Barriers and facilitators to initial and continued attendance at community-based lifestyle programmes among families of overweight and obese children: a systematic review

The success of childhood weight management programmes relies on family engagement. While attendance offers many benefits including the support to make positive lifestyle changes, the majority of families referred to treatment decline. Moreover, for those who do attend, benefits are often compromised by high programme attrition. This systematic review investigated factors influencing attendance at community-based lifestyle programmes among families of over-weight or obese children. A narrative synthesis approach was used to allow for the inclusion of quantitative, qualitative and mixed-method study designs. Thirteen studies met the inclusion criteria. Results suggest that parents provided the impetus for programme initiation, and this was driven largely by a concern for their child's psychological health and wellbeing. More often than not, children went along without any real reason or interest in attending. Over the course of the programme, however, children's positive social experiences such as having fun and making friends fostered the desire to continue. The stigma surrounding excess weight and the denial of the issue amongst some parents presented barriers to enrolment and warrant further study. This study provides practical recommendations to guide future policy makers, programme delivery teams and researchers in developing strategies to boost recruitment and minimise attrition

Promoting men’s awareness, self-examination, and help-seeking for testicular disorders: a systematic review of interventions

Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men’s knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. / Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed. / Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men’s awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. / Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. / Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671

Follow-up of blood-pressure lowering and glucose control in type 2 diabetes.

BACKGROUND In the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) factorial trial, the combination of perindopril and indapamide reduced mortality among patients with type 2 diabetes, but intensive glucose control, targeting a glycated hemoglobin level of less than 6.5%, did not. We now report results of the 6-year post-trial follow-up. METHODS We invited surviving participants, who had previously been assigned to perindopril–indapamide or placebo and to intensive or standard glucose control (with the glucose-control comparison extending for an additional 6 months), to participate in a post-trial follow-up evaluation. The primary end points were death from any cause and major macrovascular events. RESULTS The baseline characteristics were similar among the 11,140 patients who originally underwent randomization and the 8494 patients who participated in the post-trial follow-up for a median of 5.9 years (blood-pressure–lowering comparison) or 5.4 years (glucose-control comparison). Between-group differences in blood pressure and glycated hemoglobin levels during the trial were no longer evident by the first post-trial visit. The reductions in the risk of death from any cause and of death from cardiovascular causes that had been observed in the group receiving active blood-pressure–lowering treatment during the trial were attenuated but significant at the end of the post-trial follow-up; the hazard ratios were 0.91 (95% confidence interval [CI], 0.84 to 0.99; P=0.03) and 0.88 (95% CI, 0.77 to 0.99; P=0.04), respectively. No differences were observed during follow-up in the risk of death from any cause or major macrovascular events between the intensive-glucose-control group and the standard-glucose-control group; the hazard ratios were 1.00 (95% CI, 0.92 to 1.08) and 1.00 (95% CI, 0.92 to 1.08), respectively. CONCLUSIONS The benefits with respect to mortality that had been observed among patients originally assigned to blood-pressure–lowering therapy were attenuated but still evident at the end of follow-up. There was no evidence that intensive glucose control during the trial led to long-term benefits with respect to mortality or macrovascular events

Assessing the Potential for Zone-Specific Management of Cereals in Low-Rainfall South-Eastern Australia: Combining On-Farm Results and Simulation Analysis

In the low-rainfall region of south-eastern Australia, distinctive soil types reflecting the typical landscape of higher elevated dunes and swale zones at the bottom can be found within one field. Different soil characteristics cause consequently large variability in cropping productivity between soils and across seasons. To assess the possibilities for zone-specific management, five farmer fields were zoned into a dune, mid-slope and swale zone. For each site, zone yields were mapped over 2 years and soil properties were surveyed. This information was used to parameterize and validate the APSIM model for each zone. Field-measured PAWC increased from the dune to the swale zone. On-farm results and simulation analysis showed distinctive yield performance of the three designed zones. However, yield is not related to PAWC, it is rather a complex relationship between soil type, fertility and rainfall. While in high-rainfall years, the swale zones yielded higher due to higher soil organic carbon content and less drainage losses, the dune zones performed better in the low-rainfall years due to lower evaporation losses. This study emphasizes that in this specific environment where soil variation in texture and subsoil constraints strongly influence crop performance, mechanistic crop models and long-term field observations are necessary for better understanding of zone-specific performance, and simple linear relationships across years or sites are not useful

Combined application of nitrogen and phosphorus to enhance nitrogen use efficiency and close the wheat yield gap on varying soils in semi‐arid conditions

A primary driver of the wheat yield gap in Australia and globally is the supply of nitrogen (N) and options to increase N use efficiency (NUE) are fundamental to closure of the yield gap. Co‐application of N with phosphorus (P) is suggested as an avenue to increase fertiliser NUE, and inputs of N and P fertiliser are key variable costs in low rainfall cereal crops. Within field variability in the response to nutrients due to soil and season offers a further opportunity to refine inputs for increased efficiency. The response of wheat to N fertiliser input (0, 10, 20, 40 and 80 kg N ha‐1) under four levels of P fertiliser (0, 5, 10 and 20 kg P ha−1) was measured on three key low rainfall cropping soils (dune, mid‐slope and swale) across a dune‐swale system in a low rainfall semi‐arid environment in South Australia, for three successive cropping seasons. Wheat on sandy soils produced significant and linear yield and protein responses across all three seasons, while wheat on a clay loam only produced a yield response in a high rainfall season. Responses to P fertiliser were measured on the sandy soils but more variable in nature and a consistent effect of increased P nutrition leading to increased NUE was not measured

Gene expression in a microspore-derived cell suspension culture of Brassica Napus exhibiting enhanced oil production

xxi, 256 leaves : ill. ; 28 cm.Triacylglycerol (TAG) production in the microspore derived (MD) cell suspension culture ofBrassica napus L. cv Jet Neuf was enhanced when the sucrose concentration in the growth medium was increased from 2 to 14 % (w/v). mRNA differential display by polymerase chain reaction was used to examine gene expression in cells grown at different sucrose concentrations in order to identify mRNAs which could be associated with oil formation. The anchored primer, T12AA, was used to screen one subset, representing approximately one twelfth of the transcript population, isolated from cultures grown in media supplemented to 2, 6 and 14 % (w/v) sucrose. Analysis of this mRNA subset revealed thirteen cDNAs which appeared to be upregulated as the sucrose concentration was increased. Cloning and sequencing revealed multiple cDNA fragments for each signal detected by differential display. RT-PCR analysis of sixteen different cDNAs revealed that eight encoded mRNAs which were upregulated in parallel to the increase in media sucrose. Comparison of the eight upregulated cDNAs to other sequences in GenBank revealed the following: (1) BSS8A had a 100% identity with the last 25 amino acids of an acyl carrier protein from Arabidopsis thaliana, (2) BSS1A displayed homology to a number of sequences of unknown function, (3) BSS1 IB displayed weak but significant homology to a number of sequences of unknown function, (4) BSS13A displayed homology to four members of the thioredoxin family from ,4. thaliana and (5) four Had no significant homology to previously reported sequences which makes them potential candidates to encode lipogenic enzymes. These results indicate that differential display of mRNA may be a simple and rapid method for the identification of sucrose-modulated gene expression changes in this system and for the characterization of novel sequences potentially encoding lipogenic proteins

Mitigation of carbon using Atriplex nummularia revegetation

The use of abandoned or marginally productive land to mitigate greenhouse gas emissions may avoid competition with food and water production. Atriplex nummularia Lindl. is a perennial shrub commonly established for livestock forage on saline land, however, its potential for carbon mitigation has not been systematically evaluated. Similarly, although revegetation is an allowable activity to mitigate carbon within Article 3.4 of the United Nations Framework Convention on Climate Change's Kyoto Protocol, there is a paucity of information on rates of carbon mitigation in soils and biomass through this mechanism. For six sites where A. nummularia had been established across southern Australia four were used to assess changes in soil carbon storage and four were used to develop biomass carbon sequestration estimates. A generalised allometric equation for above and below ground biomass was developed, with a simple crown volume index explaining 81% of the variation in total biomass. There were no significant differences in soil organic carbon storage to 0.3 m or 2 m depth compared to existing agricultural land-use. Between 2.2 and 8.3 Mg C ha−1 or 0.2–0.6 Mg C ha−1 yr−1 was sequestered in above and below ground biomass and this translates to potential total sequestration of 1.1–3.6 Tg C yr−1 on saline land across Australia. Carbon income and forage grazing may thus provide a means to finance the stabilization of compromised land

Student, faculty, and staff approval of university smoke/tobacco-free policies: an analysis of campus newspaper articles

Objective: To provide a nontraditional source of data to university policymakers regarding student, faculty, and staff approval of university smoke/tobacco-free policies, as published through campus newspaper articles. Methods: From January to April 2016, a total of 2523 articles were retrieved concerning campus smoking/tobacco at 4-year, public universities. Of these, 54 articles met the inclusion factors, which described 30 surveys about campus approval of tobacco-free policies and 24 surveys about smoke-free policies. Results: In all, the surveys included more than 130 000 respondents. With the exception of 4 surveys, all reported that the most of the respondents approved a tobacco/smoke-free campus policy. Conclusions: Although the study had several limitations, the findings provide a synthesis from a nontraditional data source that is consistent with findings from the peer-reviewed literature, in which most of the students, faculty, and staff on university campuses approve of smoke/tobacco-free campus policies