PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies

<p>Abstract</p> <p>Background</p> <p>Given the increase in overweight and obesity prevalence in adolescents in the last decade, effective prevention strategies for these conditions in adolescents are urgently needed. The PRALIMAP (Promotion de l'ALImentation et de l'Activité Physique) trial aims to evaluate the effectiveness for these conditions of 3 health promotion strategies -- educational, screening and environmental -- applied singly or in combination in high schools over a 2-year intervention period.</p> <p>Methods</p> <p>PRALIMAP is a stratified 2 × 2 × 2 factorial cluster randomised controlled trial including 24 state high schools in Lorraine, northeastern France, in 2 waves: 8 schools in 2006 (wave 1) and 16 in 2007 (wave 2). Students entering the selected high schools in the 4 academic years from 2006 to 2009 are eligible for data collection. Interventional strategies are organized over 2 academic years. The follow-up consists of 3 visits: at the entry of grade 10 (T0), grade 11 (T1) and grade 12 (T2). At T0, 5,458 (85.7%) adolescents participated. The educational strategy consists of nutritional lessons, working groups and a final party. The screening strategy consists in detecting overweight/obesity and eating disorders in adolescents and proposing, if necessary, an adapted care management program of 7 group educational sessions. The environmental strategy consists in improving dietary and physical activity offerings in high schools and facilities, especially catering. The main outcomes are body size evolution over time, nutritional behaviour and knowledge, health and quality of life. An evaluation process documents how each intervention strategy is implemented in the schools and estimates the dose of the intervention, allowing for a per protocol analysis after the main intention-to-treat analysis.</p> <p>Discussion</p> <p>PRALIMAP aims at improving the prevention and management of overweight and obesity in adolescents by translating current evidence into public health practice. Particular attention is paid to clustering, multiple factorials and long-term duration to address common pitfalls in health promotion trials. The results should inform how best to implement, in a school environment, effective nutrition prevention programs targeting adolescents who are at a point their lives when they develop responsibilities and empowerment for health attitude behaviours.</p> <p>Trial registration</p> <p>This trial is registered at ClinicalTrials.gov under <a href="http://clinicaltrials.gov/ct2/show/NCT00814554">NCT00814554</a>.</p

Method for improving nucleation of crystals from solution

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Cumulative and bidirectional association of physical activity and sedentary behaviour with health-related quality of life in adolescents

International audienceBACKGROUND:The directionality of the association of physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) remains unknown in adolescents. This study aimed to investigate the association of 2-year cumulative level of PA and SB with HRQoL and the reverse association.METHODS:We included 1445 adolescents in France from a 2-year longitudinal study with three follow-up times (PRALIMAP trial). At each follow-up, adolescents completed the International Physical Activity Questionnaire for PA and SB and the Duke Health Profile for HRQoL. Statistical analyses involved linear and logistic regressions adjusted for socio-demographic characteristics.RESULTS:The cumulative number of times an adolescent achieved the PA recommendations during the 2 years was associated with better physical, mental, social and general HRQoL (p for trend < 0.0001). In contrast, high SB predicted low HRQoL for most dimensions except social HRQoL (p = 0.12). Combining PA and SB, the effect of recommended PA on HRQoL was offset in part by high SB. In the reverse association, high HRQoL predicted high PA (overall, vigorous, moderate and recommended PA), but was not associated with SB.CONCLUSIONS:The association between PA and HRQoL was cumulative and bidirectional among adolescents, whereas low HRQoL seemed to be a consequence of high SB rather than a cause (cumulative but not bidirectional). Promoting recommended PA and low SB may help improve HRQoL among adolescents, with a possible virtuous cycle with regard to PA

Participation d’adolescents en surpoids de milieu défavorisé à une intervention de promotion de l’activité physique à l’école

International audienceContexte : L’importance de l’activité physique (AP) et des inégalités sociales afférentes, dans la prévention et la prise en charge de l’obésité fait l’objet de débats. Notre objectif était d’identifier, au sein du programme PRALIMAP-INÉS, les déterminants de la participation d’adolescents en surpoids de milieu défavorisé.Méthodes : Cinq séances collectives dont deux spécifiques à l’AP et des activités adaptées individuelles ont été animées par des diététiciens, professionnels de l’activité physique et psychologues. Elles ont été proposées à 411 adolescents de 13 à 18 ans en situation de surpoids et d’obésité de milieu défavorisé et participant à PRALIMAP-INÉS, dans 35 collèges et lycées vosgiens.Résultats : La participation à au moins une séance collective était meilleure chez les collégiens comparée aux lycéens (OR = 2,2) et chez ceux qui déclaraient des difficultés financières pour payer une licence (OR = 5,8). Le nombre de séance augmentait avec l’indice de masse corporelle ; il était plus élevé chez les collégiens (+ 0,7 séance) et plus faible chez ceux déclarant des difficultés financières (– 1,1 séance). La participation à un entretien en AP était significativement meilleure chez les filles (OR = 1,8), chez ceux qui participaient à l’Union Nationale du Sport Scolaire (OR = 2,4) et qui déclaraient ne pas avoir d’amis avec qui pratiquer (OR = 2,7). Les niveaux d’AP et de sédentarité n’étaient pas associés à la participation.Conclusions : La participation initiale aux activités collectives PRALIMAP-INÉS était élevée chez les adolescents défavorisés avec difficultés financières mais son maintien tout au long du programme était chez eux plus difficile. Identifier les leviers du maintien de la participation est un défi majeur pour la pérennité du programme

Adolescents’ Physical Activity and Sedentary Behavior: A Pathway in Reducing Overweight and Obesity: The PRALIMAP 2-Year Cluster Randomized Controlled Trial

International congress on physical activity and public health. Rio de Janeiro, Brésil. Avril 2014.International audienceBACKGROUND:explaining why and how overweight prevention programs were effective was a real need; especially the potential role of physical activity (PA) and sedentary behavior (SB) should be highlighted. This study aimed to evaluate the 2-year effectiveness of a screening and care strategy in adolescents' weight reduction with regards to PA and SB change.METHODS:1745 adolescents aged 15.1 years from PRALIMAP trial was included (n = 840 for screening and care group and n = 905 for control group). PA and SB time (international physical activity questionnaire: IPAQ), body mass index (BMI), and BMI z-score were assessed at inclusion and after 2-year intervention. Hierarchical mixed models were applied.RESULTS:Compared with the control group, screening and care strategy was associated with an increase in global PA (58 min/week), a moderate PA (43 min/week), the adherence to the French PA guidelines (OR = 1.3), and a decrease in SB (-198 min/week). The 2-year weight change decreased when adjusted for PA and SB suggesting that the effect of screening and care strategy was partly mediated by PA and SB.CONCLUSION:Screening and care intervention seemed to be effective in increasing PA and decreasing SB. The induced PA and SB modifications contributed to the observed weight change

Change in physical activity levels among disadvantaged adolescents. The PRALIMAP-INÉS school-based overweight prevention program

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Using SILAC strategy to identify protein effectors in the wheat-Fusarium graminearum pathosystem

Using SILAC strategy to identify protein effectors in the wheat-Fusarium graminearum pathosystem. 7. Effectome meetin

Sociodemographic and psychological characteristics associated with discrepancy between body satisfaction and weight change among adolescents

International audienceThis study aimed to describe the discrepancy between body satisfaction change and weight change among adolescents following a 2-year school-based intervention, to identify associated sociodemographic factors, and to explore possible associations with perceived health indicators. We used data from a northeastern France representative adolescents sample (14-18 years old) who participated in the PRALIMAP (PRomotion de l'ALIMentation et de l'Activité Physique) study (2006-2009). Weight change was measured by the change in body mass index z-score from the start to the end of the study. Body satisfaction and self-perceived health (anxiety, depression, eating disorder and quality of life) changes were assessed using self-administered questionnaires. Discrepancy between body satisfaction change and weight change was described with cross-tabulations, and subdivided into optimism/pessimism (i.e. positive/negative body satisfaction change compared to weight change). Sociodemographic factors associated with discrepancy were determined by multivariate logistic regression models. Adjusted linear regression models described 2-year change in weight and self-perceived health according to discrepancy. Among the 3279 adolescents included (aged 15.1 ± 0.6 years), the proportion of discrepancy was 74.8% (pessimism = 41.6%; optimism = 33.2%). Discrepancy, especially pessimism, was higher in boys than in girls (OR = 1.44 [1.19; 1.74], p = .0002), and in socially advantaged adolescents (OR = 1.82 [1.20; 2.74], p = .004) than in disadvantage ones. Body satisfaction change was rather in line with anxiety, depression and quality of life changes than weight change. Body satisfaction change should be considered in overweight and obesity prevention interventions alongside body weight change, and could be used as indicator of long-term behavior maintenance. Clinical trials registry and number: ClinicalTrials.gov (NCT01688453)

Youth and Leisure time

Factors associated to T0 PA, BMI and daily sitting time data completion. (DOCX 18 kb

Continuous-Flow Tubular Crystallization to Discriminate between Two Competing Crystal Polymorphs. Part II: antisolvent crystallization

The development of a continuous flow antisolvent crystallization protocol for a commercial active pharmaceutical ingredient, Brivaracetam, is described. To obtain increased nucleation kinetics of the desired crystalline form, solutions of Brivaracetam/isopropyl acetate are injected into micrometric tubing and mixed with a refrigerated antisolvent hexane. In this way very high supersaturation conditions are induced shortly after mixing. Residence times below 1 s after mixing in short tubular crystallizers are necessary for the desired, but thermodynamically unstable, crystals to grow. Arresting all crystal growth by immediate removal of the antisolvent containing mother liquors by continuous filtration or by casting the product onto filter paper prevents the formation of the thermodynamically stable pseudopolymorph - undesired due to its needle shape and solvated nature. Sufficient solid material output can be generated in order to be implemented in actual processing conditions if combined with suited continuous filtration units.info:eu-repo/semantics/publishe