Addressing Obesity in Stevenage, Hertfordshire: A Consultation with Young People

Public Health England have identified that almost a quarter of children are overweight when they start primary school, which increases to a third when they leave in year 6 aged 10-11 years. This has implications for young peoples’ physical and mental health and also later in adult life. The newly launched NIHR Applied Research Collaboration (ARC) East of England is focusing on selected areas of health inequality and this includes neighbourhoods in Stevenage, Hertfordshire which have high rates of childhood obesity. In order to find out what young people think about these issues, Hertfordshire County Council and the University of Hertfordshire carried out a collaborative project in 2019. Hertfordshire County Council have adopted a Whole Systems approach to obesity and are keen to engage with young people in order to prioritise issues identified by them. The importance of ‘involving’ young people in shaping services has been widely documented. Two researchers met twice with 56 young people (from a range of schools) aged 16 years who were attending the National Citizen Service (NCS) scheme at a school in Stevenage in the summer holidays. A number of involvement activities were carried out during the sessions. The young people, with help from the researchers, facilitated their own informal discussion groups, using maps, flips charts, post-it notes and an anonymous suggestion box. The first session did not mention obesity but allowed open discussion about what it was like to live in Stevenage and the second session focussed more on the issue of ‘obesity and weight’. The young people were encouraged to find their own solutions and imagine if they “were in charge”. The four main themes that came from the sessions were; affordability, crime and anti-social behaviour, transport and places to go and eat. A number of solutions were suggested by the young people which included; healthy environment (e.g. cycle paths, street lights, regulation of shops), community approach (e.g. more affordable sports activities), schools (e.g. raise awareness, promote sport), focus on young people (e.g. activities for young people and healthy affordable eating outlets) and helping people maintain a healthy weight. The priorities identified by local young people and the wider issues they raised are important to take into consideration when shaping any intervention or public health initiative, especially when considering the wider determinants of health. Listening to the issues and solutions and using the language of young people is vital and young people should be included in co-designing any services that are aimed at them. Involving local young people who know an area and who can identify important issues is vital for any successful public health intervention

"Here everyone is the same" - a qualitative evaluation of participating in a Boccia (indoor bowling) group: innovative practice

This qualitative study explored the impact of a Boccia (modified indoor bowls) group on the lives of people with dementia and their carers. Semi-structured interviews with people with dementia (N=6), carers (N=10) and the group organisers (N=6) analysed using thematic analysis revealed four main themes. ‘The struggle of being a carer’ was relieved by participating in the group and benefiting from the caring support and social aspects of “This group is a family”. “The unique nature of Boccia” helped it to provide physical and mental stimulation as well as being an inclusive and enjoyable group. These aspects contributed to many participants describing the group as a Dementia friendly environment where “Here everyone is the same:” treated as equals, without feeling hindered or defined by dementia. Boccia appears an exciting initiative but further research is needed to see if these findings can be replicated with other groups

Swimming for dementia: an exploratory qualitative study

Swimming is a non-weight bearing form of exercise that can be enjoyable and promote physical fitness. This qualitative study investigated a local group established as part of a national dementia swimming initiative. Semi-structured interviews with people with dementia (N=4), carers or companions (N=4) and the organisers and facilitators of the group (N=6) were analysed using thematic analysis. This revealed four main themes: (1) the pleasure of swimming and its benefits as a form of exercise and for building confidence and empowering participants; (2) the importance of insight and empathy in creating a safe and secure experience; (3) the impact of dementia; and (4) how participants valued being part of a group ‘all in the same boat’. ‘Dementia friendly swimming’ appears to be a valuable form of exercise but it requires considerable preparation and support to make it happen

Impact of a multiple birth on maternal mental health and early mother-infant interactions: implications for information provision in IVF treatment

One in four IVF pregnancies is a twin birth. This research explored the impact of a multiple IVF birth on maternal mental health and examined whether twin status conferred additional risk for poor mother-infant interaction and parenting stress following a premature birth. It further surveyed factors which had influenced couples' decisions regarding embryo transfer. A prospective study of 175 mothers conceiving after IVF found mothers of multiples (n=56) had a three-fold risk of scoring above the threshold for depression in the postpartum period. Unsettled and irregular infant behaviour was another independent risk factor. Theme analysis revealed mothers of multiples were more likely to express negative themes such as 'tiredness'. More mothers of singletons described 'feeling wonderful'. Mothers of premature twins (n=17) were closely matched with mothers of premature singletons and compared using the Nursing Child Assessment Teaching Scale (NCATS), Home Observation for Measurement of the Environment (HOME) Responsivity subscale and the Parenting Stress Index. There were no differences in maternal NCATS scores but twin infants were less responsive and provided less clear cues. Mothers of twins were less responsive in an everyday setting and 25% (versus 0%) reported extreme levels of parenting stress. Singleton mothers had significantly lower scores for the parent child dysfunctional interaction subscale. None of the couples surveyed (n=68) had chosen to transfer a single embryo (eSET). Only 19.1% rated desire for twins as an important factor in their decision. Most important was desire to increase the chance of pregnancy (92.6%). Couples perceived eSET as reducing the chance of pregnancy. Most couples found the decision about number of embryos to transfer easy and rated medical advice as very important suggesting a need for more support for this complex decision. This thesis established that a single birth offers important psychosocial advantages for both mother and baby, findings which could promote informed decisions regarding embryo transfer

Pea aphids (Hemiptera: Aphididae) have diurnal rhythms when raised independently of a host plant

Seasonal timing is assumed to involve the circadian clock, an endogenous mechanism to track time and measure day length. Some debate persists, however, and aphids were among the first organisms for which circadian clock involvement was questioned. Inferences about links to phenology are problematic, as the clock itself is little investigated in aphids. For instance, it is unknown whether aphids possess diurnal rhythms at all. Possibly, the close interaction with host plants prevents independent measurements of rhythmicity. We reared the pea aphid Acyrthosiphon pisum (Harris) on an artificial diet, and recorded survival, moulting, and honeydew excretion. Despite their plant-dependent life style, aphids were independently rhythmic under light-dark conditions. This first demonstration of diurnal aphid rhythms shows that aphids do not simply track the host plant's rhythmicity

Swimming for dementia: an exploratory qualitative study

Swimming is a non-weight bearing form of exercise that can be enjoyable and promote physical fitness. This qualitative study investigated a local group established as part of a national dementia swimming initiative. Semi-structured interviews with people with dementia (N=4), carers or companions (N=4) and the organisers and facilitators of the group (N=6) were analysed using thematic analysis. This revealed four main themes: (1) the pleasure of swimming and its benefits as a form of exercise and for building confidence and empowering participants; (2) the importance of insight and empathy in creating a safe and secure experience; (3) the impact of dementia; and (4) how participants valued being part of a group ‘all in the same boat’. ‘Dementia friendly swimming’ appears to be a valuable form of exercise but it requires considerable preparation and support to make it happen

Evaluating the role of a humanoid robot to support learning in children with profound and multiple disabilities

Purpose The purpose of this paper is to identify ways teachers might employ a robot to achieve learning objectives with pupils with intellectual disabilities and potential outcome measures. Design/methodology/approach A series of five case studies where teacher-pupil dyads were observed during five planned video-recorded sessions with a humanoid robot. Engagement was rated in a classroom setting and during the last session with the robot. Video recordings were analysed for duration of engagement, teacher assistance and number of goals achieved. Findings Teachers identified a wide range of learning objectives ranging from an appreciation of cause and effect to improving the pupil's sense of direction. The robot's role could be to reward behaviour, provide cues or provide an active element to learning. Rated engagement was significantly higher with the robot than in the classroom. Research limitations/implications A robot with a range of functions that allowed it to be engaging and motivating for the wide range of pupils in special education would be expensive and require teachers to learn how to use it. The findings identify ways to provide evidence that this expenditure of time and money is worthwhile. Originality/value There is almost no research teachers can refer to on using robots to support learning in children with intellectual disabilities. This paper is therefore of value for researchers who wish to investigate using robots to educate children with intellectual disabilities, as it can provide vital information to aid study design

A damping circadian clock drives weak oscillations in metabolism and locomotor activity of aphids (Acyrthosiphon pisum)

Timing seasonal events, like reproduction or diapause, is crucial for the survival of many species. Global change causes phenologies worldwide to shift, which requires a mechanistic explanation of seasonal time measurement. Day length (photoperiod) is a reliable indicator of winter arrival, but it remains unclear how exactly species measure day length. A reference for time of day could be provided by a circadian clock, by an hourglass clock, or, as some newer models suggest, by a damped circadian clock. However, damping of clock outputs has so far been rarely observed. To study putative clock outputs of Acyrthosiphon pisum aphids, we raised individual nymphs on coloured artificial diet, and measured rhythms in metabolic activity in light-dark illumination cycles of 16: 08 hours (LD) and constant conditions (DD). In addition, we kept individuals in a novel monitoring setup and measured locomotor activity. We found that A. pisum is day-active in LD, potentially with a bimodal distribution. In constant darkness rhythmicity of locomotor behaviour persisted in some individuals, but patterns were mostly complex with several predominant periods. Metabolic activity, on the other hand, damped quickly. A damped circadian clock, potentially driven by multiple oscillator populations, is the most likely explanation of our results

Continuous twin screw granulation : robustness of lactose/MCC-based formulations

In recent years, significant progress has been made in the field of continuous twin screw granulation. However, only limited knowledge is currently available on the impact of active pharmaceutical ingredient (API) properties on granule quality and processability. In this study, the response behavior of four formulations containing APIs (5–10% drug load) with diverse characteristics was compared to the behavior of the corresponding placebo formulation consisting of lactose, microcrystalline cellulose (MCC) and hydroxypropylmethylcellulose (HPMC). API selection was based on extensive material characterization, combining conventional testing with in silico descriptors. For each formulation, a design of experiments was set up, evaluating the impact of liquid to solid (L/S) ratio and screw speed. Response ranges, response behavior and processability of each of the four formulations proved very similar to the placebo formulation when an appropriate center point L/S ratio was chosen. Hence, this robust placebo formulation could prove useful by decreasing drug product development time and consequently providing patients with a faster access to innovative medicine. Additionally, APIs with similar properties exhibited highly comparable response behavior at similar L/S ratios, indicating the potential use of surrogate APIs in novel drug product development

Symptoms into words: how medical patients talk about fatigue

Fatigue, which is the central symptom of CFS/ME, is notoriously difficult to define. We describe an investigation in which we raise two questions. First, does the way people use fatigue-related language reflect distinctive patterns? Second, is there a particular pattern characteristic of CFS/ME? These questions can be asked with various theories of language and meaning in mind, as we discuss. Our orientation is towards the intersubjective realities revealed by language, rather than towards the neurological substrate of fatigue. We created a questionnaire including 105 items connected with the experience of fatigue. We then compared responses in samples of adults fulfilling clinical criteria for three conditions in which fatigue is described: CFS/ME, Parkinson ’s disease, and multiple sclerosis. Principal components factor analysis of the three groups together did suggest patterns that we think reflect different intersubjective realities connected with fatigue-related language. In the CFS/ME group, cluster analysis showed that the pattern of responses differed significantly from the other two diagnostic groups. Cluster analysis does not reveal the nature of differences but the CFS/ME respondents marked a higher number of questionnaire items as ‘exactly how I feel ’. We suggest that the language used by people diagnosed with CFS/ME represents less localised experiences than in the other two diagnoses. In the interpretation of symptoms it is helpful to make a distinction between a generalised feeling and an experience that is more readily localised in time and space