Effect of Movement Activities on Student Engagement: A Handbook of Movement Activities for Elementary Teachers

A handbook has been developed to aid teachers in the incorporation of movement activities in the elementary classroom. The activities can be done between lessons or between long periods of focus. The activities will help to gain attention and engagement of students. The activities in the handbook are to be used as a supplement to any existing elementary curriculum. The handbook consists of seventy-eight activities that may be used in a variety of classroom settings. Current literature and research surrounding the topics of engagement, stimulation, retention, and the importance of movement for adolescents were explored

Clinicians' and Consumers' Perspectives of Obesity Treatments

Background: Obesity is associated with an increased risk of many non-communicable diseases, including cardiovascular disease, diabetes and cancer. Currently in New Zealand almost one third of all adults are classified as obese or having a Body Mass Index (BMI) of over 30kg/m2. Rates of obesity in New Zealand and around the world continue to rise, despite attempts from many suffering from obesity to lose weight. Traditionally, methods used by those trying to lose weight have involved increasing physical activity (energy expenditure), and decreasing the amount of calories consumed in the form of food and beverages (energy intake). It is now recognised that owing to various biochemical and genetic differences between individuals, some may find it easier to lose weight than others. Nevertheless, health professionals and sufferers alike are awakening to the multi-faceted nature of this disease and therefore the need for a multi-faceted treatment approach. In the present study, consumers and clinicians shared their thoughts about the barriers to and enablers of the effectiveness of current obesity treatments, and their suggestions for the future. Objective: The overall aim of the present study was to investigate the similarities and differences between clinicians’ and consumers’ perspectives of obesity treatments, in order to contribute to the existing body of literature and to develop hypotheses for future research. Design: An observational design for data collection, and a thematic analysis technique to analyse data were used in the present qualitative study. A total 61 participants were recruited including 32 ‘clinicians’ and 29 ‘consumers’. Eight focus groups were conducted, recorded and transcribed verbatim before analysis. All data were analysed using thematic analysis, a ‘bottom-up’ approach to identifying key themes. NVivo qualitative software was used to organise the data and to assist with the generation of codes throughout the analysis. Results: The participants in this study agreed that obesity treatments could be improved by increased psychological intervention, including efforts to reduce the impacts of obesity stigma; tailored educational materials and treatment campaigns to meet the needs of ethnic minorities; and initiatives that promote enjoyment, strength of community, and long-lasting follow-up and support. Barriers to the achievement of obesity treatment success included the influence of distorted nutritional messages within food marketing and media advertising on consumers’ perceptions of healthy food; and the overall lack of reliable treatment initiatives for those seeking behaviour change and thus weight management. Conclusion: Consumers and clinicians alike are exasperated and discouraged by the lack of effectiveness of obesity treatments. Feelings of frustration, anger, hopelessness and desperation resonated from both sides of the patient/provider fence throughout this explorative study. However, despite this apparent negativity, consumers especially illustrated a persistent defiance to overcome their battles with weight. Overall, clinicians appeared to lack a defined treatment pathway for the treatment of obesity. This warrants further investigation before a multi-disciplinary approach to treatment can be achieved

Retrospective assessment of a collaborative digital asthma program for Medicaid-enrolled children in southwest Detroit: reductions in short-acting beta-agonist (SABA) medication use

Background Real-world evidence for digitally-supported asthma programs among Medicaid-enrolled children remains limited. Using data from a collaborative quality improvement program, we evaluated the impact of a digital intervention on asthma inhaler use among children in southwest Detroit. Methods Children (6–13 years) enrolled with Kids Health Connection (KHC), a program involving home visits with an asthma educator, were invited to participate in a digital self-management asthma program (Propeller Health). Patients were provided with a sensor to capture short-acting beta-agonist (SABA) medication use, and given access to a paired mobile app to track usage. Patients’ healthcare providers and caregivers (“followers”) were invited to view data as well. Retrospective paired t-tests assessed change in mean SABA use and SABA-free days (SFD) over time, and regressions explored the relationship between followers and medication use. Results Fifty-one patients were assessed. Mean program participation was nine months, and patients had on average 3 followers. From the first to last participation month, mean SABA use decreased from 0.68 to 0.25 puffs/day (p\u3c0.001), and mean SFD increased from 25.2 to 28.1 days/month (p\u3c0.001). 76% of patients had an increase in the number of SFD. There was a positive, but non-significant, relationship between the number of followers and reductions in SABA inhaler use. Conclusions We observed a significant reduction in SABA inhaler use and an increase in the number of SABA-free days among Medicaid-enrolled children enrolled in a multi-modal digital asthma program

Implementing a One-on-One Peer Support Program for Cancer Survivors Using a Motivational Interviewing Approach: Results and Lessons Learned

Peer Connect matches cancer survivors and caregivers (guides) with those currently experiencing cancer-related issues seeking support (partners). Motivational interviewing (MI)-based communication skills are taught to provide patient-centered support. There is little guidance about MI-based applications with cancer survivors who may have multiple coping needs. This paper addresses the results and lessons learned from implementing Peer Connect. Thirteen cancer survivors and two caregivers received a 2-dayMI, DVD-based training along with six supplemental sessions. Nineteen partners were matched with guides and received telephone support. Evaluation included guide skill assessment (Motivational Interviewing Treatment Integrity Code) and 6-month follow-up surveys with guides and partners. Guides demonstrated MI proficiency and perceived their training as effective. Guides provided on average of five calls to each partner. Conversation topics included cancer fears, family support needs, coping and care issues, and cancer-related decisions. Partners reported that guides provided a listening ear, were supportive, and nonjudgmental. Limited time availability of some guides was a challenge. MI can provide support for cancer survivors and caregivers without specific behavioral concerns (e.g., weight and smoking). An MI support model was both feasible and effective and can provide additional support outside of the medical system

The combination of autofluorescence endoscopy and molecular biomarkers is a novel diagnostic tool for dysplasia in Barrett's oesophagus.

OBJECTIVE: Endoscopic surveillance for Barrett's oesophagus (BO) is limited by sampling error and the subjectivity of diagnosing dysplasia. We aimed to compare a biomarker panel on minimal biopsies directed by autofluorescence imaging (AFI) with the standard surveillance protocol to derive an objective tool for dysplasia assessment. DESIGN: We performed a cross-sectional prospective study in three tertiary referral centres. Patients with BO underwent high-resolution endoscopy followed by AFI-targeted biopsies. 157 patients completed the biopsy protocol. Aneuploidy/tetraploidy; 9p and 17p loss of heterozygosity; RUNX3, HPP1 and p16 methylation; p53 and cyclin A immunohistochemistry were assessed. Bootstrap resampling was used to select the best diagnostic biomarker panel for high-grade dysplasia (HGD) and early cancer (EC). This panel was validated in an independent cohort of 46 patients. RESULTS: Aneuploidy, p53 immunohistochemistry and cyclin A had the strongest association with dysplasia in the per-biopsy analysis and, as a panel, had an area under the receiver operating characteristic curve of 0.97 (95% CI 0.95 to 0.99) for diagnosing HGD/EC. The diagnostic accuracy for HGD/EC of the three-biomarker panel from AFI+ areas was superior to AFI- areas (p<0.001). Compared with the standard protocol, this panel had equal sensitivity for HGD/EC, with a 4.5-fold reduction in the number of biopsies. In an independent cohort of patients, the panel had a sensitivity and specificity for HGD/EC of 100% and 85%, respectively. CONCLUSIONS: A three-biomarker panel on a small number of AFI-targeted biopsies provides an accurate and objective diagnosis of dysplasia in BO. The clinical implications have to be studied further

RH5.1-CyRPA-Ripr antigen combination vaccine shows little improvement over RH5.1 in a preclinical setting

Background: RH5 is the leading vaccine candidate for the Plasmodium falciparum blood stage and has shown impact on parasite growth in the blood in a human clinical trial. RH5 binds to Ripr and CyRPA at the apical end of the invasive merozoite form, and this complex, designated RCR, is essential for entry into human erythrocytes. RH5 has advanced to human clinical trials, and the impact on parasite growth in the blood was encouraging but modest. This study assessed the potential of a protein-in-adjuvant blood stage malaria vaccine based on a combination of RH5, Ripr and CyRPA to provide improved neutralizing activity against P. falciparum in vitro. Methods: Mice were immunized with the individual RCR antigens to down select the best performing adjuvant formulation and rats were immunized with the individual RCR antigens to select the correct antigen dose. A second cohort of rats were immunized with single, double and triple antigen combinations to assess immunogenicity and parasite neutralizing activity in growth inhibition assays. Results: The DPX® platform was identified as the best performing formulation in potentiating P. falciparum inhibitory antibody responses to these antigens. The three antigens derived from RH5, Ripr and CyRPA proteins formulated with DPX induced highly inhibitory parasite neutralising antibodies. Notably, RH5 either as a single antigen or in combination with Ripr and/or CyRPA, induced inhibitory antibodies that outperformed CyRPA, Ripr. Conclusion: An RCR combination vaccine may not induce substantially improved protective immunity as compared with RH5 as a single immunogen in a clinical setting and leaves the development pathway open for other antigens to be combined with RH5 as a next generation malaria vaccine

Adult cancer survivorship care: experiences from the LIVESTRONG centers of excellence network

The objectives of this study were to characterize survivorship models of care across eight LIVESTRONG Survivorship Center of Excellence (COE) Network sites and to identify barriers and facilitators influencing survivorship care

3D printed flow plates for the electrolysis of water: an economic and adaptable approach to device manufacture

The electrolysis of water is considered a promising route to the production of hydrogen from renewable energy sources. Electrolysers based on proton exchange membranes (PEMs) have a number of advantages including high current density, high product gas purity and the ability to operate at high pressure. Despite these advantages the high cost of such devices is an impediment to their widespread deployment. A principal factor in this cost are the materials and machining of flow plates for distribution of the liquid reagents and gaseous products in the electrochemical cell. We demonstrate the production and operation of a PEM electrolyser constructed from silver coated 3D printed components fabricated from polypropylene. This approach allows construction of light weight, low cost electrolysers and the rapid prototyping of flow field design. Furthermore we provide data on the operation of this electrolyser wherein we show that performance is excellent for a first generation device in terms of overall efficiency, internal resistances and current–voltage response. This development opens the door to the fabrication of light weight and cheap electrolysers as well as related electrochemical devices such as flow batteries and fuel cells

GWAS Meta-Analysis of Suicide Attempt: Identification of 12 Genome-Wide Significant Loci and Implication of Genetic Risks for Specific Health Factors

Objective: Suicidal behavior is heritable and is a major cause of death worldwide. Two large-scale genome-wide association studies (GWASs) recently discovered and crossvalidated genome-wide significant (GWS) loci for suicide attempt (SA). The present study leveraged the genetic cohorts from both studies to conduct the largest GWAS metaanalysis of SA to date. Multi-ancestry and admixture-specific meta-analyses were conducted within groups of significant African, East Asian, and European ancestry admixtures. Methods: This study comprised 22 cohorts, including 43,871 SA cases and 915,025 ancestry-matched controls. Analytical methods across multi-ancestry and individual ancestry admixtures included inverse variance-weighted fixed-effects meta-analyses, followed by gene, gene-set, tissue-set, and drug-target enrichment, as well as summary-data-based Mendelian randomization with brain expression quantitative trait loci data, phenome-wide genetic correlation, and genetic causal proportion analyses. Results: Multi-ancestry and European ancestry admixture GWAS meta-analyses identified 12 risk loci at p values &lt;5×10-8. These loci were mostly intergenic and implicated DRD2, SLC6A9, FURIN, NLGN1, SOX5, PDE4B, and CACNG2. The multi-ancestry SNP-based heritability estimate of SA was 5.7% on the liability scale (SE=0.003, p=5.7×10-80). Significant brain tissue gene expression and drug set enrichment were observed. There was shared genetic variation of SA with attention deficit hyperactivity disorder, smoking, and risk tolerance after conditioning SA on both major depressive disorder and posttraumatic stress disorder. Genetic causal proportion analyses implicated shared genetic risk for specific health factors. Conclusions: This multi-ancestry analysis of suicide attempt identified several loci contributing to risk and establishes significant shared genetic covariation with clinical phenotypes. These findings provide insight into genetic factors associated with suicide attempt across ancestry admixture populations, in veteran and civilian populations, and in attempt versus death.</p

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe