SmokeFree Sports 2012-13: Final Project Report

Many children enjoy taking part in physical activity, whilst physical education, sport and play are common denominators among children worldwide. Physical activity contexts therefore provide an opportunity to deliver health promotion activity en masse in a positive, fun and healthy environment. Over the past three years SmokeFree Sports has sought to harness this potential and develop an effective and engaging mechanism to prevent and protect children from smoking. The main purpose of this report is to provide an overview of the research findings from the final phase of the SmokeFree Sports project – a smoking prevention intervention conducted in Liverpool primary schools in the 2012-13 academic year. The report also includes a summary of the innovative practices and campaign activities that have captured the interest of children and families, teachers and schools, and the local community. Information is presented in as much detail as possible, whilst findings are reported objectively together with practical recommendations so that others can learn from our experience

Evaluation of the Liverpool Drink Less Enjoy More intervention

In the UK it is an offence to knowingly sell alcohol to, or purchase alcohol for, a drunk person (Regulated under Section 141 and 142 of the Licensing Act 2003). However, until recent times public awareness, bar server compliance and police enforcement of this legislation has appeared to be low. Critically, UK nightlife environments are often characterised by high levels of intoxication and alcohol-related harms. Excessive alcohol use damages the public’s health, while managing nightlife drunkenness and associated problems such as anti-social behaviour and violence places huge demands on police, local authorities and health services. To reduce such harms an extensive range of policies and interventions have been implemented at local and national levels including high profile policing, changes to licensing laws and environmental measures to improve safety. Whilst there is some evidence to indicate that these measures may contain and manage alcohol-related harms, they do little to reduce levels of intoxication or address harmful and pervasive cultures of nightlife drunkenness. A study conducted in Liverpool in 2013 found that 84% of alcohol purchase attempts by pseudo-intoxicated actors in pubs, bars and nightclubs were successful (i.e. alcohol was sold to the actor; Hughes et al., 2014). Studies conducted elsewhere have suggested that reductions in the service of alcohol to drunks, and associated harms, in nightlife settings can be achieved through the implementation of multi-component interventions that incorporate community mobilisation, enforcement of the laws around the service of alcohol to drunks and responsible bar server training. Thus to address the sale of alcohol to drunks in the city’s nightlife, local partners developed and implemented the multi-component Say No To Drunks pilot intervention. The intervention aimed to: increase awareness of legislation preventing sales of alcohol to drunks; support bar staff compliance with the law; provide a strong deterrence to selling alcohol to drunks; and promote responsible drinking amongst nightlife users. Following an evaluation of Say No To Drunks, the intervention was further refined, broadened and implemented as a second phase in 2015 – rebranded to Drink Less Enjoy More. To inform the continued development of the intervention, the Centre for Public Health at Liverpool John Moores University was commissioned to evaluate the intervention, comparing the results to previous work

Effect of a sport-for-health intervention (SmokeFree Sports) on smoking-related intentions and cognitions among 9-10 year old primary school children: a controlled trial.

BACKGROUND: Preventing children from smoking is a public health priority. This study evaluated the effects of a sport-for-health smoking prevention programme (SmokeFree Sports) on smoking-related intentions and cognitions among primary school children from deprived communities. METHODS: A non-randomised-controlled trial targeted 9-10 year old children from Merseyside, North-West England. 32 primary schools received a programme of sport-for-health activities over 7 months; 11 comparison schools followed usual routines. Data were collected pre-intervention (T0), and at 8 months (T1) and one year post-intervention (T2). Smoking-related intentions and cognitions were assessed using an online questionnaire. Intervention effects were analysed using multi-level modelling (school, student), adjusted for baseline values and potential confounders. Mixed-sex focus groups (n = 18) were conducted at T1. RESULTS: 961 children completed all assessments and were included in the final analyses. There were no significant differences between the two study groups for non-smoking intentions (T1: β = 0.02, 95 % CI = -0.08-0.12; T2: β = 0.08, 95 % CI = -0.02-0.17) or for cigarette refusal self-efficacy (T1: β = 0.28, 95 % CI = -0.11-0.67; T2: β = 0.23, 95 % CI = -0.07-0.52). At T1 there was a positive intervention effect for cigarette refusal self-efficacy in girls (β = 0.72, 95 % CI = 0.21-1.23). Intervention participants were more likely to 'definitely' believe that: 'it is not safe to smoke for a year or two as long as you quit after that' (RR = 1.19, 95 % CI = 1.07-1.33), 'it is difficult to quit smoking once started' (RR = 1.56, 95 % CI = 1.38-1.76), 'smoke from other peoples' cigarettes is harmful' (RR = 1.19, 95 % CI = 1.20-2.08), 'smoking affects sports performance' (RR = 1.73, 95 % CI = 1.59-1.88) and 'smoking makes 'no difference' to weight' (RR = 2.13, 95 % CI = 1.86-2.44). At T2, significant between-group differences remained just for 'smoking affects sports performance' (RR = 1.57, 95 % CI = 1.43-1.72). Focus groups showed that SFS made children determined to remain smoke free and that the interactive activities aided children's understanding of smoking harms. CONCLUSION: SFS demonstrated short-term positive effects on smoking attitudes among children, and cigarette refusal self-efficacy among girls. Although no effects were observed for non-smoking intentions, children said that SFS made them more determined not to smoke. Most children had strong intentions not to smoke; therefore, smoking prevention programmes should perhaps target early adolescents, who are closer to the age of smoking onset

Patients experiences of Polymyalgia Rheumatica: a Qualitative Literature Synthesis Review

Background Qualitative research is needed to better understand the concepts of remission and relapse in Polymyalgia Rheumatica (PMR). Remission, relapse, and disease activity have been defined heterogeneously in clinical studies which exclude the patient view leading to a discrepancy between physician and patient perspectives when evaluating disease activity. Aims The present work is part of a project of the PMR Working Group of Outcome Measures in Rheumatology (OMERACT), which is a global, volunteer-driven, non-profit research group aiming to improve outcome measures in rheumatic diseases. We carried out a synthesis of findings from multiple qualitative studies to provide a range and depth of meanings, experiences, and perspectives of participants across health-care contexts to explore the patient perspectives of disease activity in PMR. Methods A professional librarian carried out systematic search of the qualitative research literature across Ovid (Medline), EMBASE and CINAHL to identify studies of interest. Research synthesis was carried out in accordance with the ENTERQ criteria by three researchers with qualitative research experience. Results The search was carried out from each of the database point of inception to 19/10/2023. Review of abstracts, and hand searching reference lists of manuscripts identified 12 studies of interest. There were three main over-arching ideas identified within the published work: 1. Pathway to diagnosis, 2. Managing uncertainty and 3. Challenges to everyday life. Within these three over-arching ideas there were sub-themes identified within the conceptual scaffold which were underpinned with the expression of self and control. The domain of pathway diagnosis included making sense of the condition, normalisation of symptoms and struggles navigating care systems. Within the domain of manging uncertainty where the concepts of self and illness and the positive and negative effects of steroids. The Challenges to everyday life domain comprised day to day living, adaptation and psycho-social burden of disease. Conclusion This research synthesis of qualitative work on PMR has identified three over-arching domains providing a rich narrative of lived experience which point to why discrepancies exist within current physician-focused definitions of remission and relapse. Disclosure Nonspecific to this study

Stability of Yellow Fever Virus under Recombinatory Pressure as Compared with Chikungunya Virus

Recombination is a mechanism whereby positive sense single stranded RNA viruses exchange segments of genetic information. Recent phylogenetic analyses of naturally occurring recombinant flaviviruses have raised concerns regarding the potential for the emergence of virulent recombinants either post-vaccination or following co-infection with two distinct wild-type viruses. To characterize the conditions and sequences that favor RNA arthropod-borne virus recombination we constructed yellow fever virus (YFV) 17D recombinant crosses containing complementary deletions in the envelope protein coding sequence. These constructs were designed to strongly favor recombination, and the detection conditions were optimized to achieve high sensitivity recovery of putative recombinants. Full length recombinant YFV 17D virus was never detected under any of the experimental conditions examined, despite achieving estimated YFV replicon co-infection levels of ∼2.4×106 in BHK-21 (vertebrate) cells and ∼1.05×105 in C710 (arthropod) cells. Additionally YFV 17D superinfection resistance was observed in vertebrate and arthropod cells harboring a primary infection with wild-type YFV Asibi strain. Furthermore recombination potential was also evaluated using similarly designed chikungunya virus (CHIKV) replicons towards validation of this strategy for recombination detection. Non-homologus recombination was observed for CHIKV within the structural gene coding sequence resulting in an in-frame duplication of capsid and E3 gene. Based on these data, it is concluded that even in the unlikely event of a high level acute co-infection of two distinct YFV genomes in an arthropod or vertebrate host, the generation of viable flavivirus recombinants is extremely unlikely

Constraints on Nucleon Decay via "Invisible" Modes from the Sudbury Neutrino Observatory

Data from the Sudbury Neutrino Observatory have been used to constrain the lifetime for nucleon decay to ``invisible'' modes, such as n -> 3 nu. The analysis was based on a search for gamma-rays from the de-excitation of the residual nucleus that would result from the disappearance of either a proton or neutron from O16. A limit of tau_inv > 2 x 10^{29} years is obtained at 90% confidence for either neutron or proton decay modes. This is about an order of magnitude more stringent than previous constraints on invisible proton decay modes and 400 times more stringent than similar neutron modes.Comment: Update includes missing efficiency factor (limits change by factor of 2) Submitted to Physical Review Letter

Cosmogenic neutron production at the Sudbury Neutrino Observatory

Neutrons produced in nuclear interactions initiated by cosmic-ray muons present an irreducible background to many rare-event searches, even in detectors located deep underground. Models for the production of these neutrons have been tested against previous experimental data, but the extrapolation to deeper sites is not well understood. Here we report results from an analysis of cosmogenically produced neutrons at the Sudbury Neutrino Observatory. A specific set of observables are presented, which can be used to benchmark the validity of geant4 physics models. In addition, the cosmogenic neutron yield, in units of 10-4 cm2/(g·μ), is measured to be 7.28±0.09(stat)-1.12+1.59(syst) in pure heavy water and 7.30±0.07(stat)-1.02+1.40(syst) in NaCl-loaded heavy water. These results provide unique insights into this potential background source for experiments at SNOLAB

Isospin symmetry in B(E2) values: Coulomb excitation study of Mg-21

The $T_z$~=~$-\frac{3}{2}$ nucleus ${}^{21}$Mg has been studied by Coulomb excitation on ${}^{196}$Pt and ${}^{110}$Pd targets. A 205.6(1)-keV $\gamma$-ray transition resulting from the Coulomb excitation of the $\frac{5}{2}^+$ ground state to the first excited $\frac{1}{2}^+$ state in ${}^{21}$Mg was observed for the first time. Coulomb excitation cross-section measurements with both targets and a measurement of the half-life of the $\frac{1}{2}^+$ state yield an adopted value of $B(E2;\frac{5}{2}^+\rightarrow\frac{1}{2}^+)$~=~13.3(4)~W.u. A new excited state at 1672(1)~keV with tentative $\frac{9}{2}^+$ assignment was also identified in ${}^{21}$Mg. This work demonstrates large difference of the $B(E2;\frac{5}{2}^+\rightarrow\frac{1}{2}^+)$ values between $T$~=~$\frac{3}{2}$, $A$~=~21 mirror nuclei. The difference is investigated in the shell-model framework employing both isospin conserving and breaking USD interactions and using modern \textsl{ab initio} nuclear structure calculations, which have recently become applicable in the $sd$ shell.Comment: 8 pages, 6 figures, submitted to Phys. Rev. C, Rapid Communicatio

A cross-sectional survey investigating women's information sources, behaviour, expectations, knowledge and level of satisfaction on advice received about diet and supplements before and during pregnancy

Background The reported long-term effects of poor maternal nutrition and uptake of recommended supplements before and during pregnancy was the impetus behind this study. Our objectives were to investigate and understand women’s expectations, knowledge, behaviour and information sources used regarding the use of nutrition and vitamin supplements before and during pregnancy. Methods A cross-sectional survey using a self-administered questionnaire was undertaken. A purposive sampling technique was used. Women attending the antenatal clinic at Croydon University Hospital during 2015 were invited to take part in the study. The data was analysed using descriptive statistics, paired sample T-tests and Chi-squared tests, with the level of significance set at 5% (p < 0.05). Results A total of 133 pregnant women completed the survey. Analysis of the results showed that women are currently using electronic resources (33%, n = 42) rather than healthcare professionals (19%, n = 25) as an information source before pregnancy. Women who sourced information through the internet were significantly more likely to take folic acid (p = 0.006) and vitamin D (p = 0.004) before pregnancy. Women preferred to receive information from the antenatal clinic (62%, n = 83), internet (46%, n = 61) and from mobile applications (27%, n = 36). Although women believed they had sufficient knowledge (60%, n = 80) and had received adequate advice (53%, n = 70) concerning the correct supplements to take, this was not demonstrated in their behaviour, with only a small number of women (37%, n = 49) taking a folic acid supplement before pregnancy. Women mistakenly perceived the timing of supplement advice as correct, with only a small number of women (18%, n = 23) considering the advice on supplements as too late. Conclusions Despite the small sample size, this study demonstrated that women did not receive timely and/or accurate advice to enable them to take the recommended supplements at the optimal time. Women had the misconception that they understood the correct use of pregnancy supplements. This misunderstanding may be prevented by providing women intending to become pregnant with a structured, approved electronic source of information that improves their supplements uptake