Participation in Physical Education Classes and Health-Related Behaviours among Adolescents from 67 Countries

The present study sought to examine the associations between participation in physical education (PE) classes and a range of health-related behaviours among adolescents. Secondary analysis of self-reported data from the Global Student Health Survey, collected between 2010 and 2017 from 222,121 adolescents (N = 117,914 girls; 49.0%; aged 13–17 years) from 67 countries and five world regions, was carried out. Participation in PE classes (0, 1–2, ≥3 days/week) was the independent variable. Physical activity (PA); sedentary behaviour (SB); active travel to school; fruit, vegetables, and alcohol consumption; and smoking; as well as adopting ≥5 of these healthy behaviours; were the dependent variables. Complex samples logistic regressions were performed to explore the associations between participation in PE classes and health-related behaviours. The results revealed that 18.2% of adolescents did not take part in PE classes. A total of 56.7% and 25.1% of adolescents reported participating in PE classes on 1–2 and ≥3 days/week, respectively. Only 26.8% of adolescents adopted ≥5 healthy behaviours. Participation in PE classes was positively associated with PA, active travel, fruit consumption, and vegetable consumption (only for ≥3 days/week), but was negatively associated with meeting SB recommendations, and with not smoking (only for girls and ≥3 days/week). Overall, PE participation was positively associated with adopting ≥5 healthy behaviours, with favourable results found for those who attended more PE classes. The findings revealed a positive association between participation in PE classes and a range of health-related behaviours among adolescents. This suggests that, worldwide, quality PE should be delivered at least 3 days per week up to daily to promote healthy lifestyles among adolescents.

“i Did Whatever They Wanted Me to Do”: a Qualitative Secondary Analysis Using Reproductive Justice to Explore Sexual Violence Among Justice-involved Latina Mothers

Background: One in three women experience sexual violence during their lifetime; however, little is known about this phenomenon with respect to justice-involved Latina mothers. Using the reproductive justice framework as a theoretical lens, we examined sexual violence in Latina mothers who had experienced incarceration and were thus involved in the justice system.Methods: This was a secondary analysis of a qualitative data set. The reproductive justice framework provided a theoretical lens for examining the women’s rights to bodily autonomy, to have or not have children, and to live in safe, sustainable environments given the intersection of incarceration and sexual violence.Results: Women (N = 12) recounted their experiences of sexual violence after having been incarcerated. Incarceration and resulting sexual violence led to discrimination, limited bodily autonomy, sexual exploitation, substance use, depression, anxiety, re-traumatization, recidivism, underreporting of violence, underutilization of healthcare resources, strained relationships, family separation, and unsafe environments. Conclusions: More research is needed to understand the social, economic, and political contexts that perpetuate sexual violence among justice-involved women. Universal healthcare, participatory research, changing cultural mindsets, decriminalization of sex work, and more comprehensive tracking and prosecution of sexual predators may be key to ending sexual violence in justice-involved mothers.

Disparities in Oral Nutritional Supplement Usage and Dispensing Patterns across Primary Care in Ireland: ONSPres Project

When treating malnutrition, oral nutritional supplements (ONSs) are advised when optimising the diet is insufficient; however, ONS usage and user characteristics have not been previously analysed. A retrospective secondary analysis was performed on dispensed pharmacy claim data for 14,282 anonymised adult patients in primary care in Ireland in 2018. Patient sex, age, residential status, ONS volume (units) and ONS cost (EUR) were analysed. The categories of ‘Moderate’ (<75th centile), ‘High’ (75th–89th centile) and ‘Very High’ ONS users (≥90th centile) were created. The analyses among groups utilised t-tests, Mann–Whitney U tests and chi-squared tests. This cohort was 58.2% female, median age was 76 years, with 18.7% in residential care. The most frequently dispensed ONS type was very-high-energy sip feeds (45% of cohort). Younger males were dispensed more ONSs than females (<65 years: median units, 136 vs. 90; p < 0.01). Patients living independently were dispensed half the volume of those in residential care (112 vs. 240 units; p < 0.01). ‘Moderate’ ONS users were dispensed a yearly median of 84 ONS units (median cost, EUR 153), ‘High’ users were dispensed 420 units (EUR 806) and ‘Very High’ users 892 yearly units (EUR 2402; p < 0.01). Further analyses should focus on elucidating the reasons for high ONS usage in residential care patients and younger males.

Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial

OBJECTIVE: To conduct <i>post-hoc</i> secondary analysis examining the association between change in physical activity (PA), measured with self-report and accelerometry, from baseline to 1 and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial. <p>RESEARCH DESIGN AND METHODS: Participants were adults with overweight/obesity and type 2 diabetes with PA data at baseline and year 1 or 4 (n = 1,978). Participants were randomized to diabetes support and education or intensive lifestyle intervention. Measures included accelerometry-measured moderate-to-vigorous PA (MVPA), self-reported PA, and composite (morbidity and mortality) CVD outcomes.</p> <p>RESULTS: In pooled analyses of all participants, using Cox proportional hazards models, each 100 MET-min/wk increase in accelerometry-measured MVPA from baseline to 4 years was associated with decreased risk of the subsequent primary composite outcome of CVD. Results were consistent for changes in total MVPA [HR=0.97 (95% CI: 0.95, 0.99)] and MVPA accumulated in <u>></u>10-minute bouts [HR=0.95 (95% CI: 0.91, 0.98)], with a similar pattern for secondary CVD outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported change in PA at 1 and 4 years were not associated with CVD outcomes.</p> <p>CONCLUSIONS: Increased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes.</p>

Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial

OBJECTIVE: To conduct <i>post-hoc</i> secondary analysis examining the association between change in physical activity (PA), measured with self-report and accelerometry, from baseline to 1 and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial. <p>RESEARCH DESIGN AND METHODS: Participants were adults with overweight/obesity and type 2 diabetes with PA data at baseline and year 1 or 4 (n = 1,978). Participants were randomized to diabetes support and education or intensive lifestyle intervention. Measures included accelerometry-measured moderate-to-vigorous PA (MVPA), self-reported PA, and composite (morbidity and mortality) CVD outcomes.</p> <p>RESULTS: In pooled analyses of all participants, using Cox proportional hazards models, each 100 MET-min/wk increase in accelerometry-measured MVPA from baseline to 4 years was associated with decreased risk of the subsequent primary composite outcome of CVD. Results were consistent for changes in total MVPA [HR=0.97 (95% CI: 0.95, 0.99)] and MVPA accumulated in <u>></u>10-minute bouts [HR=0.95 (95% CI: 0.91, 0.98)], with a similar pattern for secondary CVD outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported change in PA at 1 and 4 years were not associated with CVD outcomes.</p> <p>CONCLUSIONS: Increased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes.</p>

Variation in Family Involvement on Rounds Between English-Speaking and Spanish-Speaking Families

BACKGROUND: Family-centered rounds (FCR) is the standard of care in inpatient pediatrics. Results of studies have revealed that Spanish-speaking families can experience communication challenges and decreased empowerment on rounds. In our study, we aim to identify variation in FCR practices for Spanish-speaking compared to English-speaking families and factors contributing to these disparities. METHODS: This is a cross-sectional observational study performed by secondary analysis of a quality improvement initiative conducted at a quaternary children’s hospital. Data were collected from June 2019 to March 2020 by using observational audits. Encounters were analyzed to compare key elements of FCR (including rounds location, elicitation of family questions, involvement in discharge planning) for English-speaking and Spanish-speaking families. Multivariable logistic regression was used to compare family involvement in FCR. A sensitivity analysis was conducted to evaluate unmeasured confounding. RESULTS: Rounding encounters included 394 families (261 English-speaking and 133 Spanish-speaking). Fewer Spanish-speaking families were included in the medical team’s discussion on rounds (64.7% vs 76.3%, P = .017), were asked about questions at the start of rounds (44.4% vs 56.3%, P = .025), or were involved in discussion of discharge criteria (72.2% vs 82.8%, P = .018) when compared to English-speaking families. These differences were magnified for resident teams rounding with subspecialists. The finding of decreased family involvement in the discussion on rounds persisted after adjusting for patient age and team type. CONCLUSIONS: Spanish-speaking families were less likely to be involved in FCR compared to English-speaking families. Further investigation is needed to explore the root causes of this practice variation and to develop interventions to address disparities.

The Relationship between Kitwood's Model of Needs and a Student's Music Therapy Practice in an Acute Assessment Unit for People Living with Dementia and Mental Health Issues

<p>This study focused on reviewing a student's music therapy practice at an acute assessment unit for people living with dementia and mental health issues, finding links between the placement philosophy, and new ideas about practice. Kitwood's (1997) book on personhood and the needs of people who are living with dementia and other mental health issues appeared to resonate with the student music therapists' practice. This was supported by the active use of his model of needs by nursing staff at the placement. Investigations looked specifically at Kitwood's model of needs; how music therapy links with his philosophy and how interventions during practice connected to those needs. The data was draw from descriptive clinical notes using secondary analysis. The rich qualitative data was analysed using deductive and inductive methods. Findings are presented under Kitwood's model of needs, forming the five categories for the study. The main themes within these categories were then summarised and explanations given under both Kitwood's model of needs and music therapy interventions used to meet them. Though the findings are qualitative, specific to this study and not necessarily generalisable, several links within music therapy practice, and nursing practice revealed the importance and need for more person-centred individualised care programmes for patients in mental health settings.</p>

Effect of maternal vitamin D supplementation on nasal pneumococcal acquisition, carriage dynamics and carriage density in infants in Dhaka, Bangladesh

Background Invasive pneumococcal disease is a major cause of infant morbidity and death worldwide. Vitamin D promotes anti-pneumococcal immune responses in vitro, but whether improvements in infant vitamin D status modify risks of nasal pneumococcal acquisition in early life is not known. Methods This is a secondary analysis of data collected in a trial cohort in Dhaka, Bangladesh. Acute respiratory infection (ARI) surveillance was conducted from 0 to 6 months of age among 1060 infants of women randomized to one of four pre/post-partum vitamin D dose combinations or placebo. Nasal swab samples were collected based on standardized ARI criteria, and pneumococcal DNA quantified by qPCR. Hazards ratios of pneumococcal acquisition and carriage dynamics were estimated using interval-censored survival and multi-state modelling. Results Pneumococcal carriage was detected at least once in 90% of infants by 6 months of age; overall, 69% of swabs were positive (2616/3792). There were no differences between any vitamin D group and placebo in the hazards of pneumococcal acquisition, carriage dynamics, or carriage density (p > 0.05 for all comparisons). Conclusion Despite in vitro data suggesting that vitamin D promoted immune responses against pneumococcus, improvements in postnatal vitamin D status did not reduce the rate, alter age of onset, or change dynamics of nasal pneumococcal colonization in early infancy. Trial registration Registered in ClinicalTrials.gov with the registration number of NCT02388516 and first posted on March 17, 2015.