Publications by authors named "Marie Murphy"

159 Publications

Acceptability and feasibility of strategies to promote healthy dietary choices in UK secondary school canteens: a qualitative study.

BMC Res Notes 2021 Sep 20;14(1):365. Epub 2021 Sep 20.

Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.

Objective: To explore the acceptability and feasibility of choice architecture strategies for dietary change in UK secondary school canteens from the perspectives of pupils, school staff and catering providers through qualitative focus groups and interviews.

Results: Three focus groups with adolescents (n = 15; mean age 13.7 years; standard deviation 1.9) and eight interviews with school staff and caterers recruited from one school and catering provider in Coventry UK were undertaken. The most acceptable choice architecture strategies for intervening to drive healthy dietary choices are those that make use of proximity and positioning, on the basis that convenience was one of the main drivers for food/drink selections. Acknowledging adolescents' desire for autonomy and for food to be familiar and predictable was considered important in enhancing acceptability. Challenges to the feasibility of nudge strategies included concerns about behavioural issues, increased food waste, and a decline in uptake of canteen purchases. The design of food choice architecture interventions for secondary school settings should consider the specific characteristics of this age group and setting to ensure successful implementation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13104-021-05778-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454098PMC
September 2021

Women's Experiences of Promotion and Tenure in Academic Medicine and Potential Implications for Gender Disparities in Career Advancement: A Qualitative Analysis.

JAMA Netw Open 2021 Sep 1;4(9):e2125843. Epub 2021 Sep 1.

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco.

Importance: Gender disparities in career advancement in academic medicine have persisted despite gender parity in medical school matriculation. Although numerous explanations for this gap exist, little is known about women's experiences of promotion and tenure in academic medicine.

Objective: To examine women's experiences of promotion and tenure in academic medicine to uncover mechanisms associated with the gender disparity in career advancement.

Design, Setting, And Participants: In this qualitative study, 52 in-depth, semistructured interviews with women academic medicine faculty members were conducted in 2019. The 52 participants were drawn from 16 medical schools across the US. Institutions were selected using a purposive sampling strategy to seek diversity of geography and ownership (private or public). Within institutions, purposive and snowball sampling were used to seek diversity with respect to respondents' degree type (MD, PhD, and MD and PhD), age, and career stage. Interview transcripts were analyzed using qualitative thematic analysis. Data analysis was performed from March to December 2020.

Main Outcomes And Measures: Themes and subthemes in participants' experiences of promotion and tenure.

Results: The 52 women in this study ranged in age from 34 to 82 years (mean [SD] age, 54.0 [10.7] years). Eighteen respondents (34.6%) held an MD, 4 (7.7%) held both an MD and PhD, and 30 (57.7%) held a PhD. Fourteen respondents (26.9%) were assistant professors at the time of the study, 8 (15.4%) were associate professors, and 30 (57.7%) were full professors. Four main themes within participants' experiences of promotion and tenure that pertain to gender inequities were identified: ambiguous or inconsistent criteria for promotion or tenure; lack of standard processes for reviewing applications and making decisions; vulnerability to malicious behavior of senior faculty, department chairs, and division chiefs; and women seeing men have different experiences of advancement.

Conclusions And Relevance: The respondents' experiences of promotion and tenure suggest that promotion and tenure processes may be characterized by inconsistency and a lack of oversight, which have the potential to contribute to well-documented patterns of gender disparities in career advancement in academic medicine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamanetworkopen.2021.25843DOI Listing
September 2021

Mentoring Relationships and Gender Inequities in Academic Medicine: Findings From a Multi-Institutional Qualitative Study.

Acad Med 2021 Sep 7. Epub 2021 Sep 7.

M. Murphy is analyst IV, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, School of Medicine, San Francisco, California. H. Record is a fourth-year medical student, University of California, San Francisco, School of Medicine, San Francisco, California. J.K. Callander is a resident, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, School of Medicine, San Francisco, California. D. Dohan is professor, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, School of Medicine, San Francisco, California. J.R. Grandis is distinguished professor, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, School of Medicine, San Francisco, California.

Purpose: This study examined how mentoring relationships may reinforce or mitigate gender inequities in academic medicine.

Method: In-depth, semistructured interviews with 52 women and 52 men who are medical school faculty members were conducted at 16 institutions across the United States in 2019. Institutions were recruited using a purposive sampling strategy to seek diversity in geography, ownership (private or public), and prestige. Within institutions, purposive sampling was used to recruit equal numbers of women and men and to seek diversity in degree type (MD, PhD), age, and career stage. A coding scheme was developed through iterative analysis of the interview transcripts. All interview transcripts were then coded with the goal of identifying intersections between mentorship and experiences of and responses to gender inequities.

Results: Four key themes at the intersection of mentoring relationships and gender inequities were identified. (1) Both women and men became aware of gender inequities in academic medicine through relationships with women mentors and mentees. (2) Both women and men mentors recognized the challenges their female mentees faced and made deliberate efforts to help them navigate an inequitable environment. (3) Both women and men mentors modeled work-family balance and created family-friendly environments for their mentees. (4) Some women, but no men, reported being sexually harassed by mentors.

Conclusions: This study shows that mentoring relationships may be a context in which gender inequities are acknowledged and mitigated. It also shows that mentoring relationships may be a context in which gender inequities, such as sexual harassment, may occur. Sexual harassment in academic medicine has been widely documented, and gender inequity in academic medicine has proved persistent. While mentoring relationships may have the potential to identify and mitigate gender inequities, this study suggests that this potential remains largely unrealized.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ACM.0000000000004388DOI Listing
September 2021

Barriers and facilitators to implementing community-based physical activity interventions: a qualitative systematic review.

Int J Behav Nutr Phys Act 2021 09 7;18(1):118. Epub 2021 Sep 7.

Centre for Exercise Medicine, Physical Activity and Health, Ulster University, Belfast, Northern Ireland.

Background: Over the past decade several physical activity (PA) interventions have been shown to be efficacious in a controlled research setting, however there is a continued lack of evidence for how to successfully implement these PA interventions in real-world settings such as the community. This review aims to explore the barriers and facilitators that affect the implementation of community-based PA interventions and make recommendations to improve implementation from the included studies.

Methods: A systematic literature search of EBSCOhost, Scopus, PUBMED and Web of Science was conducted to identify articles that reported qualitative data on the implementation factors of community-based interventions where PA was a primary outcome. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) as a guide. Implementation factors and recommendations were then mapped onto the 5 domains of the CFIR and synthesised thematically.

Results: From 495 articles, a total of 13 eligible studies were identified, with 6 studies using a mixed methods approach, and 7 reporting qualitative methods only. There were 82 implementation factors identified, including 37 barriers and 45 facilitators, and a further 26 recommendations from the papers across all 5 domains of the CFIR. More barriers than facilitators were identified within the CFIR domain inner setting, in contrast to all other domains where facilitator numbers outweighed barriers.

Conclusions: This review identified many facilitators and barriers of implementing physical activity interventions in the community. A key finding of this review was the impact of implementation strategies on successful implementation of community PA interventions. From the evidence, it was clear that many barriers to implementation could have been negated or reduced by an implementation plan in which several strategies are embedded. The findings of this review also suggest more attention to individual' skills and involvement is needed to improve self-efficacy and knowledge. The role of individuals across all organisational levels, from providers to leaders, can impact on the implementation of an intervention and its success.

Trial Registration: PROSPERO - CRD42020153821 .
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12966-021-01177-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422651PMC
September 2021

The impact of COVID-19 on the physical activity and sedentary behaviour levels of pregnant women with gestational diabetes.

PLoS One 2021 20;16(8):e0254364. Epub 2021 Aug 20.

Ulster Hospital, Dundonald, South Eastern Health and Social Services Trust, Newtownabbey, Northern Ireland.

Background: The aim of this study was to understand how physical activity and sedentary behaviour levels of pregnant women with gestational diabetes in the UK have been affected by COVID-19.

Methods: An online survey exploring physical activity and sedentary behaviour levels of pregnant women with gestational diabetes during COVID-19 was distributed through social media platforms. Women who had been pregnant during the COVID-19 outbreak and had gestational diabetes, were resident in the UK, were 18 years old or over and could understand written English were invited to take part.

Results: A total of 724 women accessed the survey, 553 of these met the eligibility criteria and took part in the survey. Sedentary time increased for 79% of the women during the pandemic. Almost half of the women (47%) were meeting the physical activity guidelines pre COVID-19 during their pregnancy, this dropped to 23% during the COVID-19 pandemic. Fear of leaving the house due to COVID-19 was the most commonly reported reason for the decline. Significant associations were found between meeting the physical activity guidelines during COVID-19 and educational attainment, fitness equipment ownership and knowledge of how to exercise safely in pregnancy.

Conclusions And Implications: These results show the impact of COVID-19 on physical activity and sedentary behaviour levels and highlight the need for targeted public health initiatives as the pandemic continues and for future lockdowns. Women with gestational diabetes need to know how it is safe and beneficial to them to engage in physical activity and ways to do this from their homes if fear of leaving the house due to COVID-19 is a barrier for them. Online physical activity classes provided by certified trainers in physical activity for pregnant women may help them remain active when face-to-face appointments are reduced and limited additional resources are available.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254364PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378749PMC
August 2021

Reliability and validity of the Actiwatch and Clouclip for measuring illumination in real-world conditions.

Ophthalmic Physiol Opt 2021 Sep 13;41(5):1048-1059. Epub 2021 Aug 13.

Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK.

Purpose: To compare real-world measures of illumination obtained with the Actiwatch-2 and Clouclip-M2 with 'gold standard' photometry measures and to evaluate the ability of Actiwatch-2 to correctly identify photometer-defined conditions: scotopic (≤0.01 lux), mesopic (0.02-3 lux), indoor photopic (>3-1,000 lux) and outdoor photopic (>1,000 lux); and Clouclip to correctly identify photometer-defined conditions within its operating range (>1 lux). Inter-device reliability of Clouclip for illumination and viewing distance measures was also investigated.

Methods: A Hagner-S2 photometer was used as reference. Measures of illumination were obtained from a range of real-world conditions. To investigate inter-device reliability, five Clouclips were simultaneously exposed to varied light conditions and object distances.

Results: Strong correlations existed between illumination measured with the photometer and both Actiwatch-2 (ρ = 0.99, p < 0.0001) and Clouclip (ρ = 0.99, p < 0.0001). However, both devices underestimated illumination compared to the photometer; disparity increased with increasing illumination and was greater for Actiwatch-2 than Clouclip measures. Actiwatch-2 successfully categorised illumination level (scotopic, mesopic, indoor and outdoor photopic) in 71.2% of cases. Clouclip successfully categorised illumination levels as scotopic/mesopic (≤3 lux) and indoor and outdoor photopic in 100% of cases. Mean differences and limits of agreement (LOA) were 430.92 ± 1,828.74 and 79.35 ± 407.33 lux, between the photometer and Actiwatch-2 and photometer and Clouclip, respectively. The Intra-class Correlation Coefficients for illumination and viewing distance measured with five Clouclips were 0.85 and 0.96, respectively.

Conclusion: These data illustrate that different Clouclip devices produce comparable measures of viewing distance and illumination in real-world settings. Both Actiwatch-2 and Clouclip underestimate illumination in the field compared to gold standard photometer measures. The disparity increases at higher levels of illumination and the discrepancy was greater for Actiwatch-2 measures. For researchers interested in categorising light exposure, Clouclip classifies illumination levels >2 lux more accurately than Actiwatch-2 but cannot discriminate between scotopic and low mesopic light.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/opo.12860DOI Listing
September 2021

Music Tempo: A Tool for Regulating Walking Cadence and Physical Activity Intensity in Overweight Adults?

Int J Environ Res Public Health 2021 07 25;18(15). Epub 2021 Jul 25.

Sport and Exercise Sciences Research Institute, Ulster University, Newtownabbey BT37 0QB, UK.

This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults ( = 37; 94.26 ± 17.11 kg; 49.63 ± 12.37 years) were randomly assigned to an intervention (IG, = 17) or usual care group (UC, = 20) as part of a novel nine-month walking intervention. IG participants walked to self-selected music with a predetermined tempo and received a behavioural change support programme. At baseline, four-, six- and nine-months participants were asked to walk around an elliptical track at their habitual pace (0-2 min) and then in time to a predetermined tempo (2-8 min) designed to elicit moderate intensity. Cadence response (steps/min) was assessed and intensity (heart rate (bpm) recorded using wireless telemetry. A repeated measures general linear model (GLM) examined differences between groups over time ( < 0.05). All data is presented as means ± SD. At each assessment point both groups displayed an immediate cadence adjustment in response to music tempo ( < 0.01) i.e., habitual cadence vs. 3 METs target cadence ( < 0.05) and 3 METs target cadence vs. 5 METs target cadence ( < 0.05). Additionally, IG participants displayed an increased habitual cadence (0-2 min) at each assessment point ( < 0.05; 110 ± 9, 121.80 ± 7.5, 121.46 ± 10, 121.93 ± 7 steps/min respectively). UC participant's habitual cadence was unchanged from 0-9 months ( > 0.05; 120 ± 10, 116 ± 13, 119 ± 12 and 119 ± 9 steps/min respectively). Music tempo may be a useful regulatory tool to prompt the free-living individual to reach an appropriate stride rate to achieve a walking pace that is at least moderate intensity. It also appears that results may be trainable as throughout the study an increased habitual walking cadence was observed, in the absence of music.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18157855DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345504PMC
July 2021

The "Worktivity" mHealth intervention to reduce sedentary behaviour in the workplace: a feasibility cluster randomised controlled pilot study.

BMC Public Health 2021 07 18;21(1):1416. Epub 2021 Jul 18.

Centre for Exercise Medicine, Physical Activity and Health, Ulster University, Shore Road, Co. Antrim BT37 0QB, Newtownabbey, UK.

Background: Office work generally consists of high amounts of sedentary behaviour (SB) which has been associated with negative health consequences. We developed the "WorktivIty" mobile app to help office workers reduce their SB through self-monitoring and feedback on sedentary time, prompts to break sedentary time, and educational facts. The aim of this paper is to report the feasibility of delivering the Worktivity intervention to desk-based office workers in the workplace setting and describe methodological considerations for a future trial.

Methods: We conducted a three-arm feasibility cluster randomised controlled pilot study over an 8-week period with full time-desk based employees. Clustered randomisation was to one of three groups: Worktivity mobile app (MA; n = 20), Worktivity mobile app plus SSWD (MA+SSWD; n = 20), or Control (C; n = 16). Feasibility was assessed using measures of recruitment and retention, intervention engagement, intervention delivery, completion rates and usable data, adverse events, and acceptability.

Results: Recruitment of companies to participate in this study was challenging (8% of those contacted), but retention of individual participants within the recruited groups was high (81% C, 90% MA + SSWD, 95% MA). Office workers' engagement with the app was moderate (on average 59%). Intervention delivery was partially compromised due to diminishing user engagement and technical issues related to educational fact delivery. Sufficient amounts of useable data were collected, however either missing or unusable data were observed with activPAL™, with data loss increasing at each follow up time point. No serious adverse events were identified during the study. The majority of participants agreed that the intervention could be implemented within the workplace setting (65% MA; 72% MA + SSWD) but overall satisfaction with the intervention was modest (58% MA; 39% MA + SSWD).

Conclusions: The findings suggest that, in principle, it is feasible to implement a mobile app-based intervention in the workplace setting however the Worktivity intervention requires further technical refinements before moving to effectiveness trials. Challenges relating to the initial recruitment of workplaces and maintaining user engagement with the mHealth intervention over time need to be addressed prior to future large-scale implementation. Further research is needed to identify how best to overcome these challenges.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-021-11473-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8286585PMC
July 2021

Socio-ecological correlates of physical activity in a nationally representative sample of adolescents across Ireland and Northern Ireland.

Prev Med Rep 2021 Sep 28;23:101472. Epub 2021 Jun 28.

Physical Activity for Health, Health Research Institute, Ireland.

Physical activity (PA) is associated with a range of health benefits for adolescents. Few adolescents meet one hour daily of moderate-to-vigorous physical activity (MVPA). The World Health Organisation (WHO) now recommends an 'on average' accumulation. In light of these updates, comparing correlates associated with meeting versus not meeting the PA guidelines provides limited understanding of adolescent behavioural choices. The aim of this study was to fractionate PA behaviour and investigate influential socio-ecological correlates across a diverse range of PA categories. A nationally representative sample (N = 6,563; age = 13.5 ± 1.9 years; male = 46.2%) completed a researcher supervised self-report survey. Empirically established instruments assessing the socio-ecological correlates of PA were included. Levels of MPVA were categorised into (60mins.MVPA.daily), (60mins.MVPA.5-6 days), (60mins.MVPA.3-4 days) or (60mins.MVPA.0-2 days). Descriptive statistics, chi-square analyses and multivariate blockwise binary logistic regression models were run separately for each PA category. Few were daily active (12.7%), 33.6% active, 36.5% somewhat active and 17.2% were inactive. Results showed that correlates differed in terms of direction and strength, depending on individual activity status. Increasing age was positively associated with being somewhat active, but not with being active or daily active. Attending an 'all-girls school' was negatively associated with daily active. High interpersonal support from family, friends or teachers was negatively associated with inactive or somewhat active, reducing the likelihood of adolescents remaining in these unhealthy PA categories. This novel information is useful for exploring previously established inconsistent relationships with PA. More sensitive categorisation and intervention tailoring to diverse PA categories is required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pmedr.2021.101472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259398PMC
September 2021

The Effectiveness of School-Based Interventions on Obesity-Related Behaviours in Primary School Children: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Children (Basel) 2021 Jun 8;8(6). Epub 2021 Jun 8.

Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Sciences Research Institute, Coleraine Campus, University of Ulster, Coleraine BT52 1SA, UK.

School-based interventions are promising for targeting a change in obesity-related behaviours in children. However, the efficacy of school-based interventions to prevent obesity remains unclear. This review examined the effectiveness of school-based interventions at changing obesity-related behaviours (increased physical activity, decreased sedentary behaviour and improved nutrition behaviour) and/or a change in BMI/BMI z-score. Following PRISMA guidelines, seven databases were systematically searched from 1 January 2009 to 31 December 2020. Two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias of each of the included studies. Forty-eight studies met the inclusion criteria and were included in a narrative synthesis. Thirty-eight studies were eligible for inclusion in a meta-analysis. The findings demonstrate that interventions in children when compared to controls resulted in a small positive treatment effect in the control group (2.14; 95% CI = 0.77, 3.50). There was no significant effect on sedentary behaviour, energy intake and fruit and vegetable intake. Significant reductions were found between groups in BMI kg/m (-0.39; 95% CI = -0.47, -0.30) and BMI z-score (-0.05; 95% CI = -0.08, -0.02) in favour of the intervention. The findings have important implications for future intervention research in terms of the effectiveness of intervention components and characteristics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/children8060489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8228296PMC
June 2021

Spontaneous Bilateral Ectopic Pregnancy in a Patient With Endometriosis.

J Emerg Med 2021 Jun 17. Epub 2021 Jun 17.

Department of Emergency Medicine, SUNY Downstate Medical Center, Brooklyn, New York; Department of Emergency Medicine, Kings County Hospital Center, Brooklyn, New York.

Background Bilateral ectopic pregnancies (EPs) occur in 1 of 200,000 pregnancies. Evidence suggests that endometriosis is an independent risk factor for unilateral EPs. However, the link between endometriosis and bilateral EPs has not been established. Case Report We report a case of a bilateral EP in a patient with endometriosis. The patient was initially misdiagnosed with the unilateral EP. Why Should an Emergency Physician Be Aware of This? Although rare, bilateral EP should be on a differential diagnosis in a pregnant patient presenting with abdominal pain or vaginal bleeding. This includes patients presenting with worsening symptoms after the recent surgery for the unilateral EP. Endometriosis as a risk factor for bilateral EP cannot be established based on a single report, but such a report should raise awareness of the issue.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jemermed.2021.04.023DOI Listing
June 2021

The Association of Family, Friends, and Teacher Support With Girls' Sport and Physical Activity on the Island of Ireland.

J Phys Act Health 2021 Jun 7:1-8. Epub 2021 Jun 7.

Background: The current study was the largest physical activity (PA) surveillance assessment of youth undertaken in Ireland in recent years. The purpose of this research was to assess the impact of social support, while controlling for age and screen time, on PA and sport participation, across a representative sample of Irish female youth.

Methods: A total of 3503 children (mean age: 13.54 [2.05] y) across the island of Ireland participated. Participants completed a previously validated electronic questionnaire while supervised in a classroom setting, which investigated their (1) levels of PA; (2) screen time; (3) community sport participation; and (4) social support (friend, family, and teacher) to be physically active/partake in sport.

Results: There were significant differences, with medium and large effect sizes, for social support from friends and family across types of sports participation. Specifically, girls who participated in the most popular team sports, when compared with the most popular individual sports, reported higher social support scores for friends and family structures.

Conclusions: Findings from this study confirm the contributing influence of friends and family as sport and PA support networks for girls. Interventions should consider the importance of culturally relevant team sports for PA engagement in female youth.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jpah.2020-0386DOI Listing
June 2021

Changes in Physical Activity, Sleep, Mental Health, and Social Media Use During COVID-19 Lockdown Among Adolescent Girls: A Mixed-Methods Study.

J Phys Act Health 2021 05 11;18(6):677-685. Epub 2021 May 11.

Background: To suppress the transmission of coronavirus, many governments, including that of the island of Ireland, implemented a societal lockdown, which included school closures, limits on social gatherings, and time outdoors. This study aimed to evaluate changes in physical activity (PA), mental health, sleep, and social media use among adolescent girls during lockdown.

Methods: 281 female pupils (12-14 y) taking part in the ongoing Walking In Schools study on the island of Ireland self-reported PA, mental health, sleep, and social media use before (September-October 2019) and during lockdown (May-June 2020), via questionnaires. These were supplemented with open-ended structured interviews conducted with 16 girls during lockdown.

Results: During the period of lockdown and school closures, pupils tried new forms of PA and undertook PA with family, but there was no significant change in self-reported PA. There was a decline in health-related quality of life and motivation for exercise; however, self-efficacy for walking and happiness with appearance increased. There was no change in sleep quality or social media usage.

Conclusions: Despite the many challenges that schools face as they reopen, there is a need to continue to prioritize PA and motivation for exercise to support health and well-being in adolescent girls.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jpah.2020-0649DOI Listing
May 2021

Revisiting mouse minute virus inactivation by high temperature short time treatment.

Biotechnol Bioeng 2021 08 8;118(8):2967-2976. Epub 2021 Jun 8.

Bioproduct Research and Development, Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana, USA.

In recent years, high temperature short time (HTST) treatment technology has been increasingly adopted for medium treatment to mitigate the potential risk of viral contamination in mammalian cell culture GMP manufacturing facilities. Mouse minute virus (MMV), also called minute virus of mice (MVM), implicated in multiple viral contamination events is commonly used as a relevant model virus to assess the effectiveness of HTST treatment of cell culture media. However, results from different studies vary broadly in inactivation kinetics as well as log reduction factors (LRFs) achieved under given treatment conditions. To determine whether the reported discrepancies stemmed from differences in MMV strains, laboratory-scale HTST devices, medium matrices, and/or experimental designs, we have taken a collaborative approach to systematically assess the effectiveness of HTST treatment for MMV inactivation. This effort was conceptualized based on a media treatment gap analysis conducted by the Consortium on Adventitious Agent Contamination in Biomanufacturing (CAACB) under the MIT Center for Biomedical Innovation (CBI). Specifically, two different MMV strains were used to evaluate the effectiveness of HTST at various treatment conditions with regard to exposure temperature and hold time duration by two independent laboratories within two different companies. To minimize experimental variations, the two sites used the same batches of MMV stocks, the same commercially purchased medium, and the same model of thermocyclers as the laboratory-scale HTST device. The two independent laboratories yielded similar MMV inactivation kinetics and comparable LRF. No significant differences were observed between the two MMV strains evaluated, suggesting that the variations from prior studies were likely due to differences in equipment, medium matrices, or other factors. The data presented here indicate that MMV inactivation by HTST treatment obeys first-order kinetics and can be mathematically modeled using an Arrhenius equation. The model-based extrapolation provides a quantitative estimate of MMV inactivation by the current industry standard HTST condition (102°C for a hold time of 10 s) used for medium treatment. Finally, based on the data from the current study and the industry experience, it is recommended that any alternative virus barrier technologies adopted for medium treatment should provide a clearance of at least 3.0 LRF based on a worst-case model virus to effectively mitigate potential risks of viral contamination.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/bit.27805DOI Listing
August 2021

Effects of COVID-19 Lockdown on Adherence to Individual Home- or Gym-Based Exercise Training among Women with Postmenopausal Osteoporosis.

Int J Environ Res Public Health 2021 03 2;18(5). Epub 2021 Mar 2.

Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d'Augusto 237, 47921 Rimini, Italy.

Adherence is important for an exercise program's efficacy. This study aims at investigating whether the COVID-19 lockdown had different consequences on the adherence to an exercise program specifically designed for women with postmenopausal osteoporosis when administered as individual home training (IHT) or gym group training (GGT). At the start of the lockdown, which imposed the temporary closure of any gym activities, GGT participants were invited to continue to exercise at home. IHT participants continued to exercise at home as usual. Adherence was recorded via logs and measured as the percentage of exercise sessions actually performed out of the total number of scheduled sessions in three 1-month periods: one before (PRE) and two after (M1 and M2) the beginning of lockdown. Before lockdown, IHT (66.8% ± 26.6) and GGT (76.3% ± 26.6) adherence were similar. During lockdown, IHT participation increased (M1: 81.5% ± 31.0; M2: 88.0% ± 28.3), while that of GGT showed no statistical differences (M1: 79.4% ± 34.2; M2: 80.6% ± 36.4). Exercise protocols based on supervised gym practice must consider the possibility of disruptive events, which could cause a sudden interruption of gym activity and include educational initiatives to instruct participants to exercise effectively and safely without a trainer's direct supervision.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph18052441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967569PMC
March 2021

Children's perspectives and experiences of health, diet, physical activity and weight in an urban, multi-ethnic UK population: A qualitative study.

Child Care Health Dev 2021 Sep 23;47(5):597-607. Epub 2021 Mar 23.

School of Nursing, Midwifery and Health, Coventry University, Coventry, UK.

Background: Children from Black and South Asian ethnic groups are at risk for childhood obesity in the United Kingdom. To inform local action for childhood obesity prevention, it is crucial to explore the basis of ethnic disparities and consider the perspectives of children. This study aimed to understand cultural and contextual factors influencing childhood obesity in an ethnically diverse population using child-centred methodology.

Methods: 'Draw, write and tell' interviews were held with children aged 9-10 years in Coventry, an urban, multi-ethnic city in the United Kingdom. Data were analysed thematically using framework analysis.

Results: Twenty-six children participated (85% from Black or minority ethnic groups). Children's perspectives revealed universal themes around health, diet, physical activity and weight and highlighted issues specific to ethnic groups and those living in deprived areas. An underlying feature was weight-based stigmatization and group stereotyping, and an emphasis on internal factors as the cause of obesity. Children described some experiences of social disadvantage but did not regard these as a barrier to being physically active. Children identified cultural or religious practices or experiences of migration that influenced diet and physical activity.

Conclusions: These findings allow a broad range of children's perspectives to inform future intervention design. In addition, the study was able to identify the many similarities and small amount of diversity in children's perspectives across ethnic groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/cch.12867DOI Listing
September 2021

Detraining Effects on Musculoskeletal Parameters in Early Postmenopausal Osteopenic Women: 3-Month Follow-Up of the Randomized Controlled ACTLIFE Study.

Calcif Tissue Int 2021 07 12;109(1):1-11. Epub 2021 Mar 12.

Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Henkestrasse 91, 91052, Erlangen, Germany.

Periods of absence from supervised group exercise while maintaining physical activity might be a frequent pattern in adults' exercise habits. The aim of the present study was to determine detraining effects on musculoskeletal outcomes after a 3-month detraining period in early post-menopausal, osteopenic women. Due to the COVID-19 pandemic, we terminated the 18-month randomized controlled ACTLIFE exercise intervention immediately after the 13-month follow-up assessment. This put an abrupt stop to the high-intensity aerobic and resistance group exercise sessions undertaken three times per week by the exercise group (EG: n = 27) and the gentle exercise program performed once per week for the attention control group (CG: n = 27); but both groups were permitted to conduct individual outdoor activity for the 3-month lock-down period. Study endpoints were lean body mass (LBM), bone mineral density (BMD) at the lumbar spine (LS), maximum hip-/leg extension strength and power. Detraining-induced reductions of LBM, hip/leg strength and power (but not BMD-LS) were significantly greater (p < 0.001 to p = 0.044) compared with the CG. Significant exercise effects, i.e. differences between EG and CG, present after 13 months of exercise, were lost after 3 months of detraining for LBM (p = 0.157) and BMD-LS (p = 0.065), but not for strength (p < 0.001) and power (p < 0.001). Of note, self-reported individual outdoor activities and exercise increased by about 40% in both groups during the lock-down period. Three months' absence from a supervised group exercise protocol resulted in considerable detraining effects for musculoskeletal parameters. Thus, exercise programs for adults should be continuous rather than intermittent.Trial registration number: ClinicalTrials.gov: NCT04420806, 06.05.2020.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00223-021-00829-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954366PMC
July 2021

Development and Feasibility of a Family-Based Health Behavior Intervention Using Intelligent Personal Assistants: Randomized Controlled Trial.

JMIR Form Res 2021 Jan 28;5(1):e17501. Epub 2021 Jan 28.

Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom.

Background: Intelligent personal assistants such as Amazon Echo and Google Home have become increasingly integrated into the home setting and, therefore, may facilitate behavior change via novel interactions or as an adjunct to conventional interventions. However, little is currently known about their potential role in this context.

Objective: This feasibility study aims to develop the Intelligent Personal Assistant Project (IPAP) and assess the acceptability and feasibility of this technology for promoting and maintaining physical activity and other health-related behaviors in both parents and children.

Methods: This pilot feasibility study was conducted in 2 phases. For phase 1, families who were attending a community-based weight management project were invited to participate, whereas phase 2 recruited families not currently receiving any additional intervention. Families were randomly allocated to either the intervention group (received a smart speaker for use in the family home) or the control group. The IPAP intervention aimed to promote positive health behaviors in the family setting through utilization of the functions of a smart speaker and its linked intelligent personal assistant. Data were collected on recruitment, retention, outcome measures, intervention acceptability, device interactions, and usage.

Results: In total, 26 families with at least one child aged 5 to 12 years were recruited, with 23 families retained at follow-up. Across phase 1 of the intervention, families interacted with the intelligent personal assistant a total of 65 times. Although device interactions across phase 2 of the intervention were much higher (312 times), only 10.9% (34/312) of interactions were coded as relevant (related to diet, physical activity or well-being). Focus groups highlighted that the families found the devices acceptable and easy to use and felt that the prompts or reminders were useful in prompting healthier behaviors. Some further intervention refinements in relation to the timing of prompts and integrating feedback alongside the devices were suggested by families.

Conclusions: Using intelligent personal assistants to deliver health-related messages and information within the home is feasible, with high levels of engagement reported by participating families. This novel feasibility study highlights important methodological considerations that should inform future trials testing the effectiveness of intelligent personal assistants in promoting positive health-related behaviors.

Trial Registration: ISRCTN Registry ISRCTN16792534; http://www.isrctn.com/ISRCTN16792534.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/17501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878108PMC
January 2021

Changes in Menopausal Risk Factors in Early Postmenopausal Osteopenic Women After 13 Months of High-Intensity Exercise: The Randomized Controlled ACTLIFE-RCT.

Clin Interv Aging 2021 11;16:83-96. Epub 2021 Jan 11.

Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.

The menopausal transition is a critical period in women's lives. Exercise might be the most promising non-pharmaceutic intervention to address the large variety of risk factors related to the pronounced estradiol decline during peri- and early-postmenopause. The aim of this study was to determine the effect of an 18-month multipurpose exercise program on risk factors and symptoms related to the menopausal transition. Fifty-four women 1-5 years postmenopause with osteopenia or osteoporosis were randomly assigned 1) to a high impact weight-bearing/high-intensity/velocity resistance training group (EG: n=27) exercising three times a week or 2) to an attendance control group (CG: n=27) that performed low-intensity exercise once a week. Both groups were supplemented with cholecalciferol and calcium. The primary study endpoint was bone mineral density (BMD) at lumbar spine (LS) and total hip, secondary outcomes were lean body mass (LBM), total and abdominal body percentage, metabolic syndrome Z-Score (MetS-Z), menopausal symptoms and muscle strength and power. Due to COVID-19, the study was stopped after 13 months. We observed significant effects for BMD-LS (EG: 0.002±.018 versus CG: -.009±0.018 mg/cm2, p=0.027) but not for BMD total hip (EG: -0.01±.016 versus CG: -.009±0.020 mg/cm2, p=0.129). LBM improved significantly in the EG and decreased in the CG (0.39±1.08 vs -0.37±1.34 kg, p=0.026). Total and abdominal body fat improved significantly in the EG and was maintained in the CG (-1.44±1.49 vs -0.02±1.55 kg, p=0.002 and -1.50±2.33 vs 0.08±2.07 kg, p=0.011). Significant effects in favor of the EG were also determined for menopausal symptoms (p=0.029), hip/leg extension strength (p<0.001) and power (p<0.001). However, changes of the MetS-Z did not differ significantly (p=0.149) between EG and CG. In summary, with minor exceptions, we demonstrated the effectiveness of a multipurpose exercise protocol dedicated to early-postmenopausal women on various risk factors and complaints related to the menopausal transition.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/CIA.S283177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810823PMC
January 2021

Untapping the Health Enhancing Potential of Vigorous Intermittent Lifestyle Physical Activity (VILPA): Rationale, Scoping Review, and a 4-Pillar Research Framework.

Sports Med 2021 01;51(1):1-10

Department of Kinesiology, McMaster University, Hamilton, ON, Canada.

Recently revised public health guidelines acknowledge the health benefits of regular intermittent bouts of vigorous intensity incidental physical activity done as part of daily living, such as carrying shopping bags, walking uphill, and stair climbing. Despite this recognition and the advantages such lifestyle physical activity has over continuous vigorous intensity structured exercise, a scoping review we conducted revealed that current research in this area is, at best, rudimentary. Key gaps include the absence of an empirically-derived dose specification (e.g., minimum duration of lifestyle physical activity required to achieve absolute or relative vigorous intensity), lack of acceptable measurement standards, limited understanding of acute and chronic (adaptive) effects of intermittent vigorous bouts on health, and paucity of essential information necessary to develop feasible and scalable interventions (e.g., acceptability of this kind of physical activity by the public). To encourage collaboration and research agenda alignment among groups interested in this field, we propose a research framework to further understanding of vigorous intermittent lifestyle physical activity (VILPA). This framework comprises four pillars aimed at the development of: (a) an empirical definition of VILPA, (b) methods to reliably and accurately measure VILPA, (c) approaches to examine the short and long-term dose-response effects of VILPA, and (d) scalable and acceptable behavioural VILPA-promoting interventions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40279-020-01368-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806564PMC
January 2021

The Food provision, cUlture and Environment in secondary schooLs (FUEL) study: protocol of a mixed methods evaluation of national School Food Standards implementation in secondary schools and their impact on pupils' dietary intake and dental health.

BMJ Open 2020 10 16;10(10):e042931. Epub 2020 Oct 16.

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Introduction: Excess free sugar intake is associated with obesity and poor dental health. Adolescents consume substantially more free sugar than is recommended. National (UK) School Food Standards (SFS) are in place but are not mandatory in all schools, and their impact on the diets of secondary school pupils is unknown. We aim to evaluate how SFS and wider healthy eating recommendations (from the national School Food Plan (SFP)) are implemented in secondary schools and how they influence pupils' diets and dental health.

Methods And Analysis: Secondary-level academies/free schools in the West Midlands, UK were divided into two groups: SFS mandated and SFS non-mandated. Using propensity scores to guide sampling, we aim to recruit 22 schools in each group. We will compare data on school food provision and sales, school food culture and environment, and the food curriculum from each group, collected through: school staff, governor, pupil, parent surveys; school documents; and observation. We will explore the implementation level for the SFS requirements and SFP recommendations and develop a school food typology. We aim to recruit 1980 pupils aged 11-15 years across the 44 schools and collect dietary intake (24-hour recall) and dental health data through self-completion surveys. We will compare free sugar/other dietary intake and dental health across the two SFS groups and across the identified school types. School type will be further characterised in 4-8 case study schools through school staff interviews and pupil focus groups. Evaluation of economic impact will be through a cost-consequence analysis and an exploratory cost-utility analysis.

Ethics And Dissemination: Ethical approval was obtained from the University of Birmingham Ethical Review Committee (ERN_18-1738). Findings will be disseminated to key national and local agencies, schools and the public through reports, presentations, the media and open access publications.

Trial Registration Number: ISRCTN 68757496 (registered 17 October 2019).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-042931DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569925PMC
October 2020

Outdoor Walking Speeds of Apparently Healthy Adults: A Systematic Review and Meta-analysis.

Sports Med 2021 Jan;51(1):125-141

Ulster University, Newtownabbey, UK.

Background: Walking outdoors can be used by many individuals to meet public health guidelines for moderate-to-vigorous-intensity physical activity. The speed at which adults walk may be a proxy for intensity. Traditional estimates of indoor walking speed are unlikely to reflect self-selected usual or other instructed paces of outdoor walking speed.

Objective: To inform estimates of pace-based walking speed of apparently healthy adults in outdoor settings.

Methods: We searched four electronic databases for articles published in English between January 1970 and March 2019. Studies that reported walking speed (m/s), cadence (steps/min), or intensity (mL/kg/min) of ambulatory, apparently healthy, and community-dwelling adults (> 18 years) were included. Walking speed categories were defined according to the description provided in each study. Meta-analysis was used to synthesise speed, cadence, and intensity data by slow, usual, medium, fast, and maximal pace (where reported).

Results: Thirty-five studies, representing 14,015 participants (6808 women, 5135 men, and 2072 sex not specified), were identified. The mean (95% CI) walking speed for slow, usual, medium, fast, and maximal pace was 0.82 (0.77-0.86), 1.31 (1.27-1.35), 1.47 (1.44-1.49), 1.72 (1.64-1.81), and 1.62 (1.45-1.79) m/s, respectively. Mean cadence (95% CI) for usual and fast paces were 116.65 (114.95-118.35) and 126.75 (121.87-131.63) steps/min, respectively. The mean oxygen consumption (95% CI) for the usual and medium paces was 11.97 (11.69-12.25) and 13.34 (12.94-13.73) mL/kg/min, respectively.

Conclusion: These findings provide greater clarity with regard to how various indicators of enacted walking pace, speed, and intensity overlap and how each can be best communicated in the real-world setting to optimise health-related outcomes. Pace-based instructions can be used to support walking in outdoor settings within public health guidelines.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s40279-020-01351-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806575PMC
January 2021

Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study.

Int J Environ Res Public Health 2020 09 19;17(18). Epub 2020 Sep 19.

Centre for Exercise Medicine, Physical Activity and Health, Sport and Exercise Sciences Research Institute, Ulster University Jordanstown Campus, Shore Road, BT37 0QB Newtownabbey, Ireland.

Internationally, insufficient physical activity (PA) is a major health concern. Children in Northern Ireland (NI) are recorded as having the lowest levels of PA in the United Kingdom (UK). To date, validated and representative data on the PA levels of NI school children are limited. The aim of this study was to provide surveillance data on self-reported PA, sport and physical education (PE) participation of school children in NI. Differences between genders and factors associated with PA were also examined. A representative sample of primary ( = 446) and post-primary ( = 1508) children was surveyed in school using validated self-report measures. Findings suggest that PA levels are low, with a minority of children (13%) meeting the PA guidelines (primary pupils 20%, post-primary pupils 11%). NI school children have lower levels of PA, PE and sports participation than UK and European peers. A trend of age-related decline across all the domains of PA was apparent. The data presented highlighted that females are less likely to achieve PA guidelines, children from lower socio-economic background participate in school and community sport less often, and that enjoyment and social support are important variables in PA adherence. Policy solutions that would support implementation e.g., mandatory minimum PE time, whole school approaches to PA promotion and targeted investment in schools, particularly in areas of deprivation and for females, are suggested.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17186849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559058PMC
September 2020

The Influence of Role Models on the Sedentary Behaviour Patterns of Primary School-Aged Children and Associations with Psychosocial Aspects of Health.

Int J Environ Res Public Health 2020 07 24;17(15). Epub 2020 Jul 24.

School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, UK.

Background: High levels of sedentary behaviour (SB) are associated with poor health outcomes in children, but the effects on mental health are less clear. This study explored the relationship between SB and psychosocial aspects of health in children, and what influence key role models, including parents and schoolteachers, have on the SB levels of children.

Methods: Physical activity (PA) and SB were measured using accelerometery in 101 children, 113 parents and 9 teachers. Children were aged 9 or 10 years old and in fourth grade. Child psychosocial outcomes were assessed using the Rosenberg Self-Esteem Scale and the Strengths and Difficulties Questionnaire.

Results: Children engaged in a high volume of SB (9.6 h/day) but interrupted SB often. They accumulated less than 11,000 steps per day, and thus, many may not meet the recommended daily levels of PA. No associations were found between child SB and teacher SB during the school day or child SB and parent SB during the after-school period. No association was found between SB and self-esteem, although children with a higher body mass index had a higher number of emotional and behavioural difficulties.

Conclusions: Although there was no indication that children's SB was linked to that of parents and teachers, or that SB was associated with self-esteem or behavioural problems, school children were highly sedentary and insufficiently physically active. Therefore, there is a need to explore school practices and curriculum delivery methods, as well as school and home environments, to reduce the volume of SB children engage in.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ijerph17155345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432808PMC
July 2020

Interventions outside the workplace for reducing sedentary behaviour in adults under 60 years of age.

Cochrane Database Syst Rev 2020 07 17;7:CD012554. Epub 2020 Jul 17.

Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.

Background: Adults spend a majority of their time outside the workplace being sedentary. Large amounts of sedentary behaviour increase the risk of type 2 diabetes, cardiovascular disease, and both all-cause and cardiovascular disease mortality.

Objectives: Primary • To assess effects on sedentary time of non-occupational interventions for reducing sedentary behaviour in adults under 60 years of age Secondary • To describe other health effects and adverse events or unintended consequences of these interventions • To determine whether specific components of interventions are associated with changes in sedentary behaviour • To identify if there are any differential effects of interventions based on health inequalities (e.g. age, sex, income, employment) SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, PsycINFO, SportDiscus, and ClinicalTrials.gov on 14 April 2020. We checked references of included studies, conducted forward citation searching, and contacted authors in the field to identify additional studies.

Selection Criteria: We included randomised controlled trials (RCTs) and cluster RCTs of interventions outside the workplace for community-dwelling adults aged 18 to 59 years. We included studies only when the intervention had a specific aim or component to change sedentary behaviour.

Data Collection And Analysis: Two review authors independently screened titles/abstracts and full-text articles for study eligibility. Two review authors independently extracted data and assessed risk of bias. We contacted trial authors for additional information or data when required. We examined the following primary outcomes: device-measured sedentary time, self-report sitting time, self-report TV viewing time, and breaks in sedentary time.

Main Results: We included 13 trials involving 1770 participants, all undertaken in high-income countries. Ten were RCTs and three were cluster RCTs. The mean age of study participants ranged from 20 to 41 years. A majority of participants were female. All interventions were delivered at the individual level. Intervention components included personal monitoring devices, information or education, counselling, and prompts to reduce sedentary behaviour. We judged no study to be at low risk of bias across all domains. Seven studies were at high risk of bias for blinding of outcome assessment due to use of self-report outcomes measures. Primary outcomes Interventions outside the workplace probably show little or no difference in device-measured sedentary time in the short term (mean difference (MD) -8.36 min/d, 95% confidence interval (CI) -27.12 to 10.40; 4 studies; I² = 0%; moderate-certainty evidence). We are uncertain whether interventions reduce device-measured sedentary time in the medium term (MD -51.37 min/d, 95% CI -126.34 to 23.59; 3 studies; I² = 84%; very low-certainty evidence) We are uncertain whether interventions outside the workplace reduce self-report sitting time in the short term (MD -64.12 min/d, 95% CI -260.91 to 132.67; I² = 86%; very low-certainty evidence). Interventions outside the workplace may show little or no difference in self-report TV viewing time in the medium term (MD -12.45 min/d, 95% CI -50.40 to 25.49; 2 studies; I² = 86%; low-certainty evidence) or in the long term (MD 0.30 min/d, 95% CI -0.63 to 1.23; 2 studies; I² = 0%; low-certainty evidence). It was not possible to pool the five studies that reported breaks in sedentary time given the variation in definitions used. Secondary outcomes Interventions outside the workplace probably have little or no difference on body mass index in the medium term (MD -0.25 kg/m², 95% CI -0.48 to -0.01; 3 studies; I² = 0%; moderate-certainty evidence). Interventions may have little or no difference in waist circumference in the medium term (MD -2.04 cm, 95% CI -9.06 to 4.98; 2 studies; I² = 65%; low-certainty evidence). Interventions probably have little or no difference on glucose in the short term (MD -0.18 mmol/L, 95% CI -0.30 to -0.06; 2 studies; I² = 0%; moderate-certainty evidence) and medium term (MD -0.08 mmol/L, 95% CI -0.21 to 0.05; 2 studies, I² = 0%; moderate-certainty evidence) Interventions outside the workplace may have little or no difference in device-measured MVPA in the short term (MD 1.99 min/d, 95% CI -4.27 to 8.25; 4 studies; I² = 23%; low-certainty evidence). We are uncertain whether interventions improve device-measured MVPA in the medium term (MD 6.59 min/d, 95% CI -7.35 to 20.53; 3 studies; I² = 70%; very low-certainty evidence). We are uncertain whether interventions outside the workplace improve self-reported light-intensity PA in the short-term (MD 156.32 min/d, 95% CI 34.34 to 278.31; 2 studies; I² = 79%; very low-certainty evidence). Interventions may have little or no difference on step count in the short-term (MD 226.90 steps/day, 95% CI -519.78 to 973.59; 3 studies; I² = 0%; low-certainty evidence) No data on adverse events or symptoms were reported in the included studies.

Authors' Conclusions: Interventions outside the workplace to reduce sedentary behaviour probably lead to little or no difference in device-measured sedentary time in the short term, and we are uncertain if they reduce device-measured sedentary time in the medium term. We are uncertain whether interventions outside the workplace reduce self-reported sitting time in the short term. Interventions outside the workplace may result in little or no difference in self-report TV viewing time in the medium or long term. The certainty of evidence is moderate to very low, mainly due to concerns about risk of bias, inconsistent findings, and imprecise results. Future studies should be of longer duration; should recruit participants from varying age, socioeconomic, or ethnic groups; and should gather quality of life, cost-effectiveness, and adverse event data. We strongly recommend that standard methods of data preparation and analysis are adopted to allow comparison of the effects of interventions to reduce sedentary behaviour.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/14651858.CD012554.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7389819PMC
July 2020

Clusters of Adolescent Physical Activity Tracker Patterns and Their Associations With Physical Activity Behaviors in Finland and Ireland: Cross-Sectional Study.

J Med Internet Res 2020 09 1;22(9):e18509. Epub 2020 Sep 1.

Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.

Background: Physical activity trackers (PATs) such as apps and wearable devices (eg, sports watches, heart rate monitors) are increasingly being used by young adolescents. Despite the potential of PATs to help monitor and improve moderate-to-vigorous physical activity (MVPA) behaviors, there is a lack of research that confirms an association between PAT ownership or use and physical activity behaviors at the population level.

Objective: The purpose of this study was to examine the ownership and use of PATs in youth and their associations with physical activity behaviors, including daily MVPA, sports club membership, and active travel, in 2 nationally representative samples of young adolescent males and females in Finland and Ireland.

Methods: Comparable data were gathered in the 2018 Finnish School-aged Physical Activity (F-SPA 2018, n=3311) and the 2018 Irish Children's Sport Participation and Physical Activity (CSPPA 2018, n=4797) studies. A cluster analysis was performed to obtain the patterns of PAT ownership and usage by adolescents (age, 11-15 years). Four similar clusters were identified across Finnish and Irish adolescents: (1) no PATs, (2) PAT owners, (3) app users, and (4) wearable device users. Adjusted binary logistic regression analyses were used to evaluate how PAT clusters were associated with physical activity behaviors, including daily MVPA, membership of sports clubs, and active travel, after stratification by gender.

Results: The proportion of app ownership among Finnish adolescents (2038/3311, 61.6%) was almost double that of their Irish counterparts (1738/4797, 36.2%). Despite these differences, the clustering patterns of PATs were similar between the 2 countries. App users were more likely to take part in daily MVPA (males, odds ratio [OR] 1.27, 95% CI 1.04-1.55; females, OR 1.49, 95% CI 1.20-1.85) and be members of sports clubs (males, OR 1.37, 95% CI 1.15-1.62; females, OR 1.25, 95% CI 1.07-1.50) compared to the no PATs cluster, after adjusting for country, age, family affluence, and disabilities. These associations, after the same adjustments, were even stronger for wearable device users to participate in daily MVPA (males, OR 1.83, 95% CI 1.49-2.23; females, OR 2.25, 95% CI 1.80-2.82) and be members of sports clubs (males, OR 1.88, 95% CI 1.55-2.88; females, OR 2.07, 95% CI 1.71-2.52). Significant associations were observed between male users of wearable devices and taking part in active travel behavior (OR 1.39, 95% CI 1.04-1.86).

Conclusions: Although Finnish adolescents report more ownership of PATs than Irish adolescents, the patterns of use and ownership remain similar among the cohorts. The findings of our study show that physical activity behaviors were positively associated with wearable device users and app users. These findings were similar between males and females. Given the cross-sectional nature of this data, the relationship between using apps or wearable devices and enhancing physical activity behaviors requires further investigation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/18509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492981PMC
September 2020

Effect of Exercise Training on Bone Mineral Density in Post-menopausal Women: A Systematic Review and Meta-Analysis of Intervention Studies.

Front Physiol 2020 23;11:652. Epub 2020 Jun 23.

Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany.

Osteoporosis is a major health problem in post-menopausal women (PMW). Exercise training is considered a cost-effective strategy to prevent osteoporosis in middle aged-older people. The purpose of this study is to summarize the effect of exercise on BMD among PMW. A comprehensive search of electronic databases was conducted through PubMed, Scopus, Web of Science, Cochrane, Science Direct, Eric, ProQuest, and Primo. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) femoral neck (FN) and/or total hip were considered as outcome measures. After subgroup categorization, statistical methods were used to combine data and compare subgroups. Seventy-five studies were included. The pooled number of participants was 5,300 (intervention group: = 2,901, control group: = 2,399). The pooled estimate of random effect analysis was SMD = 0.37, 95%-CI: 0.25-0.50, SMD = 0.33, 95%-CI: 0.23-0.43, and SMD = 0.40, 95%-CI: 0.28-0.51 for LS, FN, and total Hip-BMD, respectively. In the present meta-analysis, there was a significant ( < 0.001), but rather low effect (SMD = 0.33-0.40) of exercise on BMD at LS and proximal femur. A large variation among the single study findings was observed, with highly effective studies but also studies that trigger significant negative results. These findings can be largely attributed to differences among the exercise protocols of the studies. Findings suggest that the true effect of exercise on BMD is diluted by a considerable amount of studies with inadequate exercise protocols.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fphys.2020.00652DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325605PMC
June 2020

Group Versus Standard Behavioral Couples' Therapy for Alcohol Use Disorder Patients: Cost-Effectiveness.

J Stud Alcohol Drugs 2020 03;81(2):152-163

AdCare Hospital of Worcester, Worcester, Massachusetts.

Objective: The purpose of this study was to evaluate the costs and cost-effectiveness of two treatments for 101 alcohol use disorder patients and their intimate partners--group behavioral couples' therapy plus individual-based treatment (G-BCT), or standard behavioral couples' therapy plus individual-based treatment (S-BCT).

Method: We estimated the per-patient cost of each intervention using a microcosting approach that allowed us to estimate costs of specific components in each intervention as well as the overall total costs. Using simple means analysis and multiple regression models, we estimated the incremental effectiveness of G-BCT relative to S-BCT. Immediately after treatment and 12 months after treatment, we computed incremental cost-effectiveness ratios (ICER) and cost-effectiveness acceptability curves for percentage days abstinent, adverse consequences of alcohol and drugs, and overall relationship functioning.

Results: The average per-patient cost of delivering G-BCT was $674, significantly less than the cost of S-BCT ($831). However, 12 months after treatment, S-BCT participants performed better on all outcomes compared with those in G-BCT, and the calculated ICER moving from G-BCT to S-BCT ranged from $10 to $12 across these outcomes. The current findings indicated that, except at very low willingness-to-pay values, S-BCT is a cost-effective option relative to G-BCT when considering 12-month posttreatment outcomes.

Conclusions: As expected, G-BCT was delivered at a lower cost per patient than S-BCT; however, S-BCT performed better over time on the clinical outcomes studied. These economic findings indicate that alcohol use disorder treatment providers should seriously consider S-BCT over G-BCT when deciding what format to use in behavioral couples' therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201207PMC
March 2020

Viral contamination in biologic manufacture and implications for emerging therapies.

Nat Biotechnol 2020 05 27;38(5):563-572. Epub 2020 Apr 27.

Novartis, Basel, Switzerland.

Recombinant protein therapeutics, vaccines, and plasma products have a long record of safety. However, the use of cell culture to produce recombinant proteins is still susceptible to contamination with viruses. These contaminations cost millions of dollars to recover from, can lead to patients not receiving therapies, and are very rare, which makes learning from past events difficult. A consortium of biotech companies, together with the Massachusetts Institute of Technology, has convened to collect data on these events. This industry-wide study provides insights into the most common viral contaminants, the source of those contaminants, the cell lines affected, corrective actions, as well as the impact of such events. These results have implications for the safe and effective production of not just current products, but also emerging cell and gene therapies which have shown much therapeutic promise.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41587-020-0507-2DOI Listing
May 2020

A study protocol for a clustered randomised controlled trial to evaluate the effectiveness of a peer-led school-based walking intervention on adolescent girls' physical activity: the Walking In ScHools (WISH) study.

BMC Public Health 2020 Apr 21;20(1):541. Epub 2020 Apr 21.

Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, University of Ulster, Jordanstown Campus, Newtownabbey, BT37 0QB, UK.

Background: Adolescent girls in the UK and Ireland are failing to meet current physical activity guidelines. Physical activity behaviours track from childhood to adulthood and it is important that adolescent girls are provided with opportunities to be physically active. Walking has been a central focus for physical activity promotion in adults and may effectively increase physical activity levels among younger people. Following on from a pilot feasibility trial, the purpose of this cluster randomised controlled trial (c-RCT) is to evaluate the effectiveness of a novel, low-cost, peer-led school-based walking intervention delivered across the school year at increasing physical activity levels of adolescent girls.

Methods: The Walking In ScHools (WISH) Study is a school-based c-RCT conducted with girls aged 12-14 years from eighteen schools across the Border Region of Ireland / Northern Ireland. Following baseline data collection, schools will be randomly allocated to intervention or control group. In intervention schools, female pupils aged 15-18 years will be invited to train as walk leaders and will lead younger pupils in 10-15 min walks before school, at break and lunch recess. All walks will take place in school grounds and pupils will be encouraged to participate in as many walks as possible each week. The intervention will be delivered for the whole school year (minimum 20-22 weeks). The primary outcome measure is accelerometer-measured total physical activity (counts per minute) (end of intervention). Secondary outcomes will include time spent in sedentary behaviour, light, moderate and vigorous intensity physical activity, anthropometry measures, social media usage and sleep. A mixed-methods process evaluation will also be undertaken.

Discussion: The WISH Study will examine the effectiveness of a low-cost, school-based, peer-led walking intervention in increasing physical activity in adolescent girls when delivered across the school year. If the intervention increases physical activity, it would benefit adolescent girls in the defined target area with potential for wider adoption by schools across the UK and Ireland.

Trial Registration: ISRCTN; ISRCTN12847782; Registered 2nd July 2019.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12889-020-08600-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171742PMC
April 2020
-->