a cross-sectional study in six European cities

Background: The relationship between socioeconomic position (SEP) and adolescent physical activity is uncertain, as most evidence is limited to specific settings and a restricted number of SEP indicators. This study aimed to assess the magnitude of socioeconomic differences in adolescent vigorous physical activity (VPA) across various European countries using a wide range of SEP indicators, including family-based (education, family affluence, perceived social standing, parents’ employment, housing tenure) and adolescent-based (academic performance and pocket money) ones. Methods: We used data from a survey among 10,510 students aged 14–17 from 50 schools in six European cities: Namur (BE), Tampere (FI), Hannover (DE), Latina (IT), Amersfoort (NL), Coimbra (PT). The questionnaire included socio-demographic characteristics and the amount of time spent in VPA. Results: The mean time spent practicing VPA was 60.4 min per day, with lower values for Namur (BE) and Latina (IT), and higher values for Amersfoort (NL). In the multivariable analysis, both categories of SEP indicators (family-based and adolescent based indicators) were independently associated with VPA. For each SEP indicator, lower levels of VPA were recorded in lower socioeconomic groups. In the total sample, each additional category of low SEP was associated with a decrease in mean VPA of about 4 min per day. Conclusions: This study showed that across European cities adolescent VPA is positively related to both family-based SEP and adolescents’ own SEP. When analysing socioeconomic differences in adolescent VPA, one should consider the use of multiple indicators of SEP.publishersversionpublishe

Group autonomy enhancing treatment versus cognitive behavioral therapy for anxiety disorders:A cluster‐randomized clinical trial

Background Although cognitive behavioral therapy (CBT) is effective in the treatment of anxiety disorders, few evidence-based alternatives exist. Autonomy enhancing treatment (AET) aims to decrease the vulnerability for anxiety disorders by targeting underlying autonomy deficits and may therefore have similar effects on anxiety as CBT, but yield broader effects. Methods A multicenter cluster-randomized clinical trial was conducted including 129 patients with DSM-5 anxiety disorders, on average 33.66 years of age (SD = 12.57), 91 (70.5%) female, and most (92.2%) born in the Netherlands. Participants were randomized over 15-week groupwise AET or groupwise CBT and completed questionnaires on anxiety, general psychopathology, depression, quality of life, autonomy-connectedness and self-esteem, pre-, mid-, and posttreatment, and after 3, 6, and 12 months (six measurements). Results Contrary to the hypotheses, effects on the broader outcome measures did not differ between AET and CBT (d = .16 or smaller at post-test). Anxiety reduction was similar across conditions (d = .059 at post-test) and neither therapy was superior on long term. Conclusion This was the first clinical randomized trial comparing AET to CBT. The added value of AET does not seem to lie in enhanced effectiveness on broader outcome measures or on long term compared to CBT. However, the study supports the effectiveness of AET and thereby contributes to extended treatment options for anxiety disorders. The study was preregistered at the Netherlands Clinical Trial Registry (https://www.trialregister.nl/trial/6250

The association of adolescents' smoking with the physical activity levels of their friends

Funding Information: This study is part of the SILNE-R project (Enhancing the Effectiveness of Programs and Strategies to Prevent Smoking by Adolescents: A Realist Evaluation Comparing Seven European Countries), which is supported by the European Union‘s Horizon 2020 research and innovation programme, under grant agreement 635,056. The funder was not involved and did not have any input in the design, analysis and reporting of this study. Publisher Copyright: © 2023Background: Smoking is inversely related to people's Physical Activity Level (PAL). As the behavior of friends may affect the choices and behavior of adolescents, having friends with a high PAL may potentially protect against adolescent smoking. This study aims to assess whether adolescents' smoking is associated with the PAL of their friends. Methods: SILNE-R survey data of 11.918 adolescents from 55 different schools in 7 European cities was used to determine weekly smoking, individual PAL, PAL of friends, school PAL, and smoking of friends. Multilevel, multivariable logistic regression analysis were used to assess the association between the PAL of friends and weekly smoking. Several socio-demographic variables were included as covariates in the analysis. Results: Our results indicated that 10.8% of the respondents was smoking weekly. Weekly smoking was most common among adolescents whose friends had a PAL of 0–42.0 min per day (14.5%). Respondents were significantly more likely to be smoking weekly if their friends were on average 0–42 min vs. 80–180 min physically active (OR 1.27 [95% CI 1.04–1.55]). This association existed independently of the individual PAL of respondents. Stratification for smoking of friends yielded equal results, although the association appeared to be somewhat stronger for those with smoking friends (OR 1.38 [95% CI 1.06–1.82]). Conclusion: Adolescents are less likely to smoke weekly if they associate with friends who spend >80 min per day on physical activity. Initiatives aimed at the prevention of smoking among adolescents may benefit from organizing group-based physical activity programs.publishersversionpublishe

Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance.

INTRODUCTION: 2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. METHODS: This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009-2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). RESULTS: Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60-1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14-2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). CONCLUSIONS: In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations

Single Top Quark Production as a Probe for Anomalous Moments at Hadron Colliders

Single production of top quarks at hadron colliders via $gW$ fusion is examined as a probe of possible anomalous chromomagnetic and/or chromoelectric moment type couplings between the top and gluons. We find that this channel is far less sensitive to the existence of anomalous couplings of this kind than is the usual production of top pairs by $gg$ or $q\bar q$ fusion. This result is found to hold at both the Tevatron as well as the LHC although somewhat greater sensitivity for anomalous couplings in this channel is found at the higher energy machine.Comment: New discussion and 10 new figures added. uuencoded postscript fil

Dinámica de la humedad de los combustibles y su relación con la ecología y el manejo de fuego en la región chaqueña occidental (Argentina) I: conceptos básicos

El fuego es un modelador de la mayoría de los ecosistemas vegetales del mundo, entre ellos, los correspondientes a la región chaqueña argentina donde asimismo ha sido usado ampliamente como una herramienta de manejo de la vegetación. Dada una fuente de ignición, para que un fuego pueda prosperar deben existir ciertas condiciones. Entre ellas, el contenido de humedad del combustible (CH) juega un rol fundamental ya que su magnitud influirá en la probabilidad de ignición, en el posterior comportamiento del fuego y en el impacto que éste tendrá sobre el ecosistema afectado. Existen diferencias entre el contenido de humedad de los combustibles vivos (CHCV) y el de los muertos (CHCM), debido a que el contenido del agua en cada uno de ellos responde a procesos distintos. Mientras que el CHCV responde a características propias de las especies como su fisiología y fenología, el CHCM varía de acuerdo a leyes físicas universales que regulan el intercambio de humedad entre ese combustible y el ambiente que lo rodea. Dada la relevancia que tiene CH, se han desarrollado diversos métodos y sistemas para medirlo, estimarlo, y/o poder predecirlo. Conocer su dinámica a lo largo del tiempo permite, además, determinar los períodos en los que el fuego es más propenso a ocurrir en cada ecosistema. Al presente, se han realizado estudios preliminares para algunas especies de la región chaqueña. Para el desarrollo de indicadores de peligro y modelos de comportamiento que permitan llevar a cabo quemas prescriptas con un mayor grado de seguridad y mejor cumplimiento de los objetivos, es necesario incrementar este conocimiento a un mayor número de especies. El objetivo de este trabajo fue, por lo tanto, ampliar la información existente, cuantificando la dinámica estacional del CH en diferentes especies nativas de gramíneas, arbustos y árboles de la región chaqueña. Además analizamos los efectos de la estación climática, el sitio ecológico y las características del combustible sobre el CH. En esta primera parte, presentamos las bases conceptuales sobre la combustión de los vegetales y su relación con el CH, las características que hacen a las diferencias entre combustibles vivos y muertos, los factores que inciden en sus respectivas dinámicas, y las metodologías que existen para su determinación. En los siguientes aportes se darán a conocer estas determinaciones en las principales especies de la región chaqueña argentina.Fire is one of the main natural disturbances that have shaped most of the world´s terrestrial ecosystems. In the Chaco region of Argentina, fire has also been used as a management tool for pastures improvement. Given an ignition source, for a fire to develop certain conditions must occur. Among them, the fuel moisture content (FMC) plays a very important role, since its values will affect the behavior of the fire and the consequences on the disturbed ecosystem. There are differences between live (LFMC) and dead (DFMC) fuel moisture content, mainly because the water content is governed by different processes. The LFMC depends on the species´physiological and phenological characteristics, while DFMC varies according to universal physical laws that regulate the moisture content exchange between the fuels and their environment. Given its relevance, several methods have been proposed to measure and predict FMC. Also, the knowledge of their dynamics along the seasons allows to determine the most critical periods for fire occurrence. Up to the present, preliminary studies of FMC have been determined for some species of the Chaco region. However, for developing protocols for the implementation of prescribed burning, it is necessary to broaden this knowledge to comprise a wider number of species. For the accomplishment of these objectives, we analyzed the influence of the climatic seasons, the ecological site, and the characteristics of the fuel on the FMC. In this first part, we present the conceptual bases dealing with vegetation combustion and its relations with FMC, the characterization of the differences between LFMC and DFMC, the factors controlling their respective dynamics, and the main methodologies used in their determination. In the following chapters, we will present the dynamics of FMC of the different key species of the Chaco region of Argentina.EEA Santiago del EsteroFil: Bianchi, L. Centro de Investigación y Extensión Forestal Andino Patagónico; Argentina. Universidad Nacional de la Patagonia San Juan Bosco. Sede Esquel; ArgentinaFil: Defossé, Guillermo E. Centro de Investigación y Extensión Forestal Andino Patagónico; Argentina. Universidad Nacional de la Patagonia San Juan Bosco. Sede Esquel; ArgentinaFil: Dentoni, María del Carmen. Plan Nacional de Manejo de Fuego; ArgentinaFil: Kunst, Carlos Roberto. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santiago del Estero; ArgentinaFil: Ledesma, Roxana Ramona. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santiago del Estero; ArgentinaFil: Bravo, Sandra. Universidad Nacional de Santiago del Estero. Facultad de Ciencias Forestales. Cátedra de Botánica; Argentin

Tuberculosis Microepidemics among Dispersed Migrants, Birmingham, UK, 2004-2013

MIRU-VNTR typing was supported by the Public Health England National TB Strain Typing Project. M.M. is funded by the UK Clinical Research Collaboration Modernising Medical Microbiology Consortium. C.B. is funded by the Heart of Birmingham Primary Care Trust and Public Health England

The 7th National Audit Project (NAP7) baseline survey of individual anaesthetists: preparedness for and experiences of peri-operative cardiac arrest

The Royal College of Anaesthetists' 7th National Audit Project baseline survey assessed knowledge, attitudes, practices and experiences of peri-operative cardiac arrests among UK anaesthetists and Anaesthesia Associates. We received 10,746 responses, representing a 71% response rate. In-date training in adult and paediatric advanced life support was reported by 9646 (90%) and 7125 (66%) anaesthetists, respectively. There were 8994 (84%) respondents who were confident in leading a peri-operative cardiac arrest, with males more confident than females, but only 5985 (56%) were confident in leading a debrief and 7340 (68%) communicating with next of kin. In the previous two years, 4806 (46%) respondents had managed at least one peri-operative cardiac arrest, of which 321 (7%) and 189 (4%) of these events involved a child or an obstetric patient, respectively. Respondents estimated the most common causes of peri-operative cardiac arrest to be hypovolaemia, hypoxaemia and cardiac ischaemia, with haemorrhage coming fifth. However, the most common reported causes for the most recently attended peri-operative cardiac arrest were haemorrhage; (927, 20%); anaphylaxis (474, 10%); and cardiac ischaemia (397, 9%). Operating lists or shifts were paused or stopped after 1330 (39%) cardiac arrests and 1693 (38%) respondents attended a debrief, with ‘hot’ debriefs most common. Informal wellbeing support was relatively common (2458, 56%) and formal support was uncommon (472, 11%). An impact on future care delivery was reported by 196 (4%) anaesthetists, most commonly a negative psychological impact. Management of a peri-operative cardiac arrest during their career was reported by 8654 (85%) respondents. The overall impact on professional life was more often judged positive (2630, 30%) than negative (1961, 23%), but impact on personal life was more often negative

Lifestyle and self-rated health: a cross-sectional study of 3,601 citizens of Athens, Greece

<p>Abstract</p> <p>Background</p> <p>Self-rated health (SRH) is a popular health measure determined by multiple factors. International literature is increasingly focusing on health-related behaviors such as smoking, dietary habits, physical activity, even religiosity. However, population-based studies taking into account multiple putative determinants of SRH in Greece are scarce. The aim of this study was to clarify possible determinants of SRH with an emphasis on the relationship between SRH and lifestyle variables in a large sample of urban citizens.</p> <p>Methods</p> <p>In this one-year cross-sectional study, a stratified random sample of 3,601 urban citizens was selected. Data were collected using an interview-based questionnaire about various demographic, socioeconomic, disease- and lifestyle related factors such as smoking, physical activity, dietary habits, sleep quality and religiosity. Multivariate logistic regression was used separately in three age groups [15-29 (N = 1,360), 30-49 (N = 1,122) and 50+ (N = 1,119) years old] in order to identify putative lifestyle and other determinants of SRH.</p> <p>Results</p> <p>Reporting of good SRH decreased with age (97.1%, 91.4% and 74.8%, respectively). Overall, possible confounders of the lifestyle-SRH relationship among age groups were sex, education, hospitalization during the last year, daily physical symptoms and disease status. Poor SRH was associated with less physical activity in the 15-29 years old (OR 2.22, 95%CI 1.14-4.33), with past or heavy smoking, along with no sleep satisfaction in the 30-49 years old (OR 3.23, 95%CI 1.35-7.74, OR 2.56, 95%CI 1.29-5.05, OR 1.79, 95%CI 1.1-2.92, respectively) and with obesity and no sleep satisfaction in the 50+ years old individuals (OR 1.83, 95%CI 1.19-2.81, OR 2.54, 95%CI 1.83-3.54). Sleep dissatisfaction of the 50+ years old was the only variable associated with poor SRH at the 0.001 p level of significance (OR 2.45, 99%CI 1.59 to 3.76). Subgroup analyses of the 15-19 years old individuals also revealed sleep dissatisfaction as the only significant variable correlated with SRH.</p> <p>Conclusions</p> <p>Slight differences in lifestyle determinants of SRH were identified among age groups. Sleep quality emerged as an important determinant of SRH in the majority of participants.</p