: The global obesity epidemic has been partially attributed to modern environments that encourage inactivity and overeating, yet few studies have examined specific features of the physical neighborhood environment that influence obesity. Using two different measurement methods, this study sought to identify and compare perceived and observed neighborhood indicators of obesity and a high-risk profile of being obese and inactive. Design: Cross-sectional telephone surveys (perceived) and street-scale environmental audits (observed) were conducted concurrently in two diverse US cities to assess recreational facility access, land use, transportation infrastructure and aesthetics. Subjects: A total of 1032 randomly selected urban residents (20% obese, 32% black, 65% female). Analysis: Bivariate and multivariate logistic regression analyses were conducted to estimate the association (adjusted prevalence odds ratio (aOR)) between the primary outcome (obese vs normal weight) and perceived and observed environmental indicators, controlling for demographic variables. Results: Being obese was significantly associated with perceived indicators of no nearby nonresidential destinations (aOR ¼ 2.2), absence of sidewalks (aOR ¼ 2.2), unpleasant community (aOR ¼ 3.1) and lack of interesting sites (aOR ¼ 4.8) and observed indicators of poor sidewalk quality (aOR ¼ 2.1), physical disorder (aOR ¼ 4.0) and presence of garbage (aOR ¼ 3.7). Perceived and observed indicators of land use and aesthetics were the most robust neighborhood correlates of obesity in multivariate analyses. Conclusions: The findings contribute substantially to the growing evidence base of community-level correlates of obesity and suggest salient environmental and policy intervention strategies that may reduce population-level obesity prevalence. Continued use of both measurement methods is recommended to clarify inconsistent associations across perceived and observed indicators within the same domain.

With minimal training of the auditors, the Checklist demonstrated strong reliability. Future studies are needed to provide information about its usability for various stakeholders and across different settings.

Aim Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders. Method This international patient–provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of LARS. Results Three hundred twenty‐five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. Conclusion This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.

Background:Neighborhood environmental supports for physical activity are assessed via telephone surveys (perceived) and environmental audits (observed), but the correspondence between methods is not known.Methods.Surveys (N = 1068) and audits were conducted concurrently in four diverse urban settings to measure recreational facilities, land use, transportation environment, and aesthetics. Agreement was assessed with kappa (κ) statistics.Results.Kappa values ranged from –0.06 to 0.47 for the 28 item-pairs: 17 item-pairs were classified as poor agreement (κ ≤ 0.20), 10 as fair (κ = 0.21-0.40), and 1 as good (κ = 0.47). The highest agreement was observed for proximity to parks, trails, and various land-use destinations, presence of sidewalks, and measures of neighborhood maintenance and cleanliness.Conclusions.Methodological issues and/or the likelihood of capturing distinct aspects of the environment may explain the generally low correspondence between survey and audit measures. Our findings should help researchers make informed decisions regarding measurement of environmental supports for physical activity.

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These evidence criteria provide the foundation for the translation and dissemination of evidence-based intervention planning processes through a Web-based technical advisement system for public healthcare practitioners. Limitations and future directions are considered.

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