A blueprint for building university-based boundary organisations that achieve impacts on policy and practice

The uptake and integration of scientific research into decision-making processes remains a significant challenge. Many research organisations have begun to experiment with novel institutional structures aimed at enhancing the impact of research on policy and practice. Taking Stockholm University's Baltic Eye Project as a case study, Marie Löf and Chris Cvitanovic present a blueprint for building university-based boundary organisations, setting out the seven key themes to consider. In recognition of research organisations’ often constrained fiscal environments, the four most important features are also identified: the inclusion of policy analysts within diverse teams; the establishment of clear goals; the presence of effective leaders; and secure funding

Measuring physical activity in a cardiac rehabilitation population using a smartphone-based questionnaire

BACKGROUND: Questionnaires are commonly used to assess physical activity in large population-based studies because of their low cost and convenience. Many self-report physical activity questionnaires have been shown to be valid and reliable measures, but they are subject to measurement errors and misreporting, often due to lengthy recall periods. Mobile phones offer a novel approach to measure self-reported physical activity on a daily basis and offer real-time data collection with the potential to enhance recall. OBJECTIVE: The aims of this study were to determine the convergent validity of a mobile phone physical activity (MobilePAL) questionnaire against accelerometry in people with cardiovascular disease (CVD), and to compare how the MobilePAL questionnaire performed compared with the commonly used self-recall International Physical Activity Questionnaire (IPAQ). METHODS: Thirty adults aged 49 to 85 years with CVD were recruited from a local exercise-based cardiac rehabilitation clinic in Auckland, New Zealand. All participants completed a demographics questionnaire and underwent a 6-minute walk test at the first visit. Subsequently, participants were temporarily provided a smartphone (with the MobilePAL questionnaire preloaded that asked 2 questions daily) and an accelerometer, which was to be worn for 7 days. After 1 week, a follow-up visit was completed during which the smartphone and accelerometer were returned, and participants completed the IPAQ. RESULTS: Average daily physical activity level measured using the MobilePAL questionnaire showed moderate correlation (r=.45; P=.01) with daily activity counts per minute (Acc_CPM) and estimated metabolic equivalents (MET) (r=.45; P=.01) measured using the accelerometer. Both MobilePAL (beta=.42; P=.008) and age (beta=-.48, P=.002) were significantly associated with Acc_CPM (adjusted R(2)=.40). When IPAQ-derived energy expenditure, measured in MET-minutes per week (IPAQ_met), was considered in the predicted model, both IPAQ_met (beta=.51; P=.001) and age (beta=-.36; P=.016) made unique contributions (adjusted R(2)=.47, F2,27=13.58; P<.001).There was also a significant association between the MobilePAL and IPAQ measures (r=.49, beta=.51; P=.007). CONCLUSIONS: A mobile phone-delivered questionnaire is a relatively reliable and valid measure of physical activity in a CVD cohort. Reliability and validity measures in the present study are comparable to existing self-report measures. Given their ubiquitous use, mobile phones may be an effective method for physical activity surveillance data collection

Four principles for practising and evaluating co-production - a view from sustainability research.

The co-production paradigm has become commonplace across many disciplines as a means of orchestrating the production of useful knowledge aligned to different social needs. Drawing on the expertise of 36 co-production practitioners in the field of sustainability research, Dr Albert Norström, Dr Chris Cvitanovic, Dr Marie F. Löf, Dr Simon West and Dr Carina Wyborn, present a new working definition of co-produced research and suggest how different elements of successfully co-produced knowledge can be understood and evaluated

Mediterranean Dietary Pattern and Risk of Breast Cancer

Background: A Mediterranean diet has a recognized beneficial effect on health and longevity, with a protective influence on several cancers. However, its association with breast cancer risk remains unclear. Objective: We aimed to investigate whether adherence to a Mediterranean dietary pattern influences breast cancer risk. Design: The Swedish Women’s Lifestyle and Health cohort study includes 49,258 women aged 30 to 49 years at recruitment in 1991–1992. Consumption of foods and beverages was measured at enrollment using a food frequency questionnaire. A Mediterranean diet score was constructed based on the consumption of alcohol, vegetables, fruits, legumes, cereals, fish, the ratio of unsaturated to saturated fat, and dairy and meat products. Relative risks (RR) for breast cancer and specific tumor characteristics (invasiveness, histological type, estrogen/progesterone receptor status, malignancy grade and stage) associated with this score were estimated using Cox regression controlling for potential confounders. Results: 1,278 incident breast cancers were diagnosed. Adherence to a Mediterranean dietary pattern was not statistically significantly associated with reduced risk of breast cancer overall, or with specific breast tumor characteristics. A RR (95% confidence interval) for breast cancer associated with a two-point increment in the Mediterranean diet score was 1.08 (1.00–1.15) in all women, and 1.10 (1.01–1.21) and 1.02 (0.91–1.15) in premenopausal and postmenopausal women, respectively. When alcohol was excluded from the Mediterranean diet score, results became not statistically significant. Conclusions: Adherence to a Mediterranean dietary pattern did not decrease breast cancer risk in this cohort of relatively young women

DNA methylation in infants with low and high body fatness

The authors gratefully thank the parents and children that participated in the PATHOS study.Background: Birth weight is determined by the interplay between infant genetics and the intrauterine environment and is associated with several health outcomes in later life. Many studies have reported an association between birth weight and DNA methylation in infants and suggest that altered epigenetics may underlie birthweight-associated health outcomes. However, birth weight is a relatively nonspecific measure of fetal growth and consists of fat mass and fat-free mass which may have different effects on health outcomes which motivates studies of infant body composition and DNA methylation. Here, we combined genome-wide DNA methylation profiling of buccal cells from 47 full-term one-week old infants with accurate measurements of infant fat mass and fat-free mass using air-displacement plethysmography. Results: No significant association was found between DNA methylation in infant buccal cells and infant body composition. Moreover, no association between infant DNA methylation and parental body composition or indicators of maternal glucose metabolism were found. Conclusions: Despite accurate measures of body composition, we did not identify any associations between infant body fatness and DNA methylation. These results are consistent with recent studies that generally have identified only weak associations between DNA methylation and birthweight. Although our results should be confirmed by additional larger studies, our findings may suggest that differences in DNA methylation between individuals with low and high body fatness may be established later in childhood.Swedish Research Council FormasSwedish Research Council 2015-03495Swedish Cancer Society CAN 2017/625Spanish Ministry of Economy, Industry and Competitiveness (MINE CO)European Union (EU) RYC-2016-21199 ENDORE SAF2017-87526Linkoping University LibraryBo and Vera Ax:son Johnsons Foundatio

Associations of sleep-related outcomes with behavioral and emotional functioning in children with overweight/obesity

Objective To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and deviceassessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/ obesity. Study design A total of 109 children with overweight/obesity (mean age, 10.0 (±) 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). Results SDB was positively associated with all clinical scale variables (all b > 0.197, P ≤ .041) and with lower adaptability and leadership (all b 0.196, P ≤ .045) and lower adaptability (b = 0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all b > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. Conclusions Our study suggests that SDB symptoms, but not deviceassessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability. (J Pediatr 2022;246:170-8).The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the Fondo Europeo de Desarrollo Regional (DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011). L.V.T.-L. is supported by a grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). J.H.M. is supported by a grant from the Spanish Ministry of Education, Culture, and Sport (FPU15/02645). Additional support was provided by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health, by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and European Regional Development Fund (SOMM17/6107/UGR). Funding was also provided by the SAMID III network, RETICS , funded by the PNI + D + I 2017-2021 (Spain), ISCIII Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (RD16/0022 ), the EXERNET Research Network on Exercise and Health ( DEP2005-00046/ACTI ; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 Research and Innovation Program under Grant Agreement 667302, and the HL-PIVOT network Healthy Living for Pandemic Event Protection . Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Fund (project B-CTS-355-UGR18)

Associations of Mediterranean diet with psychological ill‑being and well‑being throughout the pregnancy course: The GESTAFIT project

Purpose The relation between diet and maternal mental health during pregnancy might be relevant to prevent adverse materno-foetal outcomes. This study examined the association of Mediterranean diet (MD) adherence and MD components with mental health during pregnancy. Methods This secondary analysis of the GESTAFIT trial included longitudinal data from 152 pregnant women. Dietary habits were assessed with a food frequency questionnaire, and MD adherence was derived from it using the Mediterranean Food pattern. Psychological ill-being (i.e., negative affect, anxiety, and depression) and well-being (i.e., emotional intelligence, resilience, positive affect) were assessed with the Spanish version of well-established self-reported questionnaires. Cross-sectional (16th gestational week [g.w.]) and longitudinal associations (34th g.w.) between MD and mental health were studied using linear regression models. Results A greater MD adherence was inversely associated with negative affect and anxiety; and positively associated with emotional regulation, resilience and positive affect at the 16th and 34th g.w. (|β| ranging from 0.179 to 0.325, all p < 0.05). Additionally, a higher intake of whole grain cereals, fruits, vegetables, fish, olive oil and nuts, and a lower intake of red meat and subproducts and sweets were associated with lower negative affect, anxiety, depression and higher emotional regulation, resilience and positive affect throughout gestation (|β| ranging from 0.168 to 0.415, all p < 0.05). Conclusion A higher intake of whole grain cereals, fruits, vegetables, fish, olive oil and nuts, together with a lower intake of red meat and sweets, resulted in a higher MD adherence, which was associated with a better mental health during pregnancy.Universidad de Granada /CBUA The Regional Ministry of Health of the Junta de Andalucía (PI-0395–2016) The Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme: Scientific Units of Excellence (UCEES), and the Regional Ministry of Economy, Knowledge, Enterprises and University, European Regional Development Funds (SOMM17/6107/UGR) of the University of Granada. Spanish Ministry of Education, Culture and Sports (Grant number FPU17/03715). The Swedish Council for Health, Working Life and Welfare (2021-00036)

A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial

Background: Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective: The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods: HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results: Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions: This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy

Results from the Sweden 2016 Report Card on Physical Activity for Children and Youth

Background: The Sweden 2016 Report Card on Physical Activity (PA) for Children and Youth is a unique compilation of the existing physical and health related data in Sweden. The aim of this paper is to summarize the procedure and results from the report card. Methods: Nationally representative surveys and individual studies between 2005-2015 were included. Eleven PA and health indicators were graded using the Active Healthy Kids Canada grading system. Grades were assigned based on the percentage of children/youth meeting a defined benchmark (A: 81-100%, B: 61-80%, C: 41-60%, D: 21-40%, F: 0-20%, or incomplete (INC). Results: The assigned grades were: Overall Physical Activity, D; Organized Sport Participation, B+; Active Play, INC; Active Transportation, C+; Sedentary Behaviors, C; Family and Peers, INC; School, C+; Community and the Built Environment, B; Government Strategies and Investments, B; Diet, C-; and Obesity, D. Conclusion: The included data provides some support that overall PA is too low and sedentary behavior is too high for almost all age groups in Sweden, even with the many national policies as well as an environment that is favorable to the promotion of PA

Mediterranean Diet Adherence and Health-Related Quality of Life during Pregnancy: Is the Mediterranean Diet Beneficial in Non-Mediterranean Countries?

This study aimed to examine the association of Mediterranean diet (MD) adherence and MD components with health-related quality of life (HRQoL) in pregnant women from Spain and Sweden. A total of 138 pregnant women from Spain (age: 32.9 ± 4.6 years old) and 302 pregnant women from Sweden (age: 31.3 ± 4.1 years old) were included. MD adherence was assessed with the Mediterranean food pattern (i.e., a MD index) at the 14–16th gestational weeks. HRQoL was assessed with the Spanish and Swedish versions of the 36-item Short-Form Health Survey (SF-36 and RAND-36, respectively) at the 14–16th and 34–37th gestational weeks. A greater MD adherence was associated with better physical functioning, bodily pain, vitality, emotional role, and mental health in cross-sectional associations (2nd trimester) in the Spanish sample (all p < 0.05). Furthermore, a greater MD adherence was associated with lower bodily pain in both Spanish and Swedish samples (both p < 0.05) in the 3rd trimester. The associations of MD adherence with pain seem to be explained by a greater intake of fiber, fish, fruits, nuts, and legumes (all p < 0.05). A greater MD adherence, driven by a higher intake of fiber, fish, fruits, nuts, and legumes, was associated with lower pain throughout pregnancy in both Mediterranean and non-Mediterranean populations.Regional Ministry of Health of the Junta de Andalucía (PI-0395-2016)University of Granada, Excellence actions: Units of Excellence, Unit of Excellence on Exercise and Health (UCEES)Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and the European Regional Development Fund (ERDF), REF. SOMM17/6107/UGRSpanish Ministry of Education, Culture, and Sports (Grant number FPU17/03715)Swedish Research Council (2016-01147