Physical activity in adolescence: cross-national comparisons of levels, distributions and disparities across 52 countries

Introduction: Despite global concerns regarding physical inactivity, limited cross-national evidence exists to compare adolescents’ physical activity participation. We analysed 52 high- and low-middle income countries, with activity undertaken inside and outside of school in 2015. We investigated gender- and socioeconomic-disparities, and additionally examined correlations with country-level indices of physical education (PE) curriculum time allocation, wealth, and income inequality. / Methods: We used the Programme for International Student Assessment (PISA), a nationally representative cross-sectional survey of 15-year-olds (N=347,935). Students reported average attendance (days/week) in PE classes, and the days/week engaged in moderate activity (MPA) and vigorous activity (VPA) outside of school. Both the mean and distributions of outcomes were evaluated, as were gender- and socioeconomic-disparities. Pearson’s correlations (r) between the physical activity outcomes and PE curriculum time allocation, wealth (indexed by GDP) and income inequality (indexed by the Gini coefficient) were calculated. / Results: Activity levels inside and outside of school were higher in Eastern Europe than Western Europe, the Americas, and the Middle East/North Africa. Comparisons of average levels masked potentially important differences in distributions. For example, activity levels inside school showed a bimodal distribution in the US (mean PE class attendance 2.4 days/week; 41.3%, 6.3% and 33.1% of students attended PE classes on 0, 2 and 5 days/week respectively). In contrast, most other countries exhibited more centrally shaped distributions. Pro-male and pro-high socioeconomic disparities were modest for participation inside school, but higher for MPA and VPA outside of school. The magnitude of these also differed markedly by country. Activity in school was weakly positively correlated with PE curriculum time allocation (r=0.33); activity outside of school was strongly negatively correlated with income inequality (e.g. r=-0.69 for MPA). / Conclusion: Our findings reveal extensive cross-country differences in adolescents’ physical activity; in turn, these highlight policy areas that could ultimately improve global adolescent health, such as the incorporation of minimum country-level PE classes, and the targeting of gender- and socioeconomic- disparities in activity conducted outside of school. Our findings also highlight the utility of educational databases such as PISA for use in global population health research

Physical activity across age and study: a guide to data in six CLOSER studies

Explore the measures used to assess diverse aspects of physical activity within and across six CLOSER partner studie

Effects of feeding corn silage, pelleted, ensiled, or pelleted and ensiled alfalfa on growth and carcass characteristics of lamb

Two experiments were conducted to evaluate the effects of corn silage (CS) and alfalfa (pelleted (AP), haylage (AH), or combination (APH)) on lamb growth and carcass characteristics. The objective of Experiment 1 (Exp. 1) was to compare AH to CS in lamb feedlot diets on lamb growth and carcass characteristics. Eighty lambs were used in a 56 day experiment with a randomized complete block design. The objective of Experiment 2 (Exp. 2) was to determine the effects of alfalfa form, AP, AH or AHP, on animal performance and carcass characteristics. Seventy two lambs were used in an 82 day experiment with a randomized complete block design. In Exp. 1, lambs offered AH consumed 23.5% more feed on a daily basis than lambs offered CS. However, lambs fed CS gained weight 21.3% faster than lambs fed AH (259 versus 213 g/day, respectively). Additionally, lambs fed CS were 50.4% more efficient in converting feed to gain compared with lambs offered AH (0.173 versus 0.115 kg gain/kg feed, respectively). In Exp. 2, AP resulted in a greater dry matter intake (DMI) and average daily gain (ADG), and fewer days on feed than with AH. The combination of pellets + haylage resulted in a greater DMI, ADG, and fewer days on feed compared to AH alone. Therefore, there was an inverse relationship between both forage particle size and diet moisture content with DMI. There was no difference in daily efficiency of gain due to the form of alfalfa. Average daily gain, days on feed, and DMI are economically important criteria that differ due to the form of alfalfa even when feed efficiencies are similar.Instituto de Genética Veterinari

Nicotine preloading for smoking cessation: the Preloading RCT

Background: Nicotine preloading means using nicotine replacement therapy prior to a quit date while smoking normally. The aim is to reduce the drive to smoke, thereby reducing cravings for smoking after quit day, which are the main cause of early relapse. A prior systematic review showed inconclusive and heterogeneous evidence that preloading was effective and little evidence of the mechanism of action, with no cost-effectiveness data. Objectives: To assess (1) the effectiveness, safety and tolerability of nicotine preloading in a routine NHS setting relative to usual care, (2) the mechanisms of the action of preloading and (3) the cost-effectiveness of preloading. Design: Open-label randomised controlled trial with examination of mediation and a cost-effectiveness analysis. Setting: NHS smoking cessation clinics. Participants: People seeking help to stop smoking. Interventions: Nicotine preloading comprised wearing a 21 mg/24 hour nicotine patch for 4 weeks prior to quit date. In addition, minimal behavioural support was provided to explain the intervention rationale and to support adherence. In the comparator group, participants received equivalent behavioural support. Randomisation was stratified by centre and concealed from investigators. Main outcome measures: The primary outcome was 6-month prolonged abstinence assessed using the Russell Standard. The secondary outcomes were 4-week and 12-month abstinence. Adverse events (AEs) were assessed from baseline to 1 week after quit day. In a planned analysis, we adjusted for the use of varenicline (Champix®; Pfizer Inc., New York, NY, USA) as post-cessation medication. Cost-effectiveness analysis took a health-service perspective. The within-trial analysis assessed health-service costs during the 13 months of trial enrolment relative to the previous 6 months comparing trial arms. The base case was based on multiple imputation for missing cost data. We modelled long-term health outcomes of smoking-related diseases using the European-study on Quantifying Utility of Investment in Protection from Tobacco (EQUIPT) model. Results: In total, 1792 people were eligible and were enrolled in the study, with 893 randomised to the control group and 899 randomised to the intervention group. In the intervention group, 49 (5.5%) people discontinued preloading prematurely and most others used it daily. The primary outcome, biochemically validated 6-month abstinence, was achieved by 157 (17.5%) people in the intervention group and 129 (14.4%) people in the control group, a difference of 3.02 percentage points [95% confidence interval (CI) –0.37 to 6.41 percentage points; odds ratio (OR) 1.25, 95% CI 0.97 to 1.62; p = 0.081]. Adjusted for use of post-quit day varenicline, the OR was 1.34 (95% CI 1.03 to 1.73; p = 0.028). Secondary abstinence outcomes were similar. The OR for the occurrence of serious AEs was 1.12 (95% CI 0.42 to 3.03). Moderate-severity nausea occurred in an additional 4% of the preloading group compared with the control group. There was evidence that reduced urges to smoke and reduced smoke inhalation mediated the effect of preloading on abstinence. The incremental cost-effectiveness ratio at the 6-month follow-up for preloading relative to control was £710 (95% CI –£13,674 to £23,205), but preloading was dominant at 12 months and in the long term, with an 80% probability that it is cost saving. Limitations: The open-label design could partially account for the mediation results. Outcome assessment could not be blinded but was biochemically verified. Conclusions: Use of nicotine-patch preloading for 4 weeks prior to attempting to stop smoking can increase the proportion of people who stop successfully, but its benefit is undermined because it reduces the use of varenicline after preloading. If this latter effect could be overcome, then nicotine preloading appears to improve health and reduce health-service costs in the long term. Future work should determine how to ensure that people using nicotine preloading opt to use varenicline as cessation medication. Trial registration: Current Controlled Trials ISRCTN33031001.NIHR Health Technology Assessment programm

Non-standard errors

In statistics, samples are drawn from a population in a data-generating process (DGP). Standard errors measure the uncertainty in estimates of population parameters. In science, evidence is generated to test hypotheses in an evidence generating process (EGP). We claim that EGP variation across researchers adds uncertainty: Non-standard errors (NSEs). We study NSEs by letting 164 teams test the same hypotheses on the same data. NSEs turn out to be sizable, but smaller for better reproducible or higher rated research. Adding peer-review stages reduces NSEs. We further find that this type of uncertainty is underestimated by participants

The Diagnostic Accuracy of Two Tense Measures for Identifying 3-Year-Olds With Language Impairment

Purpose: The authors of this study investigated the diagnostic accuracy of the Finite Verb Morphology Composite (FVMC; Bedore & Leonard, 1998) and the Tense and Agreement Productivity Score (TAPS; Hadley & Short, 2005) in identifying 3-year-olds with language impairment (LI). Method: Eighteen pairs of 3-year-olds with and without LI participated in the current study. The FVMC and the TAPS were computed from 100- and 50-utterance language samples. Results: The FVMC and TAPS demonstrated higher diagnostic accuracy in the 100-utterance samples than in the 50-utterance samples. For 100-utterance samples, when children\u27s age or severity was not considered, the FVMC showed a slight advantage over the TAPS in diagnostic accuracy. However, when children\u27s age or severity was considered, the opposite pattern was observed. Conclusion: Both the FVMC and TAPS can be used to differentiate 3-year-olds with and without LI. To reliably identify 3-year-olds with LI by using tense measures, language samples with at least 100 utterances are recommended