50 research outputs found
Physical activity recommendations for early childhood: an international analysis of ten different countriesâ current national physical activity policies and practices for those under the age of 5
During the last two decades there have been growing interests on recommendations for childrenâs physical
activity. The World Health Organization (WHO) launched the first global international recommendations for
children in 2010, focusing on children and youth aged 5-17 year olds. The recommendations were based on the
dose-response relationship between the frequency, duration, intensity, type and amount of physical activity needed
for prevention of non-communicable diseases. There remains however, at time of writing, (2019) a gap in the
recommendations, as the WHO did not offer global recommendations for those children under the age of 5 (early
years).
An international policy and practice analysis, (not previously undertaken), of ten sample countries, was completed
of current national physical activity practices. Also an international comparison of early yearsâ education settings
were examined, specifically for those under the age of 5, to investigate current curricula, as well as the
qualifications, knowledge and understanding of those supporting childrenâs learning in different cultural contexts.
The sample of ten countries (Belgium, China, Denmark, Finland, Germany, Ireland, Italy, Norway, United
Kingdom and United States of America) questioned whether the global daily physical activity recommendations
(WHO, 2010) are costumed and used for to the early yearsâ age group on a national level or if they need to be
adjusted.
The analysis revealed that eight countries have developed their own national recommendations for children below
the age of 5, while only two countries do not have any early yearsâ specific physical activity recommendations.
National authorities seem to be the most common executive sources behind the recommendations. The content of
physical activity for children under the age of 5, mostly included the total amount and intensity of physical activity.
The total daily amount of physical activity in these ten countries varies between 60 minutes moderate to vigorous
intensity physical activity up to 180 min total light to moderate intensity physical activity and for some countries
the daily recommendations are only from age 1 year, not between birth and 1 year, this age range remains
unsupported.
The conclusions from the analysis of national recommendations, underlined the need to see the global
recommendations be developed for the younger age group, to support all countries. It is proposed a need for
universally new recommendations to go beyond just physical activity intensity levels and to consider how young
childrenâs development can be supported in a versatile way by physically active play. Also age specific
recommendations are offered for appropriate and purposeful physical activity to support early years and school
aged childrenâs overall development. The findings also suggest educational recommendations for staff members
of early childhood education and care settings to know appropriate and age specific recommendations to ensure
they are able to support young children to reach the national and global recommendations. Research
recommendations are also proposed
The German RECAP questionnaire: linguistic validation and cognitive debriefing in German adults with self-reported atopic eczema and parents of affected children
BackgroundRecap of atopic eczema (RECAP) is a patient-reported outcome measure (PROM) assessing eczema control. Long-term control of eczema is one of the four core outcome domains for atopic eczema trials. This instrument has been recently developed in the UK.ObjectiveThis study aimed to translate the English RECAP into German and test its content validity in a German population with self-reported atopic eczema.MethodsA six-step procedure including two forward and one backward translations, two consensus decisions and an expert review was performed to obtain a German version of RECAP. We conducted semi-standardized cognitive interviews with adults with atopic eczema (nâ=â7) and parents having children affected by this disease (nâ=â5). A âthink-aloudâ method was used and aspects of comprehensibility, comprehensiveness and relevance according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were examined. Interviews were coded using qualitative content analysis.ResultsNo particular linguistic problems were encountered during forward-backward translation. Minor wording changes were made as required. The title was adjusted to a more familiar German term of the disease (which is âNeurodermitisâ). The recall period was rephrased from âover the last weekâ to âover the last seven daysâ since there was a different cultural understanding of the time frame. Regarding content validity, the items of the German RECAP were considered to be comprehensible, comprehensive and relevant for the participants and parents of affected children. The participants understood the instruction and considered the one-week recall period and the response options as appropriate.ConclusionsA German version of RECAP that is linguistically equivalent to the original version is now available but further assessment of its measurement properties is needed
Early diagnosis of amyotrophic lateral sclerosis by threshold tracking and conventional transcranial magnetic stimulation
© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.Background and purpose: Short-interval intracortical inhibition by threshold tracking (T-SICI) has been proposed as a diagnostic tool for amyotrophic lateral sclerosis (ALS) but has not been compared directly with conventional amplitude measurements (A-SICI). This study compared A-SICI and T-SICI for sensitivity and clinical usefulness as biomarkers for ALS.
Methods: In all, 104 consecutive patients referred with suspicion of ALS were prospectively included and were subsequently divided into 62 patients with motor neuron disease (MND) and 42 patient controls (ALS mimics) by clinical follow-up. T-SICI and A-SICI recorded in the first dorsal interosseus muscle (index test) were compared with recordings from 53 age-matched healthy controls. The reference standard was the Awaji criteria. Clinical scorings, conventional nerve conduction studies and electromyography were also performed on the patients.
Results: Motor neuron disease patients had significantly reduced T-SICI and A-SICI compared with the healthy and patient control groups, which were similar. Sensitivity and specificity for discriminating MND patients from patient controls were high (areas under the receiver operating characteristic curves 0.762 and 0.810 for T-SICI and A-SICI respectively at 1-3.5 ms). Paradoxically, T-SICI was most reduced in MND patients with the fewest upper motor neuron (UMN) signs (Spearman Ï = 0.565, p = 4.3 Ă 10-6 ).
Conclusions: Amplitude-based measure of cortical inhibition and T-SICI are both sensitive measures for the detection of cortical involvement in MND patients and may help early diagnosis of ALS, with T-SICI most abnormal before UMN signs have developed. The gradation in T-SICI from pathological facilitation in patients with minimal UMN signs to inhibition in those with the most UMN signs may be due to progressive degeneration of the subset of UMNs experiencing facilitation.info:eu-repo/semantics/publishedVersio
Physical play - How do we inspire and motivate young children to be physically active through play? An international analysis of twelve countriesâ national early years curriculum policies and practices for physical activity and physical play
Lifelong movement and physical activity (PA) patterns develop during early childhood. Therefore, educators (teachers and practitioners) in early childhood education and care (ECEC) should provide opportunities to support childrenâs play, PA, and movement development. The World Health Organization (2019) offers new recommendations for PA, for children under five years. The guidelines do not specify the ways ECEC staff can support PA through play. Therefore, this paper investigates, how physical play (PP) is enacted globally. An international policy and practice analysis of twelve countries, (Australia [Victoria], Belgium [Flanders], Canada [Alberta], China, Finland, Ireland, Italy, Portugal, Spain, Sweden, UK [England] and USA) was completed by analyzing the ECEC curricula and their implementation in different cultural contexts. A content analysis was undertaken by AIESEP Early Years SIG experts revealing that PP was not clearly defined. When defined, it was described as PA, and important for childrenâs holistic development. The majority of curricula did not state the length/time for PP. Three main strategies for implementing PP were found: a) pedagogical framework; b) active learning methods; and c) motor development. This international analysis highlights the global need for better ECEC staff support in acknowledging and implementing PP to aid childrenâs overall development, PA and wellbeing
A Collaborative Epidemiological Investigation into the Criminal Fake Artesunate Trade in South East Asia
Paul Newton and colleagues' international, collaborative study found evidence that counterfeit artesunate was being manufactured in China, which prompted a criminal investigation
Large-scale analysis of structural brain asymmetries in schizophrenia via the ENIGMA consortium
Left-right asymmetry is an important organizing feature of the healthy brain that may be altered in schizophrenia, but most studies have used relatively small samples and heterogeneous approaches, resulting in equivocal findings. We carried out the largest case-control study of structural brain asymmetries in schizophrenia, using MRI data from 5,080 affected individuals and 6,015 controls across 46 datasets in the ENIGMA consortium, using a single image analysis protocol. Asymmetry indexes were calculated for global and regional cortical thickness, surface area, and subcortical volume measures. Differences of asymmetry were calculated between affected individuals and controls per dataset, and effect sizes were meta-analyzed across datasets. Small average case-control differences were observed for thickness asymmetries of the rostral anterior cingulate and the middle temporal gyrus, both driven by thinner left-hemispheric cortices in schizophrenia. Analyses of these asymmetries with respect to the use of antipsychotic medication and other clinical variables did not show any significant associations. Assessment of age- and sex-specific effects revealed a stronger average leftward asymmetry of pallidum volume between older cases and controls. Case-control differences in a multivariate context were assessed in a subset of the data (N = 2,029), which revealed that 7% of the variance across all structural asymmetries was explained by case-control status. Subtle case-control differences of brain macro-structural asymmetry may reflect differences at the molecular, cytoarchitectonic or circuit levels that have functional relevance for the disorder. Reduced left middle temporal cortical thickness is consistent with altered left-hemisphere language network organization in schizophrenia
Finishing the euchromatic sequence of the human genome
The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers âŒ99% of the euchromatic genome and is accurate to an error rate of âŒ1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead
Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial
BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Scoreâ4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5â13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management
Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures
Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo