Multidisciplinary lifestyle intervention in children and adolescents - results of the project GRIT (Growth, Resilience, Insights, Thrive) pilot study

Background: During childhood and adolescence leading behavioural risk factors for the development of cardiometabolic diseases include poor diet quality and sedentary lifestyle. The aim of this study was to determine the feasibility and effect of a real-world group-based multidisciplinary intervention on cardiorespiratory fitness, diet quality and self-concept in sedentary children and adolescents aged 9 to 15 years. Methods: Project GRIT (Growth, Resilience, Insights, Thrive) was a pilot single-arm intervention study. The 12-week intervention involved up to three outdoor High Intensity Interval Training (HIIT) running sessions per week, five healthy eating education or cooking demonstration sessions, and one mindful eating and Emotional Freedom Technique psychology session. Outcome measures at baseline and 12-week follow-up included maximal graded cardiorespiratory testing, the Australian Child and Adolescent Eating Survey, and Piers-Harris 2 children's self-concept scale. Paired samples t-test or Wilcoxon signed-rank test were used to compare baseline and follow-up outcome measures in study completers only. Results: Of the 38 recruited participants (median age 11.4 years, 53% male), 24 (63%) completed the 12-week intervention. Dropouts had significantly higher diet quality at baseline than completers. Completers attended a median 58 (IQR 55-75) % of the 33 exercise sessions, 60 (IQR 40-95) % of the dietary sessions, and 42% attended the psychology session. No serious adverse events were reported. Absolute VOpeak at 12 weeks changed by 96.2 ± 239.4 mL/min (p = 0.06). As a percentage contribution to energy intake, participants increased their intake of healthy core foods by 6.0 ± 11.1% (p = 0.02) and reduced median intake of confectionary (- 2.0 [IQR 0.0-3.0] %, p = 0.003) and baked products (- 1.0 [IQR 0.0-5.0] %, p = 0.02). Participants significantly improved self-concept with an increase in average T-Score for the total scale by 2.8 ± 5.3 (p = 0.02) and the 'physical appearance and attributes' domain scale by median 4.0 [IQR 0.5-4.0] (p = 0.02). Conclusions: The 12-week group-based multidisciplinary lifestyle intervention for children and adolescents improved diet quality and self-concept in study completers. Future practice and research should focus on providing sustainable multidisciplinary lifestyle interventions for children and adolescents aiming to improve long-term health and wellbeing. Trial registration: ANZCTR, ACTRN12618001249246. Registered 24 July 2019 - Retrospectively registere

Der Einfluss des Residenzstaats auf transnationale politische Aktivitäten von ImmigrantInnen

In der vorliegenden Arbeit untersuche ich, inwiefern Residenzstaaten und deren nationale Rahmenbedingungen transnationale politische Tätigkeiten von ImmigrantInnen beeinflussen. Diese Forschungsfrage bearbeite ich anhand des Fallbeispiels politischer kurdischer Vereine in Wien. Diese agieren transnational, indem sie sich von Österreich aus für politische Veränderungen in der Türkei einsetzen und in europaweite, pro-kurdische Netzwerke eingebunden sind. Mein empirisches Datenmaterial besteht aus acht qualitativen Interviews, die ich mit kurdischen politischen AktivistInnen geführt habe, und eigenen Beobachtungen bei unterschiedlichen Veranstaltungen der Vereine. Die theoretische Basis dieser Forschung bieten Studien mit dem Fokus auf politischem Transnationalismus und der Beziehung zwischen Nationalstaaten und politischer Partizipation von MigrantInnen. Die Arbeit beinhaltet auch einen Überblick über den historischen Kontext der Migration von KurdInnen aus der Türkei nach Österreich und der transnationalen, pro-kurdischen Betätigung. Meine Untersuchung ergab, dass die Vereine von der politischen Gelegenheitsstruktur und dem staatlichen Umgang mit pro-kurdischen Tätigkeiten in Österreich beeinflusst werden. Die politischen AkteurInnen nutzen die vorhandenen Ressourcen im Residenzland und verfolgen ihre transnationalen Anliegen in Auseinandersetzung mit den nationalen Rahmenbedingungen. Die Vereine wurden Ende der 1980er bzw. Anfang der 1990er Jahre gegründet und haben sich seither – auch in Zusammenhang mit Entwicklungen der österreichischen Politik und Gesetzeslage – verändert. Sie sind mittlerweile auch in Bezug auf die österreichische Migrationspolitik tätig und durch Kooperationen mit verschiedenen staatlichen und nicht-staatlichen Institutionen in Österreich verortet. Die Ergebnisse dieser Studie deuten darauf hin, dass Nationalstaaten und dessen Rahmenbedingungen nach wie vor das Leben und Handeln von Menschen beeinflussen, auch im „transnationalen Raum“.This thesis examines the impact receiving states have on the transnational political practices of immigrants. It is based on an empirical case study of Kurdish political organisations in Vienna which can be defined as transnational because they: 1) try to influence the Turkish Republic's treatment of the Kurdish minority from abroad; and 2) are members of larger pro-Kurdish networks in Europe. The empirical data consists of eight qualitative interviews with Kurdish political activists from different organisations, as well as observations I made at events organised by them. Research on political transnationalism and the relation between nation-states and political participation of immigrants form the theoretical basis of this study. The paper also includes a historical overview of the migration of Kurds from Turkey to Austria and of transnational, pro-Kurdish activities in Vienna. My research has shown that Kurdish political organisations in Austria are affected by its political opportunity structure and reaction to their political activities. Transnational activists use the resources provided by the receiving state and adapt to national political circumstances. These organisations were founded about 20 years ago and since then have evolved with changing national politics and legislation. Today they are also involved in the politics of migration and integration and cooperate with different governmental and non-governmental organisations in Austria. The findings indicate the ongoing influence and importance of nation-states in shaping the lives and actions of people, also in a “transnational field”

Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme A qualitative study

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations

The association between dietary patterns and the novel inflammatory markers platelet-activating factor and lipoprotein-associated phospholipase A2: a systematic review

CONTEXT: Atherosclerosis is a disease of chronic inflammation. Recent research has identified 2 novel inflammatory biomarkers: platelet-activating factor (PAF) and lipoprotein-associated phospholipase A(2) (Lp-PLA(2)). Diet has been proposed as a mediator of inflammation, but to date, the focus for these novel biomarkers has been on individual foods and nutrients rather than overall dietary patterns. OBJECTIVE: To systematically review the literature on the association between dietary patterns and PAF and Lp-PLA(2). DATA SOURCES: The PubMed, Embase, CINAHL, and Cochrane CENTRAL literature databases were searched. DATA ANALYSIS: Study quality was evaluated using the Quality Criteria Checklist. Sixteen studies (n = 4 observational and n = 12 interventional) were included and assessed for associations between dietary patterns and PAF and Lp-PLA(2). CONCLUSION: Study quality varied from neutral (n = 10) to positive (n = 6). Mediterranean, heart healthy, and vegetarian dietary patterns were associated with improved levels of PAF and Lp-PLA(2). Conversely, Western dietary patterns were less favorable. A range of well-established, healthier dietary patterns may lower inflammation and the risk of atherosclerosis. More well-designed studies are needed to confirm these findings and identify other dietary patterns that improve inflammation