Evaluation of a Pilot School-Based Physical ActivityClustered Randomised Controlled Trial—ActiveSchools: Skelmersdale

Schools are key environments in which physical activity (PA) can be promoted. Various strategies and opportunities should be used to engage children in PA within schools. The aim of this study was to evaluate the effectiveness of the multi-component Active Schools: Skelmersdale (AS:Sk) pilot intervention on children’s PA and sedentary time (ST). The AS:Sk intervention was implemented for eight weeks in four schools with three control schools continuing normal practice. It consisted of eight components: active breaks, bounce at the bell, ‘Born To Move’ videos, Daily Mile or 100 Mile Club, playground activity challenge cards, physical education teacher training, newsletters, and activity homework. Child-level measures were collected at baseline and follow-up, including objectively measured PA. After accounting for confounding variables, the intervention had a significant effect on school day ST which was significantly less for the intervention children by 9 min per day compared to the control group. The AS:Sk pilot intervention was effective in reducing school day ST but significant changes in PA were negligible. To increase the efficacy of the current and future school-based interventions, authors should focus on implementation and process evaluations to better understand how schools are implementing intervention components

Exercise referral scheme participant characteristics, referral mode and completion status

Objective: There is recent evidence that exercise referral schemes (ERSs) are beginning to permit self-referral access. Notwithstanding this, to date it is unknown whether key referral characteristics, such as age, gender and socioeconomic status are associated with a greater likelihood of self-referring to an ERS, and whether self-referral participants are more or less likely to complete schemes, than traditional healthcare referrals. Design/Setting: This study presents an evaluation and cross-sectional exploration of key participant referral characteristics of those (n = 647) who signed up to ‘Active West Lancs’; a 12-week ERS in the northwest of England. Methods: Chi-square analysis, tests of difference and binary logistic regression were conducted to explore associations between key referral characteristics and (1) the likelihood of accessing Active West Lancs via a self- or healthcare-referral and (2) the likelihood of completion.Results: Fifty-six percent of participants accessed the scheme via self-referral. These participants were more likely to be women, to report a musculoskeletal primary health condition, to access a specific site and to do so during spring. The scheme had an overall completion rate of 42.2. Participants who were older, resided in less socioeconomically deprived neighbourhoods, and accessed a specific site were more likely to complete. Self-referral participants were not more or less likely to complete than those who enrolled via healthcare-referral. Conclusions: These data do not directly identify a clear benefit or detriment to Active West Lancs’ incorporation of self-referral participants. Notwithstanding this, enabling self-referral ERS access may widen scheme participation opportunities among those reluctant to seek referral from a healthcare provider and reduce the administrative burden for healthcare providers themselves

Mutations in the binding site of TNFR1 PLAD reduce homologous interactions but can enhance antagonism of wild-type TNFR1 activity

The tumour necrosis factor receptor superfamily (TNFRSF) members contain cysteine-rich domains (CRD) in their extracellular regions, and the membrane-distal CRD1 forms homologous interactions in the absence of ligand. The CRD1 is therefore termed a pre-ligand assembly domain (PLAD). The role of PLAD-PLAD interactions in the induction of signalling as a consequence of TNF-TNFR binding led to the development of soluble PLAD domains as antagonists of TNFR activation. In the present study, we generated recombinant wild-type (WT) PLAD of TNFR1 and mutant forms with single alanine substitutions of amino acid residues thought to be critical for the formation of homologous dimers and/or trimers of PLAD (K19A, T31A, D49A and D52A). These mutated PLADs were compared with WT PLAD as antagonists of TNF-induced apoptosis or the activation of inflammatory signalling pathways. Unlike WT PLAD, the mutated PLADs showed little or no homologous interactions, confirming the importance of particular amino acids as contact residues in the PLAD binding region. However, as with WT PLAD, the mutated PLADs functioned as antagonists of TNF-induced TNFR1 activity leading to induction of cell death or NF-κB signalling. Indeed, some of the mutant PLADs, and K19A PLAD in particular, showed enhanced antagonistic activity compared with WT PLAD. This is consistent with the reduced formation of homologous multimers by these PLAD mutants effectively increasing the concentration of PLAD available to bind and antagonize WT TNFR1 when compared to WT PLAD acting as an antagonist. This may have implications for the development of antagonistic PLADs as therapeutic agents

Physical education contributes to total physical activity levels and predominantly in higher intensity physical activity categories

Children’s engagement in physical activity of a vigorous intensity or higher is more effective at promoting cardiorespiratory fitness than moderate physical activity. It remains unclear how higher intensity physical activity varies between days when schoolchildren participate in physical education (PE) and non-PE days. The purpose of this study was to assess how PE contributes to sedentary behaviour and the intensity profile of physical activity accumulated on PE days compared to non-PE days. Fifty-three schoolchildren (36 girls, 11.7 ± 0.3 years) completed five-day minute-by-minute habitual physical activity monitoring using triaxial accelerometers to determine time spent sedentary (<1.5 Metabolic Equivalent of Tasks (METs)) and in light (1.5–2.9 METs), moderate (3–5.9 METs), vigorous (6–8.9 METs), hard (9–11.9 METs) and very hard intensity (≥12 METs) physical activity on PE days and non-PE days. Sedentary time was higher on non-PE days than on PE days (mean difference: 62 minutes, p < 0.001). Hard and very hard intensity physical activity was significantly higher on PE days compared with non-PE days (mean total difference: 33 minutes, all significant at p < 0.001). During the PE lesson, boys spent more time in hard (p < 0.01) and very hard (p < 0.01) physical activity compared to girls. Schoolchildren spent significantly more time in higher intensity physical activity and significantly less time sedentary on PE days than on non-PE days. As well as reducing sedentary behaviour, the opportunity to promote such health-promoting higher intensity physical activity in the school setting warrants further investigation

Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study

Clustering of cardiometabolic risk factors can occur during childhood and predisposes individuals to cardiometabolic disease. This study calculated clustered cardiometabolic risk in 100 children and adolescents aged 10-14 years (59 girls) and explored differences according to cardiorespiratory fitness (CRF) levels and time spent at different physical activity (PA) intensities. CRF was determined using a maximal cycle ergometer test, and PA was assessed using accelerometry. A cardiometabolic risk score was computed as the sum of the standardised scores for waist circumference, blood pressure, total cholesterol/high-density lipoprotein ratio, triglycerides and glucose. Differences in clustered cardiometabolic risk between fit and unfit participants, according to previously proposed health-related threshold values, and between tertiles for PA subcomponents were assessed using ANCOVA. Clustered risk was significantly lower (p < 0.001) in the fit group (mean 1.21 ± 3.42) compared to the unfit group (mean -0.74 ± 2.22), while no differences existed between tertiles for any subcomponent of PA. Conclusion These findings suggest that CRF may have an important cardioprotective role in children and adolescents and highlights the importance of promoting CRF in youth

The mediated innovation model: a framework for researching media influence in language change

Linguistic innovations that arise contemporaneously in highly distant locations, such as quotative be like, have been termed ‘global linguistic variants’. This is not necessarily to suggest fully global usage, but to invoke more general themes of globalisation vis-à-vis space and time. This research area has grown steadily in the last twenty years, and by asserting a role for mass media, researchers have departed intrepidly from sociolinguistic convention. Yet they have largely relied on quite conventional sociolinguistic methodologies, only inferring media influence post hoc. This methodological conservatism has been overcome recently, but uncertainty remains about the overall shape of the new epistemological landscape. In this paper, I review existing research on global variants, and propose an epistemological model for researching media influence in language change: the mediated innovation model. I also analyse the way arguments are constructed in existing research, including the use of rhetorical devices to plug empirical gaps – a worthy sociolinguistic topic in its own right

Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness

Interoception refers to the sensing of internal bodily changes. Interoception interacts with cognition and emotion, making measurement of individual differences in interoceptive ability broadly relevant to neuropsychology. However, inconsistency in how interoception is defined and quantified led to a three-dimensional model. Here, we provide empirical support for dissociation between dimensions of: (1) interoceptive accuracy (performance on objective behavioural tests of heartbeat detection), (2) interoceptive sensibility (self-evaluated assessment of subjective interoception, gauged using interviews/questionnaires) and (3) interoceptive awareness (metacognitive awareness of interoceptive accuracy, e.g. confidence-accuracy correspondence). In a normative sample (N = 80), all three dimensions were distinct and dissociable. Interoceptive accuracy was only partly predicted by interoceptive awareness and interoceptive sensibility. Significant correspondence between dimensions emerged only within the sub-group of individuals with greatest interoceptive accuracy. These findings set the context for defining how the relative balance of accuracy, sensibility and awareness dimensions explain cognitive, emotional and clinical associations of interoceptive ability

Active children through individual vouchers – evaluation (ACTIVE): protocol for a mixed method randomised control trial to increase physical activity levels in teenagers

BackgroundMany teenagers are insufficiently active despite the health benefits of physical activity (PA). There is strong evidence to show that inactivity and low fitness levels increase the risk of non-communicable diseases such as coronary heart disease (CHD), type 2 diabetes and breast and colon cancers (Lee et al. Lancet 380:219–29, 2012). A major barrier facing adolescents is accessibility (e.g. cost and lack of local facilities). The ACTIVE project aims to tackle this barrier through a multi-faceted intervention, giving teenagers vouchers to spend on activities of their choice and empowering young people to improve their fitness and PA levels.DesignACTIVE is a mixed methods randomised control trial in 7 secondary schools in Swansea, South Wales. Quantitative and qualitative measures including PA (cooper run test (CRT), accelerometery over 7 days), cardiovascular (CV) measures (blood pressure, pulse wave analysis) and focus groups will be undertaken at 4 separate time points (baseline, 6 months,12 months and follow-up at 18 months). Intervention schools will receive a multi-component intervention involving 12 months of £20 vouchers to spend on physical activities of their choice, a peer mentor scheme and opportunities to attend advocacy meetings. Control schools are encouraged to continue usual practice. The primary aim is to examine the effect of the intervention in improving cardiovascular fitness.DiscussionThis paper describes the protocol for the ACTIVE randomised control trial, which aims to increase fitness, physical activity and socialisation of teenagers in Swansea, UK via a voucher scheme combined with peer mentoring. Results can contribute to the evidence base on teenage physical activity and, if effective, the intervention has the potential to inform future physical activity interventions and policy

Trial baseline characteristics of a cluster randomised controlled trial of a school-located obesity prevention programme; the Healthy Lifestyles Programme (HeLP) trial

This is the final version of the article. Available from BioMed Central via the DOI in this record.Background We have developed a healthy lifestyles programme (HeLP) for primary school aged children (9–10 years), currently being evaluated in a definitive cluster randomised controlled trial. This paper descriptively presents the baseline characteristics of trial children (BMI, waist circumference, % body fat, diet and physical activity) by gender, cluster level socio-economic status, school size and time of recruitment into the trial. Methods Schools were recruited from across the South West of England and allocated 1:1 to either intervention (HeLP) or control (usual practice) stratified by the proportion of children eligible for free school meals (FSM, 1 Year 5 class). The primary outcome is change in body mass index standard deviation score (BMI sds) at 24 months post-randomisation. Secondary outcomes are BMI sds at 18 months, waist circumference and percentage body fat sds at 18 and 24 months, proportion of children classified as underweight, overweight and obese at 18 and 24 months, physical activity (for a sub-sample) and food intake at 18 months. Results At baseline 11.4% and 13.6% of children were categorised as overweight or obese respectively. A higher percentage of girls than boys (25.3% vs 24.8%) and children from schools in FSM category 2 (28.2% vs 23.2%) were overweight or obese. Children were consuming a mean (range) of 4.15 (0–13) energy dense snacks (EDS) and 3.23 (0–9) healthy snacks (HS) per day with children from schools in FSM category 2 consuming more EDS and negative food markers and less HS and positive food markers. Children spent an average 53.6 min per day (11.9 to 124.8) in MVPA and thirteen hours (779.3 min) per day (11 h to 15 h) doing less than ‘light’ intensity activity. Less than 5% of children achieved the Departments of Health’s recommendation of 60 min of MVPA every day. Conclusion We have excellent completeness of baseline data for all measures and have achieved compliance to accelerometry not seen before in other large scale studies. Our anthropometric baseline data is representative of local and national data for children this age and reflects the gender and socio-economic variations expected of children this age in relation to physical activity and weight status.The definitive trial of HeLP is funded by the UK National Institute for Health Research (NIHR) Public Health Research Programme (10/3010/01) and a full report will be published on the NIHR website. Intervention materials and delivery was funded by the Peninsula College of Medicine and Dentistry. PenCLAHRC provided methodological support during the transition from the exploratory trial to the definitive evaluation