Physical activity and beverage consumption in preschoolers: Focus groups with parents and teachers

Background: Qualitative research is a method in which new ideas and strategies can be discovered. This qualitative study aimed to investigate parents’ and teachers’ opinions on physical activity and beverage consumption of preschool children. Through separate, independent focus groups, they expressed their perceptions on children’s current physical activity and beverage consumption levels, factors that influence and enhance these behaviours, and anticipated barriers to making changes. Methods: Multi-cultural and multi-geographical focus groups were carried out in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). In total, twenty-four focus groups with 122 parents and eighteen focus groups with 87 teachers were conducted between October 2010 and January 2011. Based on a semi-structured interview guide, questions on preschoolers’ physical activity (opinions on preschoolers’ physical factivity, how to increase physical activity, facilitators and barriers of physical activity) and beverage consumption (rules and policies, factors influencing promotion of healthy drinking, recommendations for future intervention development) were asked. The information was analyzed using qualitative data analysis software (NVivo8). Results: The focus group results indicated misperceptions of caregivers on preschoolers’ physical activity and beverage consumption levels. Caregivers perceived preschoolers as sufficiently active; they argue that children need to learn to sit still in preparation for primary school. At most preschools, children can drink only water. In some preschools sugar-sweetened beverages like chocolate milk or fruit juices, are also allowed. It was mentioned that sugar-sweetened beverages can be healthy due to mineral and vitamin content, although according to parents their daily intake is limited. These opinions resulted in low perceived needs to change behaviours. Conclusions: Although previous research shows need of change in obesity-related behaviours, the participants in the current study didn’t perceive such. The awareness of parents and teachers needs to be raised concerning their shared responsibility about healthy behaviours in preschoolers. Providing preschool teachers with ready-to-use classroom material will encourage them to change physical activity and beverage consumption, and to implement related activities in the classroom. Involvement in activities that their children perform at preschool will motivate parents to extend these behaviours to the home environment.

Self-reported lifestyle behaviours in families with an increased risk for type 2 diabetes across six European countries: a cross-sectional analysis from the Feel4Diabetes-study

BACKGROUND: A healthy lifestyle decreases the risk of developing type 2 diabetes mellitus. The current cross-sectional study aimed to describe self-reported lifestyle behaviours and compare them to current health guidelines in European Feel4Diabetes-families at risk for developing type 2 diabetes across six countries (Belgium, Finland, Spain, Greece, Hungary and Bulgaria). METHODS: Parents and their children were recruited through primary schools located in low socio-economic status areas. Parents filled out the FINDRISC-questionnaire (eight items questioning age, Body Mass Index, waist circumference, PA, daily consumption of fruit, berries or vegetables, history of antihypertensive drug treatment, history of high blood glucose and family history of diabetes), which was used for the risk assessment of the family. Sociodemographic factors and several lifestyle behaviours (physical activity, sedentary behaviour, water consumption, fruit and vegetable consumption, soft drink consumption, sweets consumption, snack consumption, breakfast consumption) of both adults and children were assessed by parental questionnaires. Multilevel regression analyses were conducted to investigate families'' lifestyle behaviours, to compare these levels to health guidelines and to assess potential differences between the countries. Analyses were controlled for age, sex and socio-economic status. RESULTS: Most Feel4Diabetes-families at risk (parents and their children) did not comply with the guidelines regarding healthy behaviours, set by the WHO, European or national authorities. Less than half of parents and children complied with the physical activity guidelines, less than 15% of them complied with the fruit and vegetable guideline, and only 40% of the children met the recommendations of five glasses of water per day. Clear differences in lifestyle behaviours in Feel4Diabetes-families at risk exist between the countries. CONCLUSIONS: Countries are highly recommended to invest in policy initiatives to counter unhealthy lifestyle behaviours in families at risk for type 2 diabetes development, taking into account country-specific needs. For future research it is of great importance to focus on families at risk in order to counter the development of type 2 diabetes and reduce health inequity. © 2022. The Author(s)

The effect of a cluster-randomized controlled trial on lifestyle behaviors among families at risk for developing type 2 diabetes across Europe: the Feel4Diabetes-study

Background: This study investigated the effect of the Feel4Diabetes-intervention, a 2-year multilevel intervention, on energy balance-related behaviors among European families at risk for developing type 2 diabetes. Intervention effects on self-reported physical activity, sedentary behavior and eating behaviors were investigated across and within the participating countries: Belgium, Finland, Greece, Spain, Hungary and Bulgaria. Methods: Families were recruited through schools, located in low socio-economic status areas. In total, 4484 families at risk for developing type 2 diabetes were selected using the FINDRISC-questionnaire. Parents’ and children’s energy balance-related behaviors data were collected by questionnaires at three time points (baseline, mid- and post intervention). Families assigned to the intervention group were invited to participate in a 2-year school-, community-, and family-based intervention to promote a healthier lifestyle, including counseling sessions (first intervention year) and text messages (second intervention year). Families assigned to the control group received standard care, including medical check-up results and recommendations and tips regarding a healthy lifestyle. To assess the intervention-effects, Mixed Models were conducted using the R-Package “lmer “with R v3.2. Results: Significant intervention effects were found on a certain number of families’ lifestyle behaviors. Significant favorable intervention effects were detected on parents’ water consumption and consumption of fruit and vegetables, and on children’s consumption of sweets and moderate-to-vigorous physical activity. Analyses by country revealed significant favorable intervention effects on water consumption and on moderate-to-vigorous physical activity in Belgian parents and on fruit and vegetable consumption among Belgian children, on sweets consumption among Spanish parents and children, and on moderate-to-vigorous physical activity among Finnish children. Unfavorable intervention effects were found on the consumption of soft drinks and sugar-containing juices among Hungarian children and parents, while when examining the intervention effects for the overall population and per country, 10 from the 112 investigated outcome variables were improved in the intervention group compared to the control group (9%). Conclusions: The Feel4Diabetes-intervention managed to improve a certain number of targeted lifestyle behaviors while the intervention was not effective on a large number of targeted lifestyle behaviors. The findings of the current study are encouraging, but further research is needed on how we can further improve effectiveness of lifestyle interventions to prevent type 2 diabetes in families at risk. Trial registration: The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov, ID: 643708. © 2021, The Author(s)

The ToyBox pre-school obesity prevention intervention for use in Scotland : results of a feasibility cluster randomised controlled trial (cRCT)

Objective: The ToyBox intervention was successful at increasing physical activity and reducing sedentary behaviour in pre-school children across Europe. The intervention involves teacher-led activities over 18 weeks which aim to increase physical activity, reduce sedentary behaviour, and promote healthy snacking and water consumption. We adapted the Toybox Europe intervention for preschools in Scotland using a co-production approach. This study aimed to test the feasibility of our adapted intervention in children attending preschools in relatively deprived areas of Glasgow, Scotland, who are considered hard to reach. Methods: The feasibility cRCT involved six preschools (three intervention, three control); control was usual curriculum. Participants were 3-5 year old children attending preschools in Glasgow, UK, and their parents. Outcomes of interest were recruitment rates, willingness to be randomised, attrition rates, questionnaire completion rate and acceptability of measurement methods. Measurements were taken at baseline and 18 weeks; anthropometry, physical activity, sleep and sedentary time using the activPal accelerometer (wear time = 7 days; 3 days considered valid), body composition via bioelectrical impedance analysis (BIA), and measures of diet and home screen time via parental questionnaire. Results: Cluster level recruitment rate was 9% (11/112 preschools) and the individual level recruitment rate was 18% (42/231 children). 36 children (16 girls) provided at least one valid measurement at baseline and follow-up (attrition rate = 16.6%). All clusters were willing to be randomised. Anthropometric measures were acceptable and feasible. Parental questionnaire response rates were low (20%). 61% of the sample provided valid accelerometer data at baseline, 27% for baseline and followup. BIA was not feasible due to poor participant compliance with protocol. Conclusions: Recruitment rates of both preschools and children was lower than anticipated compared with Toybox Europe. However, for those children who took part, the adapted intervention and the measurement methods appeared acceptable and feasible. An ongoing process evaluation will help identify ways in which recruitment of preschools, and recruitment and retention of participants, can be maximised in areas of deprivatio

Liver transplant and hepatitis C in methadone maintenance therapy: a case report

Methadone maintenance therapy for the treatment of opioid dependence continues to carry a social stigma. Until recently, patients on methadone were not considered for liver transplantation. We describe the first case of a patient on methadone who received a liver transplant for end stage liver disease and was successfully treated for recurrent hepatitis C. More than five years post transplant and three years post viral clearance, the patient continues to do well and is stable on low-dose methadone. This case emphasizes the need to reconsider the non-evidence based policy adopted by transplant centers that require methadone maintenance therapy patients to stop methadone prior to consideration for transplant evaluation

Supplementary descriptions and DNA barcodes of two rarely encountered Trisetacus species (Eriophyoidea, Phytoptidae) associated with Tertiary relict conifers from the Mediterranean region

New records and supplementary morphological descriptions of two rarely encountered Trisetacus species from Pinaceae, T. abietis Postner 1968 and T. cedri (Nalepa 1920), are reported. Trisetacus abietis was found in Abkhazia under the needle epidermis of Abies nordmanniana (Steven) Spach, a conifer endemic to the mountainous Asian coast of the Black Sea. Trisetacus cedri was found in buds of introduced Cedrus deodara(Roxb. ex D. Don) G. Don in Abkhazia and South Africa. It is the only member of Trisetacus known from Cedrus spp. For the first time we provide sequences of two genes (COI and D1–D2 28S) of T. abietis(MN022221, MN025333) and T. cedri (MN022222, MN022223, MN025334, MN025335), along with microphotographs of the damage caused by these mites on their coniferous hosts. Sequences of D1–D2 28S of T. cedri from Abkhazian and South African populations are identical; COI sequences from different populations differ by only one synonymous substitution in a codon for asparagine. Females of T. abietis have long asymmetrical 8/7-rayed empodia, whereas males have shorter symmetrical 6/6-rayed empodia and shorter solenidia ω I. Similar sexual dimorphism in tarsal appendages was previously reported in Novophytoptus, representing an endoparasitic lineage of phytoptids on monocots. In T. cedri, a “long form” and a “short form” of both males and females were detected, suggesting a complex life cycle in this species. The evolution of Trisetacus is discussed within the broader context of the molecular phylogenies of Pinaceae and Eriophyoidea, including estimations of divergence times.The Russian Foundation for Basic Research; ZIN RAS (project АААА-А19-119020790133-6) and the Russian Science Foundation.https://www.biotaxa.org/saaam2019Forestry and Agricultural Biotechnology Institute (FABI

A 12-month follow-up of a mobile-based (mHealth) obesity prevention intervention in pre-school children: the MINISTOP randomized controlled trial

Background: To date, few mobile health (mHealth) interventions aimed at changing lifestyle behaviors have measured long term effectiveness. At the 6-month follow-up the MINISTOP trial found a statistically significant intervention effect for a composite score comprised of fat mass index (FMI) as well as dietary and physical activity variables; however, no intervention effect was observed for FMI. Therefore, the aim of this study was to investigate if the MINISTOP intervention 12-months after baseline measurements: (i) improved FMI and (ii) had a maintained effect on a composite score comprised of FMI and dietary and physical activity variables. Methods: A two-arm parallel randomized controlled trial was conducted in 315 healthy 4.5 year old children between January 2014 and October 2015. Parents’ of the participating children either received the MINISTOP intervention or a basic pamphlet on dietary and physical activity behaviors (control group). After 6 months, participants did not have access to the intervention content and were measured again 6 months later (i.e. the 12-month follow-up). The Wilcoxon rank-sum test was then used to examine differences between the groups. Results: At the 12-month follow-up, no statistically significant difference was observed between the intervention and control groups for FMI (p = 0.57) and no maintained effect for the change in composite score was observed (mean ± standard deviation for the intervention and control group: + 0.53 ± 1.49 units and + 0.35 ± 1.27 units respectively, p = 0.25 between groups). Conclusions: The intervention effect observed at the 6-month follow-up on the composite score was not maintained at the 12-month follow-up, with no effect on FMI being observed at either follow-up. Future studies using mHealth are needed to investigate how changes in obesity related markers in young children can be maintained over longer time periods.The MINISTOP project was funded by the Swedish Research Council (project no. 2012–2883), the Swedish Research Council for Health, Working Life and Welfare (2012–0906), Bo and Vera Axson Johnsons Foundation, and Karolinska Institutet (M.L.). C.D.N was supported by the Swedish Nutrition Foundation and S.S was funded by the Seaver Foundation. None of the funding bodies had any contributions or influence in the design of the study, data collection, analysis, interpretation of the data, or the writing of the manuscript