The effect of structured exercise classes and a lifestyle intervention on cardiovascular risk factors in primary schoolchildren: an exploratory trial (The A-CLASS Project)

This exploratory trial evaluates the effect of a structured exercise (STEX) or lifestyle intervention (PASS) program upon cardiovascular (CV) disease risk factors in children. Sixty-one schoolchildren were randomly assigned by school to an intervention or control (CON) condition. The effect of the STEX (compared with CON) was a mean benefit of -0.018 mm for average maximum carotid intimamedia thickness. The PASS intervention did not result in clinically important effects, and no other substantial changes were observed. Relatively high probability of clinically beneficial effects of the STEX intervention suggests that a larger, definitive randomized trial with longer follow-up is warranted.     

Development and validation of a three-item questionnaire for dietitians to screen for poor oral health in people living with human immunodeficiency virus and facilitate dental referral

Aim: The aim of the present study was to develop and validate a three-item oral health questionnaire for use by dietitians in an ambulatory care setting to screen human immunodeficiency virus-1-infected patients at risk of oral diseases to facilitate dental referral. Methods: The study was a questionnaire-based survey of 273 participants attending a human immunodeficiency virus clinic in Sydney, Australia. Subjects completed the oral health questionnaire and the Oral Health Impact Profile-14 contemporaneously. Results: A statistically significant correlation (rho = 0.617 (95% CI 0.54, 0.69), P < 0.0001) was found between the oral health questionnaire and the Oral Health Impact Profile-14 indicating adequate validity. Sensitivity for the three-question oral health questionnaire was found to be 84% (95% CI 76, 89) with a specificity of 55% (95% CI 46, 63). The negative predictive value was 77 % (95% CI 68, 85). A single screening question performed less well compared with overall sensitivity of the three-item oral health questionnaire. Conclusion: The present study found the three-item oral health questionnaire to be a valid and sensitive screening tool to ‘trigger’ for further oral health assessment and referral to dental professionals. This is a useful tool for dietitians and other health-care workers involved in the multidisciplinary preventative care of people living with human immunodeficiency virus.     

Promoting fundamental movement skill development and physical activity in early childhood settings: a cluster randomized controlled trial

The aim of this study was to assess the feasibility, acceptability and potential efficacy of a physical activity program for preschool children. A 20-week, 2-arm parallel cluster randomized controlled pilot trial was conducted. The intervention comprised structured activities for children and professional development for staff. The control group participated in usual care activities, which included designated inside and outside playtime. Primary outcomes were movement skill development and objectively measured physical activity. At follow-up, compared with children in the control group, children in the intervention group showed greater improvements in movement skill proficiency, with this improvement statically significant for overall movement skill development (adjust diff. = 2.08, 95% CI 0.76, 3.40; Cohen's d = 0.47) and significantly greater increases in objectively measured physical activity (counts per minute) during the preschool day (adjust diff. = 110.5, 95% CI 33.6, 187.3; Cohen's d = 0.46). This study demonstrates that a physical activity program implemented by staff within a preschool setting is feasible, acceptable and potentially efficacious.     

Peak power output, the lactate threshold, and time trial performance in cyclists.

PURPOSE: To determine the relationship between maximum workload (W(peak)), the workload at the onset of blood lactate accumulation (W(OBLA)), the lactate threshold (W(LTlog)) and the D(max) lactate threshold, and the average power output obtained during a 90-min (W(90-min)) and a 20-min (W(20-min)) time trial (TT) in a group of well-trained cyclists. METHODS: Nine male cyclists (.VO(2max) 62.7 +/- 0.8 mL.kg(-1).min(-1)) who were competing regularly in triathlon or cycle TT were recruited for the study. Each cyclist performed four tests on an SRM isokinetic cycle ergometer over a 2-wk period. The tests comprised 1) a continuous incremental ramp test for determination of maximal oxygen uptake (.VO(2max) (L.min(-1) and mL.kg(-1).min(-1)); 2) a continuous incremental lactate test to measure W(peak), W(OBLA), W(LTlog), and the D(max) lactate threshold; and 3) a 20-min TT and 4) a 90-min TT, both to determine the average power output (in watts). RESULTS: The average power output during the 90-min TT (W(90-min)) was significantly (P < 0.01) correlated with W(peak) (r = 0.91), W(LTlog) (r = 0.91), and the D(max) lactate threshold (r = 0.77, P < 0.05). In contrast, W(20-min) was significantly (P < 0.05) related to .VO(2max) (L.min(-1)) (r = 0.69) and W(LTlog) (r = 0.67). The D(max) lactate threshold was not significantly correlated to W(20-min) (r = 0.45). Furthermore, W(OBLA) was not correlated to W(90-min) (r = 0.54) or W(20-min) (r = 0.23). In addition, .VO(2max) (mL.kg(-1).min(-1)) was not significantly related to W(90-min) (r = 0.11) or W(20-min) (r = 0.47). CONCLUSION: The results of this study demonstrate that in subelite cyclists the relationship between maximum power output and the power output at the lactate threshold, obtained during an incremental exercise test, may change depending on the length of the TT that is completed.     

A comparison of the availability and ileal digestibility of lysine in cottonseed and soya-bean meals for grower/finisher pigs

The availability of lysine and the ileal digestibility of amino acids in three cottonseed meals and a soya-bean meal for grower/finisher pigs were determined. The usefulness of the availability estimates for formulating diets was assessed. The availability of lysine, as assessed with a slope-ratio assay, was (proportion of total): cottonseed meal no. 1, 0.27; no. 2, 0.30; no. 3, 0.29; soya-bean meal, 0.90. Ileal digestibility of lysine in the meals (proportion of total) was: cottonseed meal no. 1, 0.58; no. 2, 0.68; no. 3, 0.72; soya-bean meal, 0.89. Pigs given diets formulated to the same available lysine concentration grew at similar rates and retained the same amount of lysine in the carcasses. The results indicate that, for meals of high availability (soya-bean meal), reduced ileal digestibility appears to be the main reason for reduced availability. However, in meals of low availability (cottonseed meal), reduced ileal digestibility only accounts for part of the reduced availability. Thus, the ileal digestibility of lysine is not a reliable indicator of lysine availability.     

Randomized feasibility trial of high‐intensity interval training before elective abdominal aortic aneurysm repair

Background

This study assessed the feasibility of a preoperative high‐intensity interval training (HIT) programme in patients awaiting elective abdominal aortic aneurysm repair.

Methods

In this feasibility trial, participants were allocated by minimization to preoperative HIT or usual care. Patients in the HIT group were offered three exercise sessions per week for 4 weeks, and weekly maintenance sessions if surgery was delayed. Feasibility and acceptability outcomes were: rates of screening, eligibility, recruitment, retention, outcome completion, adverse events and adherence to exercise. Data on exercise enjoyment (Physical Activity Enjoyment Scale, PACES), cardiorespiratory fitness (anaerobic threshold and peak oxygen uptake), quality of life, postoperative morbidity and mortality, duration of hospital stay and healthcare utilization were also collected.

Results

Twenty‐seven patients were allocated to HIT and 26 to usual care (controls). Screening, eligibility, recruitment, retention and outcome completion rates were 100 per cent (556 of 556), 43·2 per cent (240 of 556), 22·1 per cent (53 of 240), 91 per cent (48 of 53) and 79–92 per cent respectively. The overall exercise session attendance rate was 75·8 per cent (276 of 364), and the mean(s.d.) PACES score after the programme was 98(19) (‘enjoyable’); however, the intensity of exercise was generally lower than intended. The mean anaerobic threshold after exercise training (adjusted for baseline score and minimization variables) was 11·7 ml per kg per min in the exercise group and 11·4 ml per kg per min in controls (difference 0·3 (95 per cent c.i. –0·4 to 1·1) ml per kg per min). There were trivial‐to‐small differences in postoperative clinical and patient‐reported outcomes between the exercise and control groups.

Conclusion

Despite the intensity of exercise being generally lower than intended, the findings support the feasibility and acceptability of both preoperative HIT and the trial procedures. A definitive trial is warranted. Registration number: ISRCTN09433624 ( https://www.isrctn.com/ ).     

Suicide,mental, and physical health condition stigma in medical students

Abstract

The current study aimed to compare the personal stigma of suicide with the personal stigma for other mental and physical health conditions. 116 Australian medical students (58% women), aged between 20 and 41?years (M?=?25.02, SD?=?3.80), completed an online survey. Suicide was more highly stigmatized than most of the other mental and physical health conditions in both attitudes toward suicide and willingness to disclose. The current study highlights the need for further medical student education in suicide, as ongoing negative attitudes could negatively affect patient care and disclosure.     

Validity and reproducibility of an iodine‐specific food frequency questionnaire to estimate dietary iodine intake in older Australians

Aim: Iodine deficiency, which has adverse effects on health has re‐emerged in Australia. The present study aimed to develop and validate a novel iodine‐specific food frequency questionnaire for use in older Australians. Methods: A 49‐item food frequency questionnaire that included iodine‐rich foods was constructed and administered in 84 men and women aged 60–95 years with normal cognitive function. Dietary iodine intake assessed by the food frequency questionnaire was validated against three repeated 24‐hour dietary recalls. Urinary spot iodine concentrations were selected as iodine intake biomarker. Agreement between the two dietary methods was determined using a Bland–Altman plot and intra‐class coefficients. Correlations between dietary and urinary iodine were assessed. Forty‐three participants repeated the questionnaire after 9 months for reproducibility. Results: Mean iodine intake measured by the food frequency questionnaire and 24‐hour dietary recalls did not differ significantly (P= 0.870). The two methods were moderately correlated (r = 0.377; P < 0.05) and the Bland–Altman plots demonstrated an acceptable level of agreement (P= 0.870). Despite an association (r = 0.230; P < 0.05) between urinary iodine concentrations and 24‐hour dietary recalls, the food frequency questionnaire was not associated with urinary iodine concentration (r = 0.094; P= 0.40). The method of triads showed coefficients of 0.238 (urinary iodine), 0.953(food frequency questionnaire), 0.396 (24‐hour dietary recall) with the unknown true value. Conclusion: A short food frequency questionnaire to assess habitual dietary iodine intake in older Australians has been shown to be valid at the group level with regard to categorising individuals according to their habitual iodine intake. Reproducibility of the food frequency questionnaire remains to be demonstrated.