Increasing the amount of walking by children

Children’s car use is increasing. As a result of this, they are walking less. This has serious implications for their quantity of physical activity and consequently for their health. In this paper, findings are presented from a research project being carried out in the Centre for Transport Studies at University College London to examine these effects. A major element of the research involved fitting 200 children with portable motion sensors for a period of four days to measure their quantity of physical activity. In parallel with this, they kept travel and activity diaries, so that it was possible to establish how much energy they consumed in various activities, including walking. It is shown that walking to school for a week consumes more calories than one week’s worth of physical education (PE) and games lessons, and that children who walk to events tend to use more energy in participating in them than children who are driven by car. The effectiveness of a specific initiative to encourage children to shift from the car to walking, namely the walking bus, is examined in detail, and found to be effective in helping to achieve this objective

Cities for children: the effects of car use on their lives

9-11 June 2004 In Britain, children are walking less than they used to. A major factor causing this decrease is the growth in car use. These trends are reducing children’s quantity of physical activity, with serious implications for their health. The purpose of this paper is to explore these themes using results from a 3-year research project entitled ‘Reducing children’s car use: the health and potential car dependency impacts’ which has been carried out in the Centre for Transport Studies at University College London in collaboration with others including Hertfordshire County Council, with fieldwork being carried out in Hertfordshire, an area immediately north of London. A major component of the project was a study of 200 children aged between 10 and 13 years of age using motion sensors coupled with the use of a travel and activity diary over four days. The sensors measured movement in three dimensions which was converted to activity calories, a measure of physical activity. Events from the travel and activity diaries were mapped onto the data from the sensors so that it was possible to isolate and analyse specific time periods, events and journeys. From these data, the comparative effects of different forms of transport on children’s physical activity have been established, producing clear evidence of the benefits of walking compared with car travel. It is found that the use of the car is linked to particular types of activity. For example, structured out-of-home activities, such as clubs and sports lessons tend to be reached by car while informal activities such as playing, are associated more with walking. This means that the shift from the latter to the former is one of the factors underlying children’s increasing use of the car. The motion sensors have facilitated the calculation of the intensity of various activities in terms of using activity calories. Walking is second only to physical education (PE) or games lessons in intensity. It was found that, for the older children, walking to and from school for a week used more activity calories than two hours of PE or games lessons, which is the recommended standard in Britain. It was also found that children who walk to activities are more active when they arrive at activities than those who travel by car, particularly in the more energetic activities, which suggests that walking brings wider health benefits than is generally recognised. Another strand of the project upon which this paper is based is the evaluation of walking buses. From the various surveys in the study it appears that about half of the trips on walking buses were previously walked, but there is not an equivalent decrease in the number of car trips because many of the children were being dropped at school in the course of a longer trip by a parent

Mutational and phenotypic characterisation of hereditary hemorrhagic telangiectasia

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia. Care delivery for HHT patients is impeded by the need for laborious, repeated phenotyping and gaps in knowledge regarding the relationships between causal DNA variants in ENG, ACVRL1, SMAD4 and GDF2, and clinical manifestations. To address this, we analyzed DNA samples from 183 previously uncharacterized, unrelated HHT and suspected HHT cases using the ThromboGenomics high-throughput sequencing platform. We identified 127 rare variants across 168 heterozygous genotypes. Applying modified American College of Medical Genetics and Genomics Guidelines, 106 variants were classified as pathogenic/likely pathogenic and 21 as nonpathogenic (variant of uncertain significance/benign). Unlike the protein products of ACVRL1 and SMAD4, the extracellular ENG amino acids are not strongly conserved. Our inferences of the functional consequences of causal variants in ENG were therefore informed by the crystal structure of endoglin. We then compared the accuracy of predictions of the causal gene blinded to the genetic data using 2 approaches: subjective clinical predictions and statistical predictions based on 8 Human Phenotype Ontology terms. Both approaches had some predictive power, but they were insufficiently accurate to be used clinically, without genetic testing. The distributions of red cell indices differed by causal gene but not sufficiently for clinical use in isolation from genetic data. We conclude that parallel sequencing of the 4 known HHT genes, multidisciplinary team review of variant calls in the context of detailed clinical information, and statistical and structural modeling improve the prognostication and treatment of HHT

Healthy Lifestyle Behaviour Decreasing Risks of Being Bullied, Violence and Injury

Background: Bullying and violence are problems of aggression in schools among adolescents. Basic daily healthy practices including nutritious diet, hygiene and physical activity are common approaches in comprehensive health promotion programs in school settings, however thier relationship to these aggressive behaviours is vague. We attempted to show the advantages of these healthy lifestyle behaviours in 9 developing countries by examining the association with being frequently bullied, violence and injury. Methodology/Principal Findings: A cross-sectional cross-national survey of 9 countries using the WHO Global School Based Student Health Survey dataset was used. Measurements included experiences of ‘‘being frequently bullied’ ’ in the preceding 30 days and violence/injury in the past 12 months. Association of risk behaviours (smoking, alcohol, sexual behaviour) and healthy lifestyle (nutrition, hygiene practices, physical activity) to being bullied, and violence/injury were assessed using multivariate logistic regression. Hygiene behaviour showed lower risks of being frequently bullied [male: RR = 0.7 (97.5CI: 0.5, 0.9); female: RR = 0.6 (0.5, 0.8)], and lower risk of experiences of violence/injury [RR = 0.7 (0.5, 0.9) for males], after controlling for risk behaviours, age, education, poverty, and country. Conclusion/Significance: Healthy lifestyle showed an association to decreased relative risk of being frequently bullied and violence/injury in developing countries. A comprehensive approach to risk and health promoting behaviours reducin

The association between family and community social capital and health risk behaviours in young people: an integrative review

Background: Health risk behaviours known to result in poorer outcomes in adulthood are generally established in late childhood and adolescence. These ‘risky’ behaviours include smoking, alcohol and illicit drug use and sexual risk taking. While the role of social capital in the establishment of health risk behaviours in young people has been explored, to date, no attempt has been made to consolidate the evidence in the form of a review. Thus, this integrative review was undertaken to identify and synthesise research findings on the role and impact of family and community social capital on health risk behaviours in young people and provide a consolidated evidence base to inform multi-sectorial policy and practice.<p></p> Methods: Key electronic databases were searched (i.e. ASSIA, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Embase, Medline, PsycINFO, Sociological Abstracts) for relevant studies and this was complemented by hand searching. Inclusion/exclusion criteria were applied and data was extracted from the included studies. Heterogeneity in study design and the outcomes assessed precluded meta-analysis/meta-synthesis; the results are therefore presented in narrative form.<p></p> Results: Thirty-four papers satisfied the review inclusion criteria; most were cross-sectional surveys. The majority of the studies were conducted in North America (n=25), with three being conducted in the UK. Sample sizes ranged from 61 to 98,340. The synthesised evidence demonstrates that social capital is an important construct for understanding the establishment of health risk behaviours in young people. The different elements of family and community social capital varied in terms of their saliency within each behavioural domain, with positive parent–child relations, parental monitoring, religiosity and school quality being particularly important in reducing risk.<p></p> Conclusions: This review is the first to systematically synthesise research findings about the association between social capital and health risk behaviours in young people. While providing evidence that may inform the development of interventions framed around social capital, the review also highlights key areas where further research is required to provide a fuller account of the nature and role of social capital in influencing the uptake of health risk behaviours.<p></p&gt

Validation of diagnostic accuracy using digital slides in routine histopathology

Background: Robust hardware and software tools have been developed in digital microscopy during the past years for pathologists. Reports have been advocated the reliability of digital slides in routine diagnostics. We have designed a retrospective, comparative study to evaluate the scanning properties and digital slide based diagnostic accuracy. Methods: 8 pathologists reevaluated 306 randomly selected cases from our archives. The slides were scanned with a 20 × Plan-Apochromat objective, using a 3-chip Hitachi camera, resulting 0.465 μm/pixel resolution. Slide management was supported with dedicated Data Base and Viewer software tools. Pathologists used their office PCs for evaluation and reached the digital slides via intranet connection. The diagnostic coherency and uncertainty related to digital slides and scanning quality were analyzed. Results: Good to excellent image quality of slides was recorded in 96%. In half of the critical 61 digital slides, poor image quality was related to section folds or floatings. In 88.2 % of the studied cases the digital diagnoses were in full agreement with the consensus. Out of the overall 36 incoherent cases, 7 (2.3%) were graded relevant without any recorded uncertainty by the pathologist. Excluding the non-field specific cases from each pathologist’s record this ratio was 1.76 % of all cases. Conclusions: Our results revealed that: 1) digital slide based histopathological diagnoses can be highly coherent with those using optical microscopy; 2) the competency of pathologists is a factor more important than the quality of digital slide; 3) poor digital slide quality do not endanger patient safety as these errors are recognizable by the pathologist and further actions for correction could be taken. Virtual slides: The virtual slide(s) for this article can be found here

Efficiency of the "routine" external choledoch drainage method for patients with acute cholecystitis

Purpose of the study: To justify the efficiency of 'routine' choledoch drainage for patients suffering from acute cholecystitis. Materials and methods: The study was carried out at the Septic Surgery Department, Rostov-on-Don Emergency Care Hospital. The survey included 532 patients with various forms of acute cholecystitis admitted to the surgery department from 2016 through 2017. Age of the patients: 38 to 67 years. All patients were operated (laparoscopic cholecystectomy), with a 'routine' choledoch drainage performed according to an original method (RF Patent No. 2218949). Results: Results collected during the study demonstrated advisability and effectiveness of the method, which did not only prevent reoperation but also facilitated quick post-surgery organism rehabilitation. Whenever the 'routine' choledoch drainage method was used, during the postoperative care period we diagnosed choledocholithiasis in 14,8% of cases representing an indication for endoscopic papillosphincterotomy, in 82,4% of cases we noted early normalization of the total bilirubin and hemodiastase levels, improvement of the patients' condition, and shorter stay at the in-patient department. Conclusions: The range of indications for choledoch drainage in cases of acute cholecystitis should be expanded. Our method allows to reduce the number of postoperative complications and shorten the hospital stay representing both a positive factor for patients, and economic benefit for the department.Цель исследования: Обосновать эффективность использования «рутинного» дренирования холедоха у пациентов с острым холециститом. Материалы и методы: Работа выполнена на базе хирургического отделения МБУЗ ГБСМП г. Ростова-на-Дону. В исследование вошли 532 пациента с различными формами острого холецистита, находившихся на лечении в хирургическом отделении с 2016 по 2017 год. Возраст пациентов от 38 до 67 лет. Все пациенты были прооперированы (лапароскопическая холецистэктомия), выполнено «рутинное» дренирование холедоха по оригинальной методике (Федеральный патент РФ №2218949). Результаты: Полученные в ходе исследования результаты показали целесообразность и эффективность метода, которая заключается не только в предотвращении повторных операций, но и быстрой реабилитации организма после операции. При использовании «рутинного» дренирования холедоха, в послеоперационном периоде, нами был диагностирован холедохолитиазв 14,6% случаев, что явилось показанием к выполнению эндоскопической папиллосфинктеротомии, у 82,4% была отмечена ранняя нормализацию уровня общего билирубина и амилазы крови, улучшение состояния пациентов, и сокращение сроков пребывания в стационаре. Выводы: Необходимо расширить показания к выполнению дренирования холедоха при остром холецистите. Наша методика позволяет своевременно диагностировать нарушения желчеоттока, сократить количество послеоперационных осложнений, и срок пребывания пациентов в стационаре, что является не только положительным фактором для пациента, но и экономически выгодным для отделения