Adolescent girls' and parents' views on recruiting and retaining girls into an after-school dance intervention: implications for extra-curricular physical activity provision

<p>Abstract</p> <p>Background</p> <p>Many adolescents are not sufficiently active and girls are less active than boys. Physical activity interventions delivered during curriculum time have reported weak effects. More sustained changes in physical activity may be obtained by facilitating participation in enjoyable activities. Dance is the favourite activity of UK girls but there is a shortage of dance provision. Dance sessions delivered after the school day could prove to be an effective means of engaging adolescent girls in physical activity. There is a lack of information about the factors that would affect girls' recruitment and retention in an after-school dance programme.</p> <p>Methods</p> <p>Focus groups were conducted with 65, Year 7 (11-12 year old) girls from 4 secondary schools in Bristol. In-depth phone interviews were also conducted with 16 (4 per school) of the girls' parents. Interviews and focus groups examined issues that would affect recruitment into the intervention, strategies that could be used to attract girls who have little or no previous experience in dance, any factors that would increase their interest in participating in an after-school dance programme and any factors that would affect retention in the programme. All interviews and focus groups were digitally recorded and thematically analysed.</p> <p>Results</p> <p>Girls reported that a taster session in which they had an opportunity to sample the intervention content and "word of mouth" campaigns by peers, who did not need to be their friends, would encourage them to participate in an after-school dance programme. Sessions that maximised enjoyment and facilitated socialisation opportunities would enhance retention. Parents reported that encouraging groups of friends to join the programme, and stressing the enjoyment of the session would increase participation.</p> <p>Conclusions</p> <p>Recruitment and retention campaigns that focus on enjoyment, socialisation, mastery, goal setting and relating to other girls may be effective strategies for recruiting and retaining girls in an after-school dance programme. These factors are consistent with well-established theories of individual behaviour change such as self-determination theory and social cognitive theory. Recruitment and retention campaigns that are targeted to address theoretically derived mediators of behaviour may be more effective than traditional approaches.</p

Bristol Girls Dance Project Feasibility Trial: Outcome and process evaluation results

Background: Many adolescent girls do not engage in sufficient physical activity (PA). This study examined the feasibility of conducting a cluster randomized controlled trial (RCT) to evaluate an after-school dance program to increase PA among 11-12 year old girls in Bristol, UK.Methods: Three-arm, cluster RCT. Three secondary schools were assigned to intervention arm. Intervention participants received a 9-week dance program with 2, 90-minute dance classes per week. Participants at 2 control schools received incentives for data collection. Participants at 2 additional control schools received incentives and a delayed dance workshop. Accelerometer data were collected at baseline (time 0), during the last week of the dance program (time 1) and 20 weeks after the start of the study (time 2). Weekly attendance, enjoyment and perceived exertion were assessed in intervention participants. Post-study qualitative work was conducted with intervention participants and personnel.Results: 40.1% of girls provided consent to be in the study. The mean number of girls attending at least one dance session per week ranged from 15.4 to 25.9. There was greater number of participants for whom accelerometer data were collected in control arms. The mean attendance was 13.3 sessions (maximum = 18). Perceived exertion ratings indicated that the girls did not find the sessions challenging. The dance teachers reported that the program content would benefit from revisions including less creative task time, a broader range of dance genres and improved behavioral management policies. At time 2, the 95% confidence intervals suggest between 5 and 12 minutes more weekday MVPA in the intervention group compared with the control incentives only group, and between 6 minutes fewer and 1 minute more compared with the control incentives plus workshop group. Between 14 and 24 schools would be required to detect a difference of 10 minutes in mean weekday MVPA between intervention and control groups.Conclusions: It is possible to recruit 11-12 year old girls to participate in an after-school dance study. An after-school dance intervention has potential to positively affect the PA levels of 11-12 year old girls but an adequately powered RCT is required to test this intervention approach. © 2012 Jago et al.; licensee BioMed Central Ltd

Isolation and culture of murine bone marrow-derived macrophages for nitric oxide and redox biology

Macrophages are mononuclear phagocytes derived from haematopoietic progenitors that are widely distributed throughout the body. These cells participate in both innate and adaptive immune responses and lie central to the processes of inflammation, development, and homeostasis. Macrophage physiology varies depending on the environment in which they reside and they exhibit rapid functional adaption in response to external stimuli. To study macrophages in vitro, cells are typically cultured ex vivo from the peritoneum or alveoli, or differentiated from myeloid bone marrow progenitor cells to form bone marrow-derived macrophages (BMDMs). BMDMs represent an efficient and cost-effective means of studying macrophage biology. However, the inherent sensitivity of macrophages to biochemical stimuli (such as cytokines, metabolic intermediates, and RNS/ROS) makes it imperative to control experimental conditions rigorously. Therefore, the aim of this study was to establish an optimised and standardised method for the isolation and culture of BMDMs. We used classically activated macrophages isolated from WT and nitric oxide (NO)-deficient mice to develop a standardised culture method, whereby the constituents of the culture media are defined. We then methodically compared our standardised protocol to the most commonly used method of BMDM culture to establish an optimal protocol for the study of nitric oxide (NO)-redox biology and immunometabolism in vitro. [Abstract copyright: Copyright © 2020. Published by Elsevier Inc.

Nitric Oxide Modulates Metabolic Remodeling in Inflammatory Macrophages through TCA Cycle Regulation and Itaconate Accumulation

Classical activation of macrophages (M(LPS+IFNγ)) elicits the expression of inducible nitric oxide synthase (iNOS), generating large amounts of NO and inhibiting mitochondrial respiration. Upregulation of glycolysis and a disrupted tricarboxylic acid (TCA) cycle underpin this switch to a pro-inflammatory phenotype. We show that the NOS cofactor tetrahydrobiopterin (BH4) modulates IL-1β production and key aspects of metabolic remodeling in activated murine macrophages via NO production. Using two complementary genetic models, we reveal that NO modulates levels of the essential TCA cycle metabolites citrate and succinate, as well as the inflammatory mediator itaconate. Furthermore, NO regulates macrophage respiratory function via changes in the abundance of critical N-module subunits in Complex I. However, NO-deficient cells can still upregulate glycolysis despite changes in the abundance of glycolytic intermediates and proteins involved in glucose metabolism. Our findings reveal a fundamental role for iNOS-derived NO in regulating metabolic remodeling and cytokine production in the pro-inflammatory macrophage

Adherence to 24-Hour Movement Guidelines for the Early Years and associations with social-cognitive development among Australian preschool children

Background: The new Australian 24-Hour Movement Guidelines for the Early Years recommend that, for preschoolers, a healthy 24-h includes: i) ≥180 min of physical activity, including ≥60 min of energetic play, ii) ≤1 h of sedentary screen time, and iii) 10–13 h of good quality sleep. Using an Australian sample, this study reports the proportion of preschool children meeting these guidelines and investigates associations with social-cognitive development. Methods: Data from 248 preschool children (mean age = 4.2 ± 0.6 years, 57% boys) participating in the PATH-ABC study were analyzed. Children completed direct assessments of physical activity (accelerometry) and social cognition (the Test of Emotional Comprehension (TEC) and Theory of Mind (ToM)). Parents reported on children’s screen time and sleep. Children were categorised as meeting/not meeting: i) individual guidelines, ii) combinations of two guidelines, or iii) all three guidelines. Associations were examined using linear regression adjusting for child age, sex, vocabulary, area level socio-economic status and childcare level clustering. Results: High proportions of children met the physical activity (93.1%) and sleep (88.7%) guidelines, whereas fewer met the screen time guideline (17.3%). Overall, 14.9% of children met all three guidelines. Children meeting the sleep guideline performed better on TEC than those who did not (mean difference [MD] = 1.41; 95% confidence interval (CI) = 0.36, 2.47). Children meeting the sleep and physical activity or sleep and screen time guidelines also performed better on TEC (MD = 1.36; 95% CI = 0.31, 2.41) and ToM (MD = 0.25; 95% CI = −0.002, 0.50; p = 0.05), respectively, than those who did not. Meeting all three guidelines was associated with better ToM performance (MD = 0.28; 95% CI = −0.002, 0.48, p = 0.05), while meeting a larger number of guidelines was associated with better TEC (3 or 2 vs. 1/none, p < 0.02) and ToM performance (3 vs. 2, p = 0.03). Conclusions: Strategies to promote adherence to the 24-Hour Movement Behaviour Guidelines for the Early Years among preschool children are warranted. Supporting preschool children to meet all guidelines or more guidelines, particularly the sleep and screen time guidelines, may be beneficial for their social-cognitive development

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

An investigation into the associations of physical activity and electronic media use with cognitive and psychosocial health in preschool children

Physical inactivity and electronic media use have been shown to be detrimentally associated with several health and developmental outcomes in the early years, however investigations into cognitive and psychosocial health outcomes are limited. The aim of this Doctoral thesis was to cross-sectionally and longitudinally investigate associations between physical activity (intensity and type) and electronic media use (type) with cognitive and psychosocial health in preschool children (3- to 5-years). This thesis aimed to provide evidence to better understand and improve the health and well-being of children, and to help inform policies and practices related to physical activity and electronic media use in young children. This Doctorate is comprised of a literature review, five original research papers using data from a prospective observational study – the Preschool Activity, Technology, Health, Adiposity, Behaviour and Cognition (PATH-ABC) study – and an overall discussion and conclusion chapter discussing the implications of the findings. Chapter 1 introduces the topic and provides the aims and research questions outlined for this thesis. This chapter then discusses the significance of the research, its delimitations, limitations and definitions of key terms. Chapter 2 provides a literature review of the topic area. It provides definitions of physical activity and electronic media use, and then discusses the measurement of these behaviours. The chapter discusses current physical activity and electronic media guidelines, and prevalence rates in early childhood. This is then followed by a review of the evidence on associations of physical activity and electronic media use with cognitive and psychosocial health outcomes in early childhood, including a discussion of possible mechanisms. Lastly, this chapter discusses the translation of research into practice and reconciles the available evidence, highlighting gaps for further research. Chapter 3 examines the cross-sectional associations of objectively-measured physical activity and modified organised sport participation with executive functions (i.e., cognitive control abilities that are central to thinking and learning, including working memory, inhibition and shifting) and psychosocial health in preschool children. Light intensity physical activity was negatively associated with children\u27s visual-spatial working memory, while the positive association between vigorous intensity physical activity and visualspatial working memory approached significance. Similarly, higher levels of vigorous intensity physical activity were associated with fewer internalising behaviour problems. However, vigorous and moderate-to vigorous intensity physical activity were positively associated with externalising behaviour problems. In addition, modified organised sport participants displayed higher shifting performance compared to those who did not participate in sport. Chapter 4 examines the longitudinal associations of objectively measured physical activity and modified organised sport participation at 3- to 5-years with executive functions and psychosocial health 12 months later. Vigorous intensity physical activity at baseline was positively associated with children’s shifting performance at follow-up, while this association for moderate-to-vigorous intensity physical activity approached statistical significance. Children who did not participate in modified organised sport at baseline demonstrated better inhibition scores 12 months later compared to sports participants. No longitudinal associations were evident between physical activity or modified organised sport participation and psychosocial health. Chapter 5 examines the cross-sectional associations of electronic media use with executive functions and psychosocial health in preschool children. Negative associations were observed for total electronic media use and TV/program viewing with children’s visualspatial working memory. However, high-dose app users (≥30 min/day) displayed higher phonological working memory compared to non-users. Similarly, compared to non-users, low dose app users (1 - 29 min/day) displayed fewer total psychosocial difficulties. Chapter 6 examines longitudinal associations of electronic media use at 3- to 5-years with executive functions and psychosocial health 12 months later. Higher levels of program viewing at baseline were significantly associated with more externalising behaviours and total psychosocial difficulties at follow-up. Likewise, high-dose app users (≥30 min/day) at baseline displayed significantly lower inhibition capabilities 12 months later, compared to low-dose app users (1 - 29 min/day), although neither group significantly differed from non-users. Chapter 7 examines cross-sectional and longitudinal associations of compliance with the Australian 24-Hour Movement Guidelines for the Early Years with executive functions and psychosocial health in preschool children. Associations were examined for meeting: i) individual recommendations; ii) combinations of recommendations; iii) the number of recommendations; and iv) the overall guidelines. Cross-sectionally, children who met both the physical activity and sleep guidelines combined displayed better phonological working memory and shifting performance, compared to those who did not. Compared to children who met one/no guidelines, children who met two guidelines displayed better phonological working memory, whereas the difference in phonological working memory between children who meet three guidelines, and those who met one/no guidelines approached significance. Children who met three guidelines demonstrated better shifting ability compared to children who met one/no guidelines. The difference in shifting ability between children who met two guidelines compared to those who met one/no guidelines approached significance. Longitudinally, children who met the physical activity guideline at 3-5 years displayed better shifting performance 12 months later compared to those who did not. However, children who met the overall integrated 24-h movement behaviour guidelines did not display better executive functions or psychosocial health outcomes, compared to those who did not, cross-sectionally or longitudinally. No significant cross-sectional or longitudinal associations were observed for psychosocial health outcomes. Chapter 8 concludes by reconciling this evidence, and discussing its implications for the community, researchers and policy makers in relation to supporting young children’s cognitive and psychosocial health, and how these outcomes might be influenced by participation in physical activity and engagement with electronic media. Specifically, this thesis integrates these findings with other available evidence to suggest the most beneficial intensities and types of physical activity, and types and doses of electronic media use in the early years, to assist in placing children on the best pathway to optimal health and give them the best start to life

Cross-Sectional Associations of Application Use and Media Program Viewing with Cognitive and Psychosocial Development in Preschoolers

Executive functions and psychosocial health during childhood are positively associated with health and developmental outcomes into adulthood. Electronic media use has been reported to adversely affect health and development in children; however, what remains unclear is whether contemporary media behaviors, such as electronic application (app) use, exerts similar effects on health and development. We investigated the associations of electronic media use (program viewing and app use) with cognitive and psychosocial development in preschoolers. Parents of preschool children (n = 247, 4.2 ± 0.6 years) reported the time their child spent using electronic media. Direct assessment of the children’s executive functions (working memory, inhibition, and shifting) and educator-reported psychosocial difficulties were also collected. Associations were examined using linear regression adjustments for covariates and preschool clustering. Small, but significant, negative associations were observed for total electronic media use (b = −0.001; 95% CI: −0.003, −0.000; p = 0.026) and program viewing (b = −0.002; 95% CI: −0.003, −0.000; p = 0.033) with children’s visual–spatial working memory. However, high-dose app users demonstrated higher phonological working memory scores compared to non-users (MD = 0.31; 95% CI: 0.04, 0.58; p = 0.025). Similarly, compared to non-users, low-dose app users displayed statistically significantly fewer total difficulties (MD = −1.67; 95% CI: −3.31, −0.02; p = 0.047). No associations were evident for high-dose app users and the remaining outcomes. The results may suggest that attempts to reduce program viewing while promoting moderate levels of app use may exert positive influences on children’s executive functions and psychosocial development

Early Childhood Media Exposure and Self-Regulation: Bidirectional Longitudinal Associations

Objective: To investigate: 1) prospective associations between media exposure (television viewing, computers, and electronic games) at 2 years and self-regulation at 4 and 6 years, and 2) bidirectional associations between media exposure and self-regulation at 4 and 6 years. We hypothesized that media exposure and self-regulation would show a negative prospective association and subsequent bidirectional inverse associations. Methods: Data from the nationally-representative Longitudinal Study of Australian Children when children were aged 2 years (n = 2786) and 4/6 years (n = 3527) were used. Primary caregivers reported children\u27s weekly electronic media exposure. A composite measure of self-regulation was computed from caregiver-, teacher-, and observer-report data. Associations were examined using linear regression and cross-lagged panel models, accounting for covariates. Results: Lower television viewing and total media exposure at 2 years were associated with higher self-regulation at 4 years (both β = −0.02; 95% confidence interval [CI], −0.03 to −0.01). Lower self-regulation at 4 years was also significantly associated with higher television viewing (β = −0.15; 95% CI, −0.21 to −0.08), electronic game use (β = −0.05; 95% CI, −0.09 to −0.01), and total media exposure (β = −0.19; 95% CI, −0.29 to −0.09) at 6 years. However, media exposure at 4 years was not associated with self-regulation at 6 years. Conclusions: Although media exposure duration at 2 years was associated with later self-regulation, and self-regulation at 4 years was associated with later media exposure, associations were of small magnitude. More research is needed to examine content quality, social context, and mobile media use and child self-regulation

No country for old men?: the role of a ‘Gentlemen's Club’ in promoting social engagement and psychological well-being in residential care

Objective: Social isolation is a common problem in older people who move into care that has negative consequences for well-being. This is of particular concern for men, who are marginalised in long-term care settings as a result of their reduced numbers and greater difficulty in accessing effective social support, relative to women. However, researchers in the social identity tradition argue that developing social group memberships can counteract the effects of isolation. We test this account in this study by examining whether increased socialisation with others of the same gender enhances social identification, well-being (e.g. life satisfaction, mood), and cognitive ability. Method: Care home residents were invited to join gender-based groups (i.e. Ladies and Gentlemen's Clubs). Nine groups were examined (five male groups, four female groups) comprising 26 participants (12 male, 14 female), who took part in fortnightly social activities. Social identification, personal identity strength, cognitive ability and well-being were measured at the commencement of the intervention and 12 weeks later. Results: A clear gender effect was found. For women, there was evidence of maintained well-being and identification over time. For men, there was a significant reduction in depression and anxiety, and an increased sense of social identification with others. Conclusion: While decreasing well-being tends to be the norm in long-term residential care, building new social group memberships in the form of gender clubs can counteract this decline, particularly among men