Association of parenting practices to encourage or discourage physical activity with Hispanic preschool children's objectively measured physical activity

Oral Session - Determinants of physical activity in children and adolescents: no. O.002Conference Theme: Promoting Healthy Eating and Activity WorldwidePURPOSE: Assess the association of parenting practices (PP) to encourage or discourage physical activity (PA) with Hispanic 3-5 year old children’s objectively measured PA METHOD: Cross-sectional study of Hispanic parent-child dyads (n= 84) who reported their demographics and frequency of using PP that encourage (structure/encouragement) or discourage (promote inactive transport, promote screen time, psychological control, and safety concerns) child PA using verified scales. Children wore Actigraph GT3X accelerometers recording 15 second epochs for 7 days. Allowing for re-wears …postprin

Psychometrics of new scales of parenting practices to encourage or discourage Hispanic preschool children's physical activity

Conference Theme: Promoting Healthy Eating and activity worldwidePoster - Personal and environmental determinants of physical activity in children and adolescents: abstract P077PURPOSE: Develop and assess the psychometrics of a new instrument for parenting practices (PP) that encourage or discourage physical activity (PA) in Hispanic preschool children. METHOD: Cross--‐sectional study of 240 Hispanic parents who reported their demographics and frequency of using PP that encourage (structure and encouragement) or discourage (promoting inactivity, psychological control, safety …postprin

Information seeking, mental health and loneliness: Longitudinal analyses of adults in the UK COVID-19 mental health and wellbeing study

Information seeking has generally been seen as an adaptive response to the COVID-19 pandemic. However, it may also result in negative outcomes on mental health. The present study tests whether reporting COVID-related information seeking throughout the pandemic is associated with subsequently poorer mental health outcomes. A quota-based, non-probability-sampling methodology was used to recruit a nationally representative sample. COVID-related information seeking was assessed at six waves along with symptoms of depression, anxiety, mental wellbeing and loneliness (N = 1945). Hierarchical linear modelling was used to assess the relationship between COVID-related information seeking and mental health outcomes. Information seeking was found to reduce over time. Overall, women, older and higher socioeconomic group individuals reported higher levels of information seeking. At waves 1-4 (March-June 2020) the majority of participants reported that they sought information on Covid 1-5 times per day, this decreased to less than once per day in waves 5 and 6 (July-November 2020). Higher levels of information seeking were associated with poorer mental health outcomes, particularly clinically significant levels of anxiety. Use of a non-probability sampling method may have been a study limitation, nevertheless, reducing or managing information seeking behaviour may be one method to reduce anxiety during pandemics and other public health crises

Health Product Risk Communication: Is the message getting through?

Risk communication is an important component of improving the health and safety of Canadians. For numerous departments and agencies at all levels of government, as well as public and private organizations, effective risk communication can protect Canadians from preventable hazards. The Minister of Health, on behalf of Health Canada (the Sponsor), asked the Council of Canadian Academies (the Council) to provide an evidence-based and authoritative assessment of the state of knowledge on measurement and evaluation of health risk communication. This assessment focuses on identifying tools, evaluation methods, gaps in the literature, and barriers and facilitators to carrying out successful communication and evaluation activities. Specifically, this assessment examines the following questions: How can the effectiveness of health risk communications be measured and evaluated? • What types of instruments/tools are currently available for health risk communication? • What methodological best practices can be used to evaluate the reach, use and benefit of health risk communication? • What research could be done to inform the measurement of the effectiveness of risk communications? • What are the existing barriers to effective risk communications and what best practices exist to address these challenges? To address the charge, the Council assembled a multi-disciplinary panel of 11 experts (the Panel) from Canada and abroad. The Panel’s composition reflected a balance of expertise, experience, and demonstrated leadership in academic, clinical, and regulatory fields. Each member served as an informed individual, rather than as a representative of a particular discipline, patron, organization, or region

Variation in diabetes care by age: opportunities for customization of care

BACKGROUND: The quality of diabetes care provided to older adults has usually been judged to be poor, but few data provide direct comparison to other age groups. In this study, we hypothesized that adults age 65 and over receive lower quality diabetes care than adults age 45–64 years old. METHODS: We conducted a cohort study of members of a health plan cared for by multiple medical groups in Minnesota. Study subjects were a random sample of 1109 adults age 45 and over with an established diagnosis of diabetes using a diabetes identification method with estimated sensitivity 0.91 and positive predictive value 0.94. Survey data (response rate 86.2%) and administrative databases were used to assess diabetes severity, glycemic control, quality of life, microvascular and macrovascular risks and complications, preventive care, utilization, and perceptions of diabetes. RESULTS: Compared to those aged 45–64 years (N = 627), those 65 and older (N = 482) had better glycemic control, better health-related behaviors, and perceived less adverse impacts of diabetes on their quality of life despite longer duration of diabetes and a prevalence of cardiovascular disease twice that of younger patients. Older patients did not ascribe heart disease to their diabetes. Younger adults often had explanatory models of diabetes that interfere with effective and aggressive care, and accessed care less frequently. Overall, only 37% of patients were simultaneously up-to-date on eye exams, foot exams, and glycated hemoglobin (A1c) tests within one year. CONCLUSION: These data demonstrate the need for further improvement in diabetes care for all patients, and suggest that customisation of care based on age and explanatory models of diabetes may be an improvement strategy that merits further evaluation

Experimental Demonstration of the Fitness Consequences of an Introduced Parasite of Darwin's Finches

Introduced parasites are a particular threat to small populations of hosts living on islands because extinction can occur before hosts have a chance to evolve effective defenses. An experimental approach in which parasite abundance is manipulated in the field can be the most informative means of assessing a parasite's impact on the host. The parasitic fly Philornis downsi, recently introduced to the Galápagos Islands, feeds on nestling Darwin's finches and other land birds. Several correlational studies, and one experimental study of mixed species over several years, reported that the flies reduce host fitness. Here we report the results of a larger scale experimental study of a single species at a single site over a single breeding season.We manipulated the abundance of flies in the nests of medium ground finches (Geospiza fortis) and quantified the impact of the parasites on nestling growth and fledging success. We used nylon nest liners to reduce the number of parasites in 24 nests, leaving another 24 nests as controls. A significant reduction in mean parasite abundance led to a significant increase in the number of nests that successfully fledged young. Nestlings in parasite-reduced nests also tended to be larger prior to fledging.Our results confirm that P. downsi has significant negative effects on the fitness of medium ground finches, and they may pose a serious threat to other species of Darwin's finches. These data can help in the design of management plans for controlling P. downsi in Darwin's finch breeding populations

Compound Evolutionary History of the Rhesus Macaque Mhc Class I B Region Revealed by Microsatellite Analysis and Localization of Retroviral Sequences

In humans, the single polymorphic B locus of the major histocompatibility complex is linked to the microsatellite MIB. In rhesus macaques, however, haplotypes are characterized by the presence of unique combinations of multiple B genes, which may display different levels of polymorphism. The aim of the study was to shed light on the evolutionary history of this highly complex region. First, the robustness of the microsatellite MIB-linked to almost half of the B genes in rhesus macaques (Mamu-B)–for accurate B haplotyping was studied. Based on the physical map of an established haplotype comprising 7 MIB loci, each located next to a certain Mamu-B gene, two MIB loci, MIB1 and MIB6, were investigated in a panel of MHC homozygous monkeys. MIB1 revealed a complex genotyping pattern, whereas MIB6 analysis resulted in the detection of one or no amplicon. Both patterns are specific for a given B haplotype, show Mendelian segregation, and even allow a more precise haplotype definition than do traditional typing methods. Second, a search was performed for retroelements that may have played a role in duplication processes as observed in the macaque B region. This resulted in the description of two types of duplicons. One basic unit comprises an expressed Mamu-B gene, adjacent to an HERV16 copy closely linked to MIB. The second type of duplicon comprises a Mamu-B (pseudo)gene, linked to a truncated HERV16 structure lacking its MIB segment. Such truncation seems to coincide with the loss of B gene transcription. Subsequent to the duplication processes, recombination between MIB and Mamu-B loci appears to have occurred, resulting in a hyperplastic B region. Thus, analysis of MIB in addition to B loci allows deciphering of the compound evolutionary history of the class I B region in Old World monkeys

Feasibility of a randomised trial of a continuing medical education program in shared decision-making on the use of antibiotics for acute respiratory infections in primary care: the DECISION+ pilot trial

Abstract Background The misuse and limited effectiveness of antibiotics for acute respiratory infections (ARIs) are well documented, and current approaches targeting physicians or patients to improve appropriate use have had limited effect. Shared decision-making could be a promising strategy to improve appropriate antibiotic use for ARIs, but very little is known about its implementation processes and outcomes in clinical settings. In this matter, pilot studies have played a key role in health science research over the past years in providing information for the planning, justification, and/or refinement of larger studies. The objective of our study was to assess the feasibility and acceptability of the study design, procedures, and intervention of the DECISION+ program, a continuing medical education program in shared decision-making among family physicians and their patients on the optimal use of antibiotics for treating ARIs in primary care. Methods A pilot clustered randomised trial was conducted. Family medicine groups (FMGs) were randomly assigned, to either the DECISION+ program, which included three 3-hour workshops over a four- to six-month period, or a control group that had a delayed exposure to the program. Results Among 21 FMGs contacted, 5 (24%) agreed to participate in the pilot study. A total of 39 family physicians (18 in the two experimental and 21 in the three control FMGs) and their 544 patients consulting for an ARI were recruited. The proportion of recruited family physicians who participated in all three workshops was 46% (50% for the experimental group and 43% for the control group), and the overall mean level of satisfaction regarding the workshops was 94%. Conclusions This trial, while aiming to demonstrate the feasibility and acceptability of conducting a larger study, has identified important opportunities for improving the design of a definitive trial. This pilot trial is informative for researchers and clinicians interested in designing and/or conducting studies with FMGs regarding training of physicians in shared decision-making. Trial Registration Clinicaltrials.Gov NCT0035431

Care management for Type 2 diabetes in the United States: a systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>This systematic review and meta-analysis aims at assessing the composition and performance of care management models evaluated in the last decade and their impact on patient important outcomes.</p> <p>Methods</p> <p>A comprehensive literature search of electronic bibliographic databases was performed to identify care management trials in type 2 diabetes. Random effects meta-analysis was used when feasible to pool outcome measures.</p> <p>Results</p> <p>Fifty-two studies were eligible. Most commonly reported were surrogate outcomes (such as HbA1c and LDL), followed by process measures (clinic visit or testing frequency). Less frequently reported were quality of life, patient satisfaction, self-care, and healthcare utilization. Most care management modalities were carved out from primary care. Meta-analysis demonstrated a statistically significant but trivial reduction of HbA1c (weighted difference in means -0.21%, 95% confidence interval -0.40 to -0.03, p < .03) and LDL-cholesterol (weighted difference in means -3.38 mg/dL, 95% confidence interval -6.27 to -0.49, p < .02).</p> <p>Conclusions</p> <p>Most care management programs for patients with type 2 diabetes are 'carved-out', accomplish limited effects on metabolic outcomes, and have unknown effects on patient important outcomes. Comparative effectiveness research of different models of care management is needed to inform the design of medical homes for patients with chronic conditions.</p