131 research outputs found

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

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    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

    Englacial Architecture of Lambert Glacier, East Antarctica

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    The analysis of englacial layers using radio-echo sounding data enables the characterisation and reconstruction of current and past ice-sheet flow. Despite the Lambert Glacier catchment being one of the largest in Antarctica, discharging ~16 % of East Antarctica&rsquo;s ice, its englacial architecture has been little analysed. Here, we present a comprehensive analysis of Lambert Glacier&rsquo;s englacial architecture using radio-echo sounding data collected by the Antarctica's Gamburtsev Province Project (AGAP) North survey. We used an &ldquo;internal-layering continuity index&rdquo; (ILCI) to characterise the internal architecture of the ice and identify four macro-scale ILCI zones with distinct glaciological contexts. Whilst the catchment is dominated by continuous englacial layering, disrupted or discontinuous layering is highlighted by the ILCI at both the onset of enhanced ice flow (defined here as &gt;15 ma&minus;1) and along the shear margin, revealing the transition from internal-deformation-controlled to basal-sliding-dominated ice flow. These zones are characterised by buckled and folded englacial layers which align with the current ice-flow regime, and which we interpret as evidence that the flow direction of the Lambert Glacier trunk has changed little, if at all, during the Holocene. However, disturbed englacial layers along a deep subglacial channel that does not correspond to modern ice-flow routing suggest that ice-flow change has occurred in a former tributary which fed Lambert Glacier from grid north. As large outlet systems such as Lambert Glacier are likely to play a vital role in the future drainage of the East Antarctic Ice Sheet, constraining their englacial architecture to reconstruct their past ice flow and assess basal conditions is important.</p

    Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls:Results of a cluster randomised controlled trial

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    Background Physical activity is associated with improved health. Girls are less active than boys. Pilot work showed that a peer-led physical activity intervention called PLAN-A was a promising method of increasing physical activity in secondary school age girls. This study examined the effectiveness and cost-effectiveness of the PLAN-A intervention. Methods We conducted a cluster randomised controlled trial with Year 9 (13–14 year old) girls recruited from 20 secondary schools. Schools were randomly assigned to the PLAN-A intervention or a non-intervention control group after baseline data collection. Girls nominated students to be peer leaders. The top 18 % of girls nominated by their peers in intervention schools received three days of training designed to prepare them to support physical activity. Data were collected at two time points, baseline (T0) and 5–6 months post-intervention (T1). Participants wore an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity (MVPA). Multivariable mixed effects linear regression was used to estimate differences in the primary outcome between the two arms on an Intention-to-Treat (ITT) basis. Resource use and quality of life were measured and a within trial economic evaluation from a public sector perspective was conducted. Results A total of 1558 girls were recruited to the study. At T0, girls in both arms engaged in an average of 51 min of MVPA per weekday. The adjusted mean difference in weekday MVPA at T1 was − 2.84 min per day (95 % CI = -5.94 to 0.25) indicating a slightly larger decline in weekday MVPA in the intervention group. Results were broadly consistent when repeated using a multiple imputation approach and for pre-specified secondary outcomes and sub-groups. The mean cost of the PLAN-A intervention was £2817 per school, equivalent to £31 per girl. Economic analyses indicated that PLAN-A did not lead to demonstrable cost-effectiveness in terms of cost per unit change in QALY. Conclusions This study has shown that the PLAN-A intervention did not result in higher levels of weekday MVPA or associated secondary outcomes among Year 9 girls. The PLAN-A intervention should not be disseminated as a public health strategy

    Differences in atmospheric phosphorus deposition amongst rural and urban land use locations in Missouri

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    Atmospheric phosphorus (AP) produced by both anthropogenic and natural processes influences phytoplankton productivity and alters carbon processing in water bodies, resulting in potential impairment and toxic phytoplankton blooms. The production of AP, which is oftentimes transported vast distances by wind dispersal in the form of enriched mineral dust, can be re-deposited by wet (precipitation based) or dry (continual) deposition. Both rural and urban locations in Missouri experience varying anthropogenic activities; therefore, distinguishing between varying land use locations at these sites provides insight as to why AP may differ. The objective of this study is to determine if AP deposition differs among rural and urban land use locations in Missouri. When soil has been recently agitated and readily exposed, we hypothesize this additional P in the atmosphere will result in higher bulk deposition flux totals (BD) in rural locations. AP was collected from three rural locations and three urban locations, using a standard sized utility bucket, altered to reduce debris. After each two-week sampling period, a total sample water volume for each site is collected, total P is analyzed (TP), which determines the BD flux of each site by factoring the time it took to collect each sample (4 samples over approximately 70 days). Rural locations had the highest BD. Rural locations were not significantly different than urban locations (F5,18 = 1.667, p = 0.194). Further analysis of AP and the implication on water bodies is needed, as AP analysis is exceedingly rare. A multitude of differing land use practices results in variables that contribute significantly to the production of AP.Crystal Rein, Sarahi Viscarra Arellano, Karl Friesen-Hughes, Ashley King, Alexia Marten, Corey Sanderson, Jason J Venkiteswaran, Helen Baulch, Nora Jessie Casson, Colin J Whitfield, and Rebecca North (University of Missouri, University of Saskatchewan, Wilfrid Laurier University, University of Winnipeg

    Peer-led physical activity intervention for girls aged 13 to 14 years : PLAN-A cluster RCT

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    Background: Increasing physical activity among girls is a public health priority. Peers play a central role in influencing adolescent behaviour. Peer-led interventions may increase physical activity in adolescent girls, and a feasibility trial had shown that PLAN-A (Peer-led physical Activity iNtervention for Adolescent girls) had evidence of promise to increase physical activity in adolescent girls. Objective: The objective was to test whether or not PLAN-A can increase adolescent girls’ physical activity, relative to usual practice, and be cost-effective. Design: This was a two-arm, cluster-randomised controlled trial, including an economic evaluation and a process evaluation. Participants: State-funded secondary schools in the UK with girls in Year 9 (aged 13–14 years) participated in the trial. All Year 9 girls in participating schools were eligible. Randomisation: Schools were the unit of allocation. They were randomised by an independent statistician, who was blinded to school identities, to the control or intervention arm, stratified by region and the England Index of Multiple Deprivation score. Intervention: The intervention comprised peer nomination (i.e. identification of influential girls), train the trainers (i.e. training the instructors who delivered the intervention), peer supporter training (i.e. training the peer-nominated girls in techniques and strategies underpinned by motivational theory to support peer physical activity increases) and a 10-week diffusion period. Outcomes: The primary outcome was accelerometer-assessed mean weekday minutes of moderate to vigorous physical activity among Year 9 girls. The follow-up measures were conducted 5–6 months after the 10-week intervention, when the girls were in Year 10 (which was also 12 months after the baseline measures). Analysis used a multivariable, mixed-effects, linear regression model on an intention-to-treat basis. Secondary outcomes included weekend moderate to vigorous physical activity, and weekday and weekend sedentary time. Intervention delivery costs were calculated for the economic evaluation. Results: A total of 33 schools were approached; 20 schools and 1558 pupils consented. Pupils in the intervention arm had higher Index of Multiple Deprivation scores than pupils in the control arm. The numbers randomised were as follows: 10 schools (n = 758 pupils) were randomised to the intervention arm and 10 schools (n = 800 pupils) were randomised to the control arm. For analysis, a total of 1219 pupils provided valid weekday accelerometer data at both time points (intervention, n = 602; control, n = 617). The mean weekday moderate to vigorous physical activity was similar between groups at follow-up. The central estimate of time spent engaging in moderate to vigorous physical activity was 2.84 minutes lower in the intervention arm than in the control arm, after adjustment for baseline mean weekday moderate to vigorous physical activity, the number of valid days of data and the stratification variables; however, this difference was not statistically significant (95% confidence interval –5.94 to 0.25; p = 0.071). There were no between-arm differences in the secondary outcomes. The intervention costs ranged from £20.85 to £48.86 per pupil, with an average cost of £31.16. Harms: None. Limitations: The trial was limited to south-west England. Conclusions: There was no evidence that PLAN-A increased physical activity in Year 9 girls compared with usual practice and, consequently, it was not cost-effective. Future work: Future work should evaluate the utility of whole-school approaches to promote physical activity in schools. Trial registration: This trial is registered as ISRCTN14539759. Funding: This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 6. See the NIHR Journals Library website for further project information. This trial was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a United Kingdom Clinical Research Commission (UKCRC)-registered Clinical Trials Unit that, as part of the Bristol Trials Centre, is in receipt of NIHR Clinical Trials Unit support funding. The sponsor of this trial was University of Bristol, Research and Enterprise Development www.bristol.ac.uk/red/. The costs of delivering the intervention were funded by Sport England

    A multivariable Mendelian randomization analysis investigating smoking and alcohol consumption in oral and oropharyngeal cancer

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    The independent effects of smoking and alcohol in head and neck cancer are not clear, given the strong association between these risk factors. Their apparent synergistic effect reported in previous observational studies may also underestimate independent effects. Here we report multivariable Mendelian randomization performed in a two-sample approach using summary data on 6,034 oral/oropharyngeal cases and 6,585 controls from a recent genome-wide association study. Our results demonstrate strong evidence for an independent causal effect of smoking on oral/oropharyngeal cancer (IVW OR 2.6, 95% CI = 1.7, 3.9 per standard deviation increase in lifetime smoking behaviour) and an independent causal effect of alcohol consumption when controlling for smoking (IVW OR 2.1, 95% CI = 1.1, 3.8 per standard deviation increase in drinks consumed per week). This suggests the possibility that the causal effect of alcohol may have been underestimated. However, the extent to which alcohol is modified by smoking requires further investigation

    Attitudes toward Precision Treatment of Smoking in the Southern Community Cohort Study

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    Background: Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smoking-related disease. Methods: We surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. Seven items assessed attitudes toward aspects of precision smoking treatment, from undergoing tests to acting on results. Items were dichotomized as favorable (5 = strongly agree/4 = agree) versus less favorable (1 = strongly disagree/2 = disagree/3 = neutral); a summary score reflecting generalized attitudes was also computed. Multivariable logistic regression tested independent associations of motivation (precontemplation, contemplation, and preparation) and confidence in quitting (low, medium, and high) with generalized attitudes, controlling for sociodemographic factors and nicotine dependence. Results: More than 70% of respondents endorsed favorable generalized attitudes toward precision medicine, with individual item favorability ranging from 64% to 83%. Smokers holding favorable generalized attitudes reported higher income and education (P \u3c 0.05). Predicted probabilities of favorable generalized attitudes ranged from 63% to 75% across motivation levels [contemplation vs. precontemplation: adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI), 1.36–3.25, P = 0.001; preparation vs. precontemplation: AOR = 1.83, 95% CI, 1.20–2.78, P = 0.005; contemplation vs. preparation: AOR = 1.15, 95% CI, 0.75–1.77, P = 0.52] and from 59% to 78% across confidence (medium vs. low: AOR = 1.91, 95% CI, 1.19–3.07, P = 0.007; high vs. low: AOR = 2.62, 95% CI, 1.68–4.10, P \u3c 0.001; medium vs. high: AOR = 0.73, 95% CI, 0.48–1.11, P = 0.14). Conclusions: Among disproportionately burdened community smokers, most hold favorable attitudes toward precision smoking treatment. Individuals with lower motivation and confidence to quit may benefit from additional intervention to engage with precision smoking treatment. Impact: Predominantly favorable attitudes toward precision smoking treatment suggest promise for future research testing their effectiveness and implementation
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