Physical activity and psychosocial characteristics of the peer supporters in the PLAN-A study – a latent class analysis

PLAN-A is a cluster randomised controlled trial of a peer-led physical activity intervention which uses peer supporters to increase the physical activity of 13–14-year-old girls in the UK. This paper uses latent class analysis to identify classes in the whole study population and investigate how those selected as peer supporters in PLAN-A were drawn from different social groups. We identified five classes of girls, based on psychosocial variables (self-esteem, physical activity self-efficacy, motivation, physical activity values among friends and peer support for physical activity (PA) and physical activity behaviour variables (average minutes of weekday MVPA, sedentary time and screen viewing). Peer supporters were similar to the whole study population in terms of overall demographics, but were drawn unequally from the five classes. In addition, there was considerable variation in the distribution of peer supporters between schools. The selection of peer supporters is an integral component of peer-led interventions and should be explored and linked to underlying theory to understand the characteristics of those recruited. However, demographic representativeness is not necessarily the aim, and simple reporting of overall demographic comparisons may mask important differences within subgroups

Learning to treat the climate emergency together: social tipping interventions by the health community

Accelerating the decarbonisation of local and national economies is a profound public health imperative. As trusted voices within communities around the world, health professionals and health organisations have enormous potential to influence the social and policy landscape in support of decarbonisation. We assembled a multidisciplinary, gender-balanced group of experts from six continents to develop a framework for maximising the social and policy influence of the health community on decarbonisation at the micro levels, meso levels, and macro levels of society. We identify practical, learning-by-doing approaches and networks to implement this strategic framework. Collectively, the actions of health-care workers can shift practice, finance, and power in ways that can transform the public narrative and influence investment, activate socioeconomic tipping points, and catalyse the rapid decarbonisation needed to protect health and health systems

Protocol for a cluster randomised controlled trial of a Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A)

Background Adolescent girls are less physically active than recommended for health, and levels decline further as they approach adulthood. Peers can influence adolescent girls’ physical activity. Interventions capitalising on peer support could positively impact physical activity behaviour in this group. Building on promising feasibility work, the purpose of this cluster randomised controlled trial is to assess whether the Peer-Led physical Activity iNtervention for Adolescent girls (PLAN-A) increases adolescent girls’ physical activity and is cost effective. Methods PLAN-A is a two-arm secondary school-based cluster randomised controlled trial, conducted with girls aged 13–14 years from twenty schools in the south west of England. The intervention requires participants to nominate influential girls within their year group to become peer supporters. The top 15% of girls nominated in each school receive three days of training designed to prepare them to support their peers to be more physically active during a ten-week intervention period. Data will be collected at two time points, at baseline (T0) and 5–6 months post-intervention (T1). Schools will be randomly allocated to the intervention (n = 10) or control (n = 10) arm after T0. At each time point, all consenting participants will wear an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity. Multivariable mixed effects linear regression will be used to estimate differences in the primary outcome between the two arms and will be examined on an Intention-to-Treat (ITT) basis. A self-report psychosocial questionnaire will be completed by participants to assess self-esteem and physical activity motivation. Resource use and quality of life will be measured for the purposes of an economic evaluation. A mixed-methods process evaluation will be conducted to explore intervention fidelity, acceptability and sustainability. Analysis of quantitative process evaluation data will be descriptive, and the framework method will be used to analyse qualitative data. Discussion This paper describes the protocol for the PLAN-A cluster randomised controlled trial, a novel approach to increasing adolescent girls’ physical activity levels through peer support

Molecular imaging of inflammation and intraplaque vasa vasorum: A step forward to identification of vulnerable plaques?

Current developments in cardiovascular biology and imaging enable the noninvasive molecular evaluation of atherosclerotic vascular disease. Intraplaque neovascularization sprouting from the adventitial vasa vasorum has been identified as an independent predictor of intraplaque hemorrhage and plaque rupture. These intraplaque vasa vasorum result from angiogenesis, most likely under influence of hypoxic and inflammatory stimuli. Several molecular imaging techniques are currently available. Most experience has been obtained with molecular imaging using positron emission tomography and single photon emission computed tomography. Recently, the development of targeted contrast agents has allowed molecular imaging with magnetic resonance imaging, ultrasound and computed tomography. The present review discusses the use of these molecular imaging techniques to identify inflammation and intraplaque vasa vasorum to identify vulnerable atherosclerotic plaques at risk of rupture and thrombosis. The available literature on molecular imaging techniques and molecular targets associated with inflammation and angiogenesis is discussed, and the clinical applications of molecular cardiovascular imaging and the use of molecular techniques for local drug delivery are addressed

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Art: a form of speech, but not like any other?

Depsosited with permission of Australian Review of Public Affairs.Protection of art occurs under Australian law in only a narrow range of circumstances where works of artistic merit are exempted from otherwise unlawful acts. In this paper I suggest that this approach to protection appears to be based on the idea that while art may constitute a form of expression, it is a particularly benign form. In fact it is likely that when art attempts to engage in the realm of the political it is at risk of falling outside of these protections. I go on to examine a number of issues that arise as a result of art being regarded as protected speech under the United States’ First Amendment. In conclusion I suggest that before entrenching a protection along the lines of the First Amendment in any future Australian Bill of Rights, further consideration is needed as such protection is limited by a provision that defines art as speech and offers protection solely against state censorship

When historic time meets Julia Kristeva’s women’s time: the reception of Judy Chicago’s The Dinner Party in Australia

© Kate MacNeill 2008One of the first visual arts events of the 1988 bicentennial year was the staging of The Dinner Party (1979), a monumental artwork by the North American artist Judy Chicago at the Melbourne Exhibition Buildings. Completed in 1979, The Dinner Party has become emblematic of a particular form of feminist art practice: namely that which makes visible the body of women in both a literal and metaphoric sense. An enormous installation, The Dinner Party is a triangular table setting at which places are laid for the women that are missing from conventional historic narratives. The place settings include elaborate crockery with each plate adopting vaginal imagery that evokes particular characteristics of each woman's historic contribution.While attracting extremely high visitor numbers whenever the work is exhibited, the artwork itself has been widely criticised. The Melbourne exhibition of this work was no exception. However on this occasion there was an added dimension to the criticism: a parochial resistance to the importation of a foreign artwork. In this paper I explore this specific instance of border crossing in feminist art practice, and the claims made by many Australian art critics that superior work was being produced by local women artists. These arguments involved assertions that The Dinner Party’s visual aesthetic was dated, that Australian artists had adopted a similar imagery prior to Chicago and that whatever impact the work might have had in 1979, by 1988 it could only be regarded as a relic

Policy ecologies, gender, work and regulation distance in film and television production

This book re-shapes thinking on ‘gender gaps’—differences between men and women in their incomes, their employment and their conditions of wor