Understanding active school travel through the Behavioural Ecological Model

Active school travel (AST) is an important source of physical activity for children and a conceptual understanding of AST is necessary to inform promotion efforts. The aim of this article is to provide a conceptual analysis of AST. All currently identified AST formulations include intra-individual variables which are often recommended as intervention targets. However, existing literature lacks clarity on precisely how these intra-individual variables might shape specific AST interventions. Moreover, evaluative studies of AST interventions typically fail to specify an underpinning theory or model. To address this limitation, the Behavioural Ecological Model (BEM), not previously addressed in AST, is presented to guide this area of research. Based on specific examples, we draw attention to the role of potential antecedents and potential reinforcers of AST, as well as potential reinforcers of motorised travel. Antecedents and reinforcers may help to explain choices of school travel mode, and to inform and increase intervention options to promote AST. Consistent with the BEM, the provision of more immediate consequences, such as fun and material prizes, is an evidence-based strategy for increasing AST which is likely to be low-cost and easier to deliver than alternative interventions. This approach to the study of AST is expected to contribute to similar analyses in this and other areas of behaviour change research, and to a more useful discussion and treatment of theoretical and conceptual behavioural models

Feasibility of an incentive scheme to promote active travel to school: a pilot cluster randomised trial

Abstract Background In Great Britain, 19% of trips to primary school within 1 mile, and 62% within 1–2 miles, are by car. Active travel to school (ATS) offers a potential source of moderate-to-vigorous physical activity (MVPA). This study tested the feasibility of an intervention to promote ATS in 9–10 year olds and associated trial procedures. Methods A parallel cluster randomised pilot trial was conducted over 9 weeks in two schools from a low-income area in northeast England. Measures included daily parental ATS reports (optionally by SMS) and child ATS reports, as well as accelerometry (ActiGraph GT3X+). At baseline, all children were asked to wear the accelerometer for the same week; in the post-randomisation phase, small subsamples were monitored each week. In the 2 weeks when a child wore the accelerometer, parents also reported the start and finish times of the journey to school. The intervention consisted of a lottery-based incentive scheme; every ATS day reported by the parent, whether by paper or SMS, corresponded to one ticket entered into a weekly £5 voucher draw. Before each draw session, the researcher prepared the tickets and placed them into an opaque bag, from which one was randomly picked by the teacher at the draw session. Results Four schools replied positively (3.3%, N = 123) and 29 participants were recruited in the two schools selected (33.0%, N = 88). Participant retention was 93.1%. Most materials were returned on time: accelerometers (81.9%), parental reports (82.1%) and child reports (97.9%). Draw sessions lasted on average 15.9 min (IQR 10–20) and overall session attendance was 94.5%. Parent-child report agreement regarding ATS was moderate (k = 0.53, CI 95% 0.45; 0.60). Differences in minutes of accelerometer-assessed MVPA between parent-reported ATS and non-ATS trips were assessed during two timeframes: during the journey to school based on the times reported by the parent (U = 390.5, p < 0.05, 2.46 (n = 99) vs 0.76 (n = 13)) and in the hour before classes (U = 665.5, p < 0.05, 4.99 (n = 104) vs 2.55 (n = 19)). Differences in MVPA minutes between child-reported ATS and non-ATS trips were also significant for each of the timeframes considered (U = 596.5, p < 0.05, 2.40 (n = 128) vs 0.81 (n = 15) and U = 955.0, p < 0.05, 4.99 (n = 146) vs 2.59 (n = 20), respectively). Conclusions Data suggest the feasibility of an ATS incentive scheme and of most trial procedures. School recruitment stood out as requiring further piloting. Trial registration ClinicalTrials.gov: NCT02282631 . Registered 5th September 2014

Adherence with isoniazid for prevention of tuberculosis among HIV-infected adults in South Africa

BACKGROUND: Tuberculosis (TB) is the most common opportunistic infection in HIV-infected adults in developing countries. Isoniazid (INH) is recommended for treatment of latent TB infection, however non-adherence is common. The purpose of this study was to apply in-house prepared isoniazid (INH) urine test strips in a clinical setting, and identify predictors of positive test results in an adherence questionnaire in HIV-infected adults taking INH for prevention of TB. METHODS: Cross-sectional study of adherence using a questionnaire and urine test strips for detection of INH metabolites at two hospitals in Pietermaritzburg, South Africa. Participants were aged at least 18 years, HIV positive, and receiving INH for prevention of tuberculosis disease. Univariate and multivariate analyses are used to identify factors relevant to adherence. RESULTS: 301 consecutive patients were recruited. 28% of participants had negative urine tests. 32 (37.2%, 95% CI25.4, 45.0) of the 86 patients who received INH from peripheral pharmacies said the pharmacy had run out of INH at some time, compared with central hospital pharmacies (p = 0.0001). In univariate analysis, a negative test was associated with self-reported missed INH doses (p = 0.043). Each 12-hour increment since last reported dose increased the likelihood of a negative test by 34% (p = 0.0007). Belief in INH safety was associated with a positive test (p = 0.021). In multivariate analysis, patients who believed INH is important for prevention of TB disease were more likely to be negative (p = 0.0086). CONCLUSION: Adequate drug availability at peripheral pharmacies remains an important intervention for TB prevention. Key questions may identify potentially non-adherent patients. In-house prepared urine tests strips are an effective and cheap method of objectively assessing INH adherence, and could be used an important tool in TB control programs

Thirdhand Tobacco Smoke: Emerging Evidence and Arguments for a Multidisciplinary Research Agenda

There is broad consensus regarding the health impact of tobacco use and secondhand smoke exposure, yet considerable ambiguity exists about the nature and consequences of thirdhand smoke (THS). We introduce definitions of THS and THS exposure and review recent findings about constituents, indoor sorption-desorption dynamics, and transformations of THS; distribution and persistence of THS in residential settings; implications for pathways of exposure; potential clinical significance and health effects; and behavioral and policy issues that affect and are affected by THS. Physical and chemical transformations of tobacco smoke pollutants take place over time scales ranging from seconds to months and include the creation of secondary pollutants that in some cases are more toxic (e.g., tobacco-specific nitrosamines). THS persists in real-world residential settings in the air, dust, and surfaces and is associated with elevated levels of nicotine on hands and cotinine in urine of nonsmokers residing in homes previously occupied by smokers. Much still needs to be learned about the chemistry, exposure, toxicology, health risks, and policy implications of THS. The existing evidence on THS provides strong support for pursuing a programmatic research agenda to close gaps in our current understanding of the chemistry, exposure, toxicology, and health effects of THS, as well as its behavioral, economic, and sociocultural considerations and consequences. Such a research agenda is necessary to illuminate the role of THS in existing and future tobacco control efforts to decrease smoking initiation and smoking levels, to increase cessation attempts and sustained cessation, and to reduce the cumulative effects of tobacco use on morbidity and mortality

Cutaneous nociception and neurogenic inflammation evoked by PACAP38 and VIP

Pituitary adenylate cyclase-activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) belong to the same secretin–glucagon superfamily and are present in nerve fibers in dura and skin. Using a model of acute cutaneous pain we explored differences in pain perception and vasomotor responses between PACAP38 and VIP in 16 healthy volunteers in a double-blind, placebo-controlled, crossover study. All participants received intradermal injections of 200 pmol PACAP38, 200 pmol VIP and placebo into the volar forearm. Measurements included pain intensity on a visual analog scale (VAS), blood flow by laser Doppler flowmetry, visual flare and wheal. Pain intensities after PACAP38 and VIP were mild and limited to a short time of about 100 s after injection. The area under the VAS-time curve was larger following PACAP38 (P = 0.004) and VIP (P = 0.01) compared to placebo. We found no statistical difference in pain perception between PACAP38 and VIP. Skin blood flow increase, flare and wheal were larger after both PACAP38 (P = 0.011) and VIP (P = 0.001) compared to placebo. VIP induced a considerably larger increase in skin blood flow, flare and wheal than PACAP38 (P = 0.002). In conclusion, we found that peripheral nociceptive cutaneous responses elicited by PACAP38 and VIP are similar in healthy volunteers. This suggests that acute pain and vasomotor responses following intradermal injections of PACAP38 and VIP are primarily mediated by VPAC receptors

Green and roasted arabica coffees differentiated by ripeness, process and cup quality via electrospray ionization mass spectrometry fingerprinting

Direct infusion electrospray ionization mass spectrometry in both the negative ESI(-)-MS and positive ESI(+)-MS ion modes are investigated to differentiate green and roasted Arabica coffees with different stages of ripeness (green, ripe and overripe), post-harvesting process (dry, wet and semi-wet) and coffees with different cup qualities. In the ESI(-)-MS of green coffees, ions from deprotonated fatty acids and chlorogenic acids are the most important for ripeness discrimination. In the ESI(+)-MS, maturity is differentiated by ions from protonated caffeine, chlorogenic acids and K+ adducts of fatty acids. To differentiate between post-harvesting process in both ionization modes, ions from fatty acids, chlorogenic acids, sugars and carboxylic acids generated in the fermentation process are the most representative. Roasted Arabica coffees are also well discriminated: in the ESI(-)-MS, ions from chlorogenic acids and short-chain organic acids derived from sugars are important. In the ESI(+)-MS, discrimination are mainly performed by low m/z ions such as protonated pyridine and alkylpiridines formed via trigonelline degradation. Both ESI(+)-MS and ESI(-)-MS are able to differentiate cup quality for Arabica roasted coffees and the ions used to perform discrimination are the same ones described in ripeness and post-harvesting processes.A habilidade da técnica de espectrometria de massas com infusão direta e ionização por eletronebulização (IES-EM), nos modos de íons positivos e negativos, foi avaliada na diferenciação de cafés Arábica verdes e torrados e com diferentes estágios de amadurecimento (verde, maduro e passado), processo pós-colheita (seco, úmido e semi-úmido) e cafés classificados por prova de xícara. No modo negativo, a análise dos cafés verdes mostrou que os íons correspondentes aos ácidos graxos e ácidos clorogênicos desprotonados são os mais importantes para a discriminação da maturidade. No modo positivo, a maturidade é diferenciada através de íons correspondentes a cafeína, ácidos clorogênicos protonados e adutos de K+ de ácidos graxos. Na diferenciação da pós-colheita, em ambos os modos de ionização, são mais importantes os íons correspondentes aos ácidos graxos, ácidos clorogênicos, açúcares e ácidos carboxílicos formados da fermentação. Cafés Arábica torrados também são discriminados com eficiência. No modo negativo, são importantes os íons correspondentes aos ácidos clorogênicos e ácidos orgânicos de cadeia curta, derivados de açúcares. No modo positivo, a discriminação é realizada por íons de baixa m/z tais como piridina e alquil piridinas protonadas, formadas através da degradação da trigonelina. Ambos os IES(+)-EM e IES(-)-EM são capazes de discriminar diferentes cafés Arábica torrados classificados por prova de xícara e os íons que permitem esta diferenciação são os mesmos descritos para a maturidade e processos pós-colheita.313321Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Action to achieve smoke-free homes- an exploration of experts' views

Background: Smoking in the home is the major cause of exposure to second-hand smoke in children in the UK, particularly those living in low income households which have fewer restrictions on smoking in the home. Reducing children's exposure to second-hand smoke is an important public health and inequalities issue. Drawing on findings from a qualitative Scottish study, this paper identifies key issues and challenges that need to be considered when developing action to promote smoke-free homes at the national and local level. Methods: Two panels of tobacco control experts (local and national) from Scotland considered the implications of the findings from a qualitative study of smokers and non-smokers (who were interviewed about smoking in the home), for future action on reducing smoking in the home. Results: Several key themes emerged through the expert panel discussions. These related to: improving knowledge about SHS among carers and professionals; the goal and approach of future interventions (incremental/harm reduction or total restrictions); the complexity of the interventions; and issues around protecting children. Conclusion: The expert panels were very aware of the sensitivities around the boundary between the 'private' home and public health interventions; but also the lack of evidence on the relative effectiveness of specific individual and community approaches on increasing restrictions on smoking in the home. Future action on smoke-free homes needs to consider and address these complexities. In particular health professionals and other key stakeholders need appropriate training on the issues around smoking in the home and how to address these, as well as for more research to evaluate interventions and develop a more robust evidence base to inform effective action on this issue

Exposure to environmental tobacco smoke among South Korean adults: a cross-sectional study of the 2005 Korea National Health and Nutrition Examination Survey

<p>Abstract</p> <p>Background</p> <p>Studies have identified that environmental tobacco smoke exposure is associated with sociodemographic factors such as age, sex, and socioeconomic status, but few studies have been conducted in South Korea. In this study, the authors investigated the extent of environmental tobacco smoke exposure and factors related in a nationally representative sample of Korean adults.</p> <p>Methods</p> <p>The data of 7,801 adults aged 19 years and over collected during the 2005 Korea National Health and Nutrition Examination Survey were analyzed. Information on smoking habits and exposure to environmental tobacco smoke was obtained by self-reports using a standardized questionnaire. Risks of environmental tobacco smoke exposure conferred by sociodemographic variables and behavioral risk factors were evaluated using logistic regression methods.</p> <p>Results</p> <p>Overall, 36.1% of nonsmokers (defined as those not currently smoking) and 50.1% of current smokers were found to be exposed to environmental tobacco smoke either at work or at home. Among the nonsmokers, women were more likely to be exposed to environmental tobacco smoke at home (OR = 5.22, 95%CI, 4.08-6.67). Furthermore, an inverse relationship was found between education level and the risk of environmental tobacco smoke exposure at home (OR = 1.73, 95%CI, 1.38-2.17 for those with a high school education; OR = 2.30, 95%CI, 1.68-3.16 for those with a middle school education; and OR = 2.58, 95%CI, 1.85-3.59 for those with less than an elementary school education vs. those with a college education or more). In addition, those with office, sales service, or manual labor jobs were found to be at significantly higher risk of environmental tobacco smoke exposure at work than those with professional, administrative, or managerial jobs. Also, the risk of environmental tobacco smoke exposure in the workplace was significantly higher for alcohol drinkers than non-drinkers (OR = 1.23, 95%CI, 1.07-1.47). After adjusting for age, sex and education, it was found that those exposed to environmental tobacco smoke at home were more likely to have been admitted to hospital during the previous year (OR 1.29, 95%CI, 1.002-1.66).</p> <p>Conclusions</p> <p>In this study of Korean adults, exposure to environmental tobacco smoke at home or work was found to be affected by sex, age, marital status, educational level, and type of occupation. Accordingly, these factors should be given appropriate consideration by those developing policies or interventions designed to control exposure to environmental tobacco smoke.</p