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Sahota P, Yu M, Polderman J, Achtem L, Stephenson A, Morgan K, Lauck S. Validation of the virtual measurement of the Essential Frailty Toolset. Eur J Cardiovasc Nurs 2022. [PMCID: PMC9384357 DOI: 10.1093/eurjcn/zvac060.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Funding Acknowledgements Type of funding sources: None. Background The Essential Frailty Toolset (EFT) is a valid measurement of frailty in people with heart valve disease. COVID-19 has prompted the transition to virtual health consultations and necessitates the validation of the virtual assessment of frailty. Methods We conducted a prospective observational cohort study to compare the measurement of EFT in person and virtual format within a maximum 2-week window of repeated measurement. The weighted Kappa tests was used to measure the agreement of EFT scores between assessments; we explored the effect of the sequence of measurement using the Cochran-Mantel-Haenszel statistic to test the general association between the timing of measurement and differences of EFT score. Results We recruited a sample of 49 patients, with a mean age of 81 ± 7 years, including 29 men (59.2%); the primary valvular heart diseases were aortic stenosis (n=40, 81.6%), mitral regurgitation (n=2, 4.1%) and tricuspid regurgitation (n=7, 14.3%). The virtual measurement of frailty was conducted using a standardised protocol. The platform for virtual connection selected by patients was FaceTime (n=20, 40.8%) and Zoom (n=29, 59.2%); the median (IQR) number of days between the in-person and the virtual assessment was 5 (3,10). The weighted Kappa estimate was 0.69 (95% CI 0.55, 0.82), illustrating a strong agreement between the separate scores obtained. The test for the general association was non-significant (p=0.82), indicating a lack of evidence for detecting an association between EFT scores and chronological order of assessment. Conclusion The EFT can be reliably measured virtual in older patients with valvular heart disease to inform clinical care.
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Affiliation(s)
- P Sahota
- St Paul's Hospital , Vancouver , Canada
| | - M Yu
- St Paul's Hospital , Vancouver , Canada
| | | | - L Achtem
- St Paul's Hospital , Vancouver , Canada
| | | | - K Morgan
- St Paul's Hospital , Vancouver , Canada
| | - S Lauck
- St Paul's Hospital , Vancouver , Canada
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Burton W, Sahota P, Twiddy M, Brown J, Bryant M. The Development of a Multilevel Intervention to Optimise Participant Engagement with an Obesity Prevention Programme Delivered in UK children's Centres. Prev Sci 2021; 22:345-356. [PMID: 33523389 PMCID: PMC8032563 DOI: 10.1007/s11121-021-01205-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Abstract
Poor participant engagement threatens the potential impact and cost-effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing these. This paper details the development of a participant engagement intervention aimed at promoting enrolment and attendance to a community-based pre-school obesity prevention programme delivered in UK children’s centres; HENRY (Health, Exercise, Nutrition for the Really Young). The Behaviour Change Wheel framework was used to guide the development of the intervention. The findings of a coinciding focused ethnography study identified barriers and levers to engagement with HENRY that informed which behaviours should be targeted within the intervention to promote engagement. A COM-B behavioural analysis was undertaken to identify whether capability, opportunity or motivation would need to be influenced for the target behaviours to occur. APEASE criteria were used to agree on appropriate intervention functions and behaviour change techniques. A multi-level participant engagement intervention was developed to promote adoption of target behaviours that were proposed to promote engagement with HENRY, e.g. ensuring the programme is accurately portrayed when approaching individuals to attend and providing ‘taster’ sessions prior to each programme. At the local authority level, the intervention aimed to increase buy-in with HENRY to increase the level of resource dedicated to engagement efforts. At the centre level, managers were encouraged to widen promotion of the programme and ensure that staff promoted the programme accurately. HENRY facilitators received training to increase engagement during sessions, and parents that had attended HENRY were encouraged to recruit their peers. This paper describes one of the first attempts to develop a theory-based multi-level participant engagement intervention specifically designed to promote recruitment and retention to a community-based obesity prevention programme. Given the challenges to implementing public health programmes with sufficient reach, the process used to develop the intervention serves as an example of how programmes that are already widely commissioned could be optimised to enable greater impact.
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Affiliation(s)
- Wendy Burton
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.
| | - Pinki Sahota
- School of Clinical and Applied Sciences, Leeds Beckett University, City Campus, Leeds, LS1 3HE, UK
| | - Maureen Twiddy
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Cottingham Rd, Hull, HU6 7RX, UK
| | - Julia Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Maria Bryant
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
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Hura K, Singh H, Sahota P, Thakkar M. 0731 Obstructive Sleep Apnea with Predominant Respiratory Effort Related Arousals: Theta Power in C3- M2 And C4-M1 Derivation Comparison in Male And Female. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Theta power in electroencephalography has been studied as a correlate to REM sleep. An increase in theta power during REM sleep has been observed in patients during recovery sleep after sleep deprivation. Emotional memories appear to be processed and consolidated during REM sleep.The role of hippocampal theta wave activity during REM sleep on emotional memory processing is limited. The importance of theta power has not been well characterized in patients with obstructive sleep apnea (OSA) with predominant respiratory Effort Related Arousals (RERAs). This report aims to study the theta power in patients with OSA with predominant Respiratory Effort Related Arousals (RERAs) with an apnea-hypopnea index (AHI) of < 5.
Methods
We have identified 38 patients with baseline polysomnograms performed from December 2019 to July 2019 with AHI < 5 and a Respiratory Disturbance Index (RDI) of at least 5 or greater. Patients with chronic hypoxemic respiratory failure, hypoventilation and predominant central sleep apnea were excluded from the study. Total power of frequency in bands was obtained for theta waves (4-8 Hz) and total waves (1-30 Hz). Relative theta power was calculated on the last REM sleep using C3-M2 and C4-M1 derivations. Paired two-tailed t-Test was performed on the theta power in C3-M2 and C4-M1 in both the sexes.
Results
Initial analysis was performed in 38 patients out of which 20 were male and 18 female. Among males, (Mean ± SEM) age was 52.3 (±2.9); Epworth Sleepiness Scale (ESS) of 6.6 (±1.1), AHI of 2.1 (±0.3), and RDI of 7.3 (±0.3).Whereas in female (Mean ± SEM) age was 46.8 (± 2.8), ESS of 7.7 (±1.4), AHI of 2.3 (±0.35), and RDI of 6.9 (±0.4). Statistically significant difference was noted in the theta power between the C3-M2 and C4-M1 derivations with P value of 0.03 and 0.04 in male and female respectively. However, no significant difference was found when C3-M2 and C4 -M1 was compared between male and female. Further, statistical analysis will be performed after gathering data from a larger sample size.
Conclusion
There was significant difference between C3-M2 and C4-M1;overall no difference was found between sexes.
Support
none
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Affiliation(s)
- K Hura
- University of Missouri, columbia, MO
| | - H Singh
- university of missouri, University of Missouri, MO
| | - P Sahota
- University of Missouri, University of Missouri, MO
| | - M Thakkar
- University of Missouri, columbia, MO
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4
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McGovney KD, Curtis AF, Mazurek M, Chan WS, Deroche CB, Munoz M, Davenport M, Takamatsu S, Takahashi N, Muckerman J, McCann D, Sahota P, Mills B, McCrae CS. 0922 Nightly Associations Between Pre-Bedtime Activity, Actigraphic Light, and Sleep in Children With ASD and Insomnia. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Approximately two thirds of children with Autism Spectrum Disorder (ASD) suffer from chronic insomnia. Current behavioral interventions for insomnia in children with ASD use sleep hygiene guidelines to educate parents and their children regarding sleep promoting habits. However, the relationship between pre-bedtime physical activity/light and sleep is understudied in ASD. The current study examined daily associations between pre-bedtime actigraphically assessed activity/light levels and objective/subjective sleep outcomes in children with ASD and insomnia.
Methods
Thirty children (Mage=8.5 yrs, SD=1.78 yrs) with comorbid ASD and insomnia completed 14 days of actigraphy measuring ambient white light intensity and activity levels every 30 seconds. Validated sleep scoring algorithms (in Actiware V. 6.0.9) estimated objective sleep onset latency (SOL), total sleep time (TST), wake time after sleep onset (WASO), and average activity/light levels 30, 60, and 120 mins prior to bedtime. Additionally, average activity/light levels 120-240, and 240-360 mins prior to bedtime were computed. Children also completed 14 daily sleep diaries (with parental assistance) measuring subjective reports of the same sleep parameters. Associations between daily estimations of pre-bedtime activity levels, light, and nighttime objective and subjective sleep were examined through multilevel modelling. Bonferroni corrections were performed to account for multiple comparisons.
Results
After Bonferroni corrections (p<.025 significance level), greater activity within 30 minutes (B=0.0465, p=.0093) and 60 minutes (B=0.0681, p=.0005) of bedtime were associated with longer subjective SOL. Pre-bedtime light exposure was not a significant predictor of sleep outcomes.
Conclusion
Results suggest that in general, variations in daily pre-bedtime activity, but not light, are associated with worse nightly subjective SOL in children with ASD and insomnia. Findings support that sleep hygiene recommendations in children with ASD include avoidance of higher levels of pre-sleep physical activity. Prospective studies examining temporal causal relationships between pre-bedtime activity and sleep in ASD are warranted.
Support
Research was supported by a University of Missouri Research Board award (McCrae, PI; Mazurek, Co-PI). Data collected as part of clinical trial NCT02755051 Targeting Sleep in Kids with Autism Spectrum Disorder at the University of Missouri (PI: McCrae).
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Affiliation(s)
- K D McGovney
- Department of Psychiatry, University of Missouri, Columbia, MO
| | - A F Curtis
- Department of Psychiatry, University of Missouri, Columbia, MO
| | - M Mazurek
- Curry School of Education and Human Development, University of Virginia, Charlottesville, VA
| | - W S Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, HONG KONG
| | - C B Deroche
- Biostatistics and Medicine Research Design Unit, School of Medicine, University of Missouri, Columbia, MO
| | - M Munoz
- Department of Educational, School, and Counseling Psychology, University of Missouri, Columbia, MO
| | - M Davenport
- Department of Educational, School, and Counseling Psychology, University of Missouri, Columbia, MO
| | | | - N Takahashi
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO
| | - J Muckerman
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO
| | - D McCann
- Department of Psychiatry, University of Missouri, Columbia, MO
| | - P Sahota
- Department of Neurology, University of Missouri, Columbia, MO
| | - B Mills
- Department of Psychiatry, University of Missouri, Columbia, MO
| | - C S McCrae
- Department of Psychiatry, University of Missouri, Columbia, MO
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5
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Bollu P, Goyal M, Sivaraman M, Taylor N, Yin L, Thakkar M, Sahota P. 0802 To Examine the Effect of Gabapentin Enacarbil in Primary Restless Legs Syndrome Patients Who are on Dopaminergic Agents and Exhibiting Augmentation. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Augmentation is defined as worsening of the symptoms of Restless Legs Syndrome after a brief period of initial improvement with dopaminergic agents resulting in either an earlier onset, increase in severity, quicker onset, spread to other body parts. The exact prevalence of this phenomenon is not known and in patients experiencing augmentation, it can pose a difficult diagnostic and therapeutic challenge to the clinician. In our study, we found extended-release gabapentin to be an effective intervention in patients experiencing dopaminergic augmentation
Methods
This is an open-label single-arm study done in patients exhibiting augmentation while on dopaminergic agents. Patients who were enrolled in the study were initiated on oral extended-release gabapentin(Horizont) 600 mg at 5 pm at the beginning of the study. At day 90, attempts were made to reduce or discontinue dopaminergic agents. International Restless Legs Syndrome-Rating Scale (IRLS) and Augmentation Severity Rating Scale(ASRS) were recorded at each visit.
Results
A total of 10 patients were enrolled in the study while only 8 patients completed it. Compared to the baseline (visit 2), there is a significant improvement in both the augmentation severity(p= 0.0131) and the IRLS (p=0.0497). Wilcoxon matched-pairs signed rank test was used for statistical analysis.
Conclusion
Extended-release Gabapentin is an effective treatment option in primary RLS patients experiencing augmentation secondary to dopaminergic medication usage.
Support
The study is funded and medication is provided by Arbor Pharmaceuticals.
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Affiliation(s)
- P Bollu
- University of Missouri, Columbia, MO
| | - M Goyal
- Harry S Truman VA Hospital, Columbia, MO
| | - M Sivaraman
- University of Missouri Health Care, Columbia, MO
| | - N Taylor
- University of Missouri Health Care, Columbia, MO
| | - L Yin
- University of Missouri Health Care, Columbia, MO
| | - M Thakkar
- Harry S Truman VA Hospital, Columbia, MO
| | - P Sahota
- University of Missouri Health Care, Columbia, MO
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Bollu P, Gurung P, Mehta T, Monegro A, Manjamalai S, Goyal M, Thakkar M, Sahota P. 0619 To Rely or No to Rely: Understanding the Demographics and Polysomnographic Features of False Negative Home Sleep Apnea Testing. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The current gold standard for a definitive diagnosis of OSA is an in-center Polysomnography (PSG). Home Sleep Apnea Testing(HSAT) has become an important tool in identifying high-risk populations. One of the limitations of the study is the lack of Electroencephalographic (EEG) data. This prevents the inclusion of Respiratory Effort Related Arousals (RERAs). We attempted to identify the patients whose HSAT showed an REI of less than 5 but are at risk for having sleep apnea based on the presence of airflow and thoraco-abdominal fluctuations.
Methods
Patients in this study were those that underwent HSAT from September 2016 till June of 2019. The studies reviewed and interpreted by board certified Sleep Specialists. Studies were done using nox-T3 sleep monitor and Nomad portable Home Sleep Testing type III devices-Both are type 3 Portable Monitors. Only those patients whose REI in their HSAT less than 5 were included in this study. All these patients had multiple airflow fluctuations in their HSAT that raised the suspicion for the presence of RERAs. None of these patients had significant hypoxemia in the HSAT.Airflow fluctuations were defined by the presence of fluctuations in the signal in the airflow channel along with increasing thoracoabdominal channels. Those patients with REI of less than 5 and without airflow fluctuations were excluded from the study.
Results
A total of 178 patients were recommended to undergo an in-center polysomnogram. Of those, 92 patients completed their polysomnogram with 59 patients ending up with a diagnosis of sleep apnea while 33 did not suggesting a false negative rate of 64.13%. Of those who were positive, 39 were females while 20 were males. Both groups did not differ significantly. Females had a median BMI of 32.9(28.19 for males), a median ESS of 11(8 in males) and a median RDI of 14.8(13.25).
Conclusion
Our study shows that both Home Sleep apnea testing can have a high proportion of false-negative results in patients exhibiting thoraco-abdominal and airflow fluctuations. The interpreting physicians should understand the limitations of the HSAT and should have a low threshold to recommend an in-center polysomnogram.
Support
None.
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Affiliation(s)
- P Bollu
- University of Missouri, Columbia, MO
| | - P Gurung
- University of Missouri, Columbia, MO
| | - T Mehta
- University of Missouri, Columbia, MO
| | - A Monegro
- University of Missouri, Columbia, MO
| | | | - M Goyal
- University of Missouri, Columbia, MO
| | - M Thakkar
- University of Missouri, Columbia, MO
| | - P Sahota
- University of Missouri, Columbia, MO
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7
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Sahota P, Christian M, Day R, Cocks K. The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme. Pilot Feasibility Stud 2019; 5:152. [PMID: 31890264 PMCID: PMC6925414 DOI: 10.1186/s40814-019-0542-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 12/06/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study aims to evaluate the feasibility and acceptability of the PhunkyFoods Programme, a primary school-based intervention to promote healthy nutrition and physical activity knowledge and behaviours to assess outcomes to inform a phase 3 trial. Methods The cluster randomised feasibility trial recruited eight primary schools from the North of England. Elibility criteria included all primary schools in one town, excluding independent and special schools and schools that comprised of only key stage 2 pupils (years 3–6). Eight schools agreed to participate. Randomisation to intervention or control arms was in a 1:1 ratio. Intervention schools received PhunkyFoods over 17 months. Control schools continued with usual curriculum. Assessors were blinded to group assignment. Measures comprised of a Healthy Lifestyle Knowledge Questionnaire and Synchronised Nutrition and Activity Program to assess diet and physical activity, height, weight, and psychological wellbeing. Feasibility outcomes were recruitment, attrition rates, interviews with teaching staff, focus groups with pupils to explore the acceptability of outcome measures, implementation, intervention content, and programme fidelity. Results Three hundred fifty-eight pupils, aged 6–9 years from eight schools were recruited at baseline (control n = 170, intervention n = 188); 337 (94.1%) at 6 months (control n = 163, intervention n = 181); and 331 (92.5%) at 18 months (control n = 152, intervention n = 179), and 6 pupils opted out. Trends in increased knowledge of healthy lifestyle behaviours, healthier eating, and liking of fruit and vegetables were reported in the intervention compared to the control group. Year 4 intervention pupils had significantly higher healthy balanced diet knowledge scores compared to control pupils, mean difference 5.1 (95% CI 0.1 to 10.1, p=0.05). At 18 months, the mean percentage of vegetables liked was higher (intervention 53.9% vs. 43.0% control). Similarly, percentage of fruits liked was also higher (intervention 76.9% vs. 67.2% control). Qualitative data showed that delivery of the intervention was feasible and acceptable to teachers and pupils. Lessons were learned to inform the phase 3 trial around the dietary assessment measure and timing of recruitment. Conclusions Whilst the study was not powered to detect a definitive effect, results suggest a potential to increase knowledge of healthy lifestyle behaviours and dietary behaviours, suggesting that with minor changes, a phase 3 trial is likely to be deliverable. Trial registration ISRCTN, ISRCTN15641330. Registered 8 May 2015—retrospectively registered, 10.1186/ISRCTN15641330
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Affiliation(s)
- Pinki Sahota
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
| | - Meaghan Christian
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
| | - Rhiannon Day
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
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8
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Bagnall A, Radley D, Jones R, Gately P, Nobles J, van Dijk M, Blackshaw4 J, Montel S, Sahota P. Whole systems approaches to obesity and other complex public health challenges: a systematic review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Increasing awareness of the complexity of public health problems, including obesity, has led to growing interest in whole systems approaches (WSAs). We carried out a systematic review of WSAs targeting obesity and other complex public health and societal issues.
Methods
Seven electronic databases were searched from 1995 to 2018. Studies were included if there had been an effort to implement a WSA. Study selection was conducted by one reviewer with a random 20% double checked. Data extraction and validity assessment were undertaken by one reviewer and checked by a second reviewer. Narrative synthesis was undertaken.
Results
65 articles were included; 33 about obesity. Most examined multicomponent community approaches, and there was substantial clinical and methodological heterogeneity. Nevertheless, a range of positive health outcomes were reported, with some evidence of whole systems thinking. Positive effects were seen on health behaviours, body mass index (BMI), parental and community awareness, community capacity building, nutrition and physical activity environments, underage drinking behaviour and health, safety and wellbeing of community members, self-efficacy, smoking and tobacco-related disease outcomes.
Features of successful approaches reported in process evaluations included: full engagement of relevant partners and community; time to build relationships, trust and capacity; good governance; embedding within a broader policy context; local evaluation; finance.
Conclusions
Systems approaches to tackle obesity can have some benefit, but evidence of how to operationalise a WSA to address public health problems is still in its infancy. Future research should: (a) develop an agreed definition of a WSA in relation to obesity, (b) look across multiple sectors to ensure consistency of language and definition, (c) include detailed descriptions of the approaches, and (d) include process and economic evaluations.
Key messages
Interventions working towards systems approaches are associated with a range of positive health outcomes. Evidence of systems science and systems thinking was less clear, even in the most “joined up” approaches.
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Affiliation(s)
- A Bagnall
- Centre for Health Promotion Research, Leeds Beckett University, Leeds, UK
| | - D Radley
- Canregie School of Sport, Leeds Beckett University, Leeds, UK
| | - R Jones
- Centre for Health Promotion Research, Leeds Beckett University, Leeds, UK
| | - P Gately
- Canregie School of Sport, Leeds Beckett University, Leeds, UK
| | - J Nobles
- Bristol Medical School, University of Bristol, Bristol, UK
| | - M van Dijk
- Diet and Obesity, Health Improvement Directorate, Leeds Beckett University, Leeds, UK
| | | | - S Montel
- Diet and Obesity, Health Improvement Directorate, Leeds Beckett University, Leeds, UK
| | - P Sahota
- School of Clincal & Applied Sciences, Leeds Beckett University, Leeds, UK
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Day RE, Sahota P, Christian MS. Effective implementation of primary school-based healthy lifestyle programmes: a qualitative study of views of school staff. BMC Public Health 2019; 19:1239. [PMID: 31500603 PMCID: PMC6734437 DOI: 10.1186/s12889-019-7550-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 08/26/2019] [Indexed: 01/17/2023] Open
Abstract
Background Primary schools are valuable settings to implement healthy lifestyle (healthy eating and physical activity) interventions, aimed at targeting childhood obesity. This study explored school staff perceptions of factors that hinder and enable successful implementation and sustainability of healthy lifestyle interventions in primary schools. Qualitative data was pooled and analysed from two evaluations carried out in primary schools in North England: a feasibility study of a nutrition and physical activity educational programme (PhunkyFoods Feasibility Study), and an evaluation of a healthy eating programme (The Food Dudes Evaluation). Methods Sixty-five qualitative semi-structured interviews were conducted with head teachers, teachers, catering managers, designated school-based programme coordinators and programme staff supporting schools with programme delivery, at 14 schools involved in both evaluations. Thematic analysis was undertaken and emergent themes categorised using a framework for successful implementation by Durlak and Dupre (2008). Results Overall, all schools were delivering a range of healthy lifestyle programmes, often with overlapping content. Perceived challenges to implementation of individual programmes included: limited time, timing of implementation, limited training and support, insufficient resources, capacity and facilities, staff perceptions of intervention and perceived skill-proficiency (for cooking and physical activities). Short-term funding, lack of external and internal support were perceived to hinder sustainability. Staff recommendations for successful implementation of future programmes included: extended training and planning time, sufficient capacity, external support for delivery, good resources (interactive, practical and adaptable), and facilities for cooking, healthy eating, gardening and physical activities. Head teachers need to prioritise delivery of a few key healthy lifestyle programmes, in an overcrowded curriculum. Schools need to employ strategies to engage participation of staff, pupils and parents long term. Conclusions Effective implementation of school-based healthy lifestyle programmes was thought to be aided by flexible and adaptable programmes, enabling good contextual fit, well-resourced programmes and effective leadership at multiple levels, pupil (pupils support delivery) and parent involvement. To facilitate sustainability, it was perceived that programmes need to be integrated within the curriculum and school policies long term, with sustained support from head teachers and staff. These findings are relevant to programme developers, policy makers and those involved in delivering interventions. Electronic supplementary material The online version of this article (10.1186/s12889-019-7550-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rhiannon Eleanor Day
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK.
| | - Pinki Sahota
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK
| | - Meaghan Sarah Christian
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK
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10
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Day RE, Krishnarao R, Sahota P, Christian MS. We still don't know that our children need vitamin D daily: a study of parents' understanding of vitamin D requirements in children aged 0-2 years. BMC Public Health 2019; 19:1119. [PMID: 31416429 PMCID: PMC6694627 DOI: 10.1186/s12889-019-7340-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/19/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been highlighted as a serious public health problem in the United Kingdom. One in four toddlers are not achieving the recommended intake for their healthy development. This study uses quantitative and qualitative methods to explore parents' perceptions, awareness and behaviours around vitamin D intake, and the acceptability of and factors affecting purchasing of food and drink fortified with Vitamin D in children aged 0-2 years old. METHODS One hundred and ninety-four parents completed an online questionnaire, advertised to parents with one child aged up to 2 years on popular social media websites. The majority of participants were mothers, White-British ethnic background, aged 25-44 years. Participants provided an email address if they wanted to be contacted about the focus groups. Recruitment posters advertising the focus groups were placed in community centres. Eighteen participated in 5 focus groups (13 parents), and 5 individual interviews. A thematic analysis methodology was applied. RESULTS Fifty-seven percent (n = 110) of parents reported receiving information about vitamin D during pregnancy and 52% (n = 100) after the birth of their child. Parents reported a low level of satisfaction with vitamin D information: many thought it was limited and recommendations on supplements were unclear. Parents wanted more information about vitamin D requirements for their child (80%, n = 153 out of 192 respondents, 2 non-response), about vitamin D and breastfeeding (56%, n = 108) and vitamin D and pregnancy (49%, n = 94). The recommendations were for simpler, easier to read, with specific and clearer guidelines; delivered regularly during routine appointments, at timely stages throughout pregnancy and after the birth. 23% (n = 45, out of 194 respondents) of parents did not know why vitamin D is important for health. Only 26% (n = 49, out of 192 respondents) of parents reported giving their youngest child a vitamin D supplement on most days of the week. The majority of parents (interview/focus group) wanted more information about foods/drinks fortified with vitamin D. CONCLUSION Parents were generally not aware of the importance of vitamin D, dietary requirements including supplementation and the availability of vitamin D fortified foods. Major improvements are required for the effective promotion of vitamin D information to parents.
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Affiliation(s)
- Rhiannon Eleanor Day
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK
| | - Roxane Krishnarao
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK
| | - Pinki Sahota
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK
| | - Meaghan Sarah Christian
- School of Clinical and Applied Sciences, Leeds Beckett University, CL615A, City Campus, Leeds, LS1 3HE, UK.
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11
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Burton W, Twiddy M, Sahota P, Brown J, Bryant M. Participant engagement with a UK community-based preschool childhood obesity prevention programme: a focused ethnography study. BMC Public Health 2019; 19:1074. [PMID: 31395041 PMCID: PMC6688247 DOI: 10.1186/s12889-019-7410-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 07/31/2019] [Indexed: 11/18/2022] Open
Abstract
Background Children’s centres in the UK provide a setting for public health programmes; offering support to families living in the most disadvantaged areas where obesity prevalence is at its highest. Health, Exercise and Nutrition in the Really Young (HENRY) is an eight-week obesity prevention programme currently delivered in children’s centres across the UK. However, low participant engagement in some local authorities threatens its potential reach and impact. This study aimed to explore the factors influencing participant engagement with HENRY to describe where local intervention may support engagement efforts. Method A focused ethnography study was undertaken in five children’s centres delivering HENRY across the UK. One hundred and ninety hours of field observations, 22 interviews with staff (commissioners, HENRY co-ordinators, managers and facilitators) and six focus groups (36 parents), took place over five consecutive days in each centre. The Consolidated Framework for Implementation Research (CFIR) was used to guide the observations and analysis of the data. Results Three overarching themes described the factors influencing participant engagement with HENRY: local authority decision making around children’s centre programmes; children’s centre implementation of HENRY; and the participant experience of HENRY. The results indicate that factors influencing participant engagement with public health programmes begin at the commissioning body level, influencing children’s centre implementation and subsequently the experience of participants. Local authority funding priorities and constraints influence availability of places and who these places are offered to, with funding often targeted towards those deemed most at need. This was perceived to have a detrimental effect on participant experience of the programme. Conclusion In summary, participant engagement is affected by multiple factors, working at different levels of the children’s centre and local authority hierarchy, most of which are at play even before participants decide whether or not they choose to enrol and maintain attendance. For programmes to achieve their optimal reach and impact, factors at the commissioning and local implementation level need to be addressed prior to addressing participant facing issues. Electronic supplementary material The online version of this article (10.1186/s12889-019-7410-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wendy Burton
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.
| | - Maureen Twiddy
- Institute of Clinical and Applied Health Research, Hull York Medical School, University of Hull, Cottingham Rd, Hull, HU6 7RX, UK
| | - Pinki Sahota
- School of Clinical and Applied Sciences, Leeds Beckett University, City Campus, Leeds, LS1 3HE, UK
| | - Julia Brown
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Maria Bryant
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
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12
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Dickerson J, Bird PK, Bryant M, Dharni N, Bridges S, Willan K, Ahern S, Dunn A, Nielsen D, Uphoff EP, Bywater T, Bowyer-Crane C, Sahota P, Small N, Howell M, Thornton G, Pickett KE, McEachan RRC, Wright J. Integrating research and system-wide practice in public health: lessons learnt from Better Start Bradford. BMC Public Health 2019; 19:260. [PMID: 30832626 PMCID: PMC6399808 DOI: 10.1186/s12889-019-6554-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 02/15/2019] [Indexed: 11/16/2022] Open
Abstract
Many interventions that are delivered within public health services have little evidence of effect. Evaluating interventions that are being delivered as a part of usual practice offers opportunities to improve the evidence base of public health. However, such evaluation is challenging and requires the integration of research into system-wide practice. The Born in Bradford’s Better Start experimental birth cohort offers an opportunity to efficiently evaluate multiple complex community interventions to improve the health, wellbeing and development of children aged 0–3 years. Based on the learning from this programme, this paper offers a pragmatic and practical guide to researchers, public health commissioners and service providers to enable them to integrate research into their everyday practice, thus enabling relevant and robust evaluations within a complex and changing system. Using the principles of co-production the key challenges of integrating research and practice were identified, and appropriate strategies to overcome these, developed across five key stages: 1) Community and stakeholder engagement; 2) Intervention design; 3) Optimising routinely collected data; 4) Monitoring implementation; and 5) Evaluation. As a result of our learning we have developed comprehensive toolkits (https://borninbradford.nhs.uk/what-we-do/pregnancy-early-years/toolkit/) including: an operational guide through the service design process; an implementation and monitoring guide; and an evaluation framework. The evaluation framework incorporates implementation evaluations to enable understanding of intervention performance in practice, and quasi experimental approaches to infer causal effects in a timely manner. We also offer strategies to harness routinely collected data to enhance the efficiency and affordability of evaluations that are directly relevant to policy and practice. These strategies and tools will help researchers, commissioners and service providers to work together to evaluate interventions delivered in real-life settings. More importantly, however, we hope that they will support the development of a connected system that empowers practitioners and commissioners to embed innovation and improvement into their own practice, thus enabling them to learn, evaluate and improve their own services.
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Affiliation(s)
- Josie Dickerson
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England.
| | - Philippa K Bird
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England
| | - Maria Bryant
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, England
| | - Nimarta Dharni
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England
| | - Sally Bridges
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England
| | - Kathryn Willan
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England
| | - Sara Ahern
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, England
| | - Abigail Dunn
- Department of Health Sciences, The University of York, York, England
| | - Dea Nielsen
- Psychology in Education Research Centre, Department of Education, The University of York, York, England
| | - Eleonora P Uphoff
- Department of Health Sciences, The University of York, York, England
| | - Tracey Bywater
- Department of Health Sciences, The University of York, York, England
| | - Claudine Bowyer-Crane
- Psychology in Education Research Centre, Department of Education, The University of York, York, England
| | - Pinki Sahota
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, England
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, England
| | | | - Gill Thornton
- Better Start Bradford, Bradford Trident, Bradford, England
| | - Kate E Pickett
- Department of Health Sciences, The University of York, York, England
| | - Rosemary R C McEachan
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England
| | - John Wright
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, England
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13
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Bagnall AM, Radley D, Jones R, Gately P, Nobles J, Van Dijk M, Blackshaw J, Montel S, Sahota P. Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health 2019; 19:8. [PMID: 30606173 PMCID: PMC6318991 DOI: 10.1186/s12889-018-6274-z] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 11/28/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Increasing awareness of the complexity of public health problems, including obesity, has led to growing interest in whole systems approaches (WSAs), defined as those that consider the multifactorial drivers of overweight and obesity, involve transformative co-ordinated action across a broad range of disciplines and stakeholders, operate across all levels of governance and throughout the life course. This paper reports a systematic review of WSAs targeting obesity and other complex public health and societal issues, such as healthy lifestyles for prevention of non-communicable disease. METHODS Seven electronic databases were searched from 1995 to 2018. Studies were included if there had been an effort to implement a WSA. Study selection was conducted by one reviewer with a random 20% double checked. Data extraction and validity assessment were undertaken by one reviewer and checked by a second reviewer. Narrative synthesis was undertaken. RESULTS Sixty-five articles were included; 33 about obesity. Most examined multicomponent community approaches, and there was substantial clinical and methodological heterogeneity. Nevertheless, a range of positive health outcomes were reported, with some evidence of whole systems thinking. Positive effects were seen on health behaviours, body mass index (BMI), parental and community awareness, community capacity building, nutrition and physical activity environments, underage drinking behaviour and health, safety and wellbeing of community members, self-efficacy, smoking and tobacco-related disease outcomes. Features of successful approaches reported in process evaluations included: full engagement of relevant partners and community; time to build relationships, trust and capacity; good governance; embedding within a broader policy context; local evaluation; finance. CONCLUSIONS Systems approaches to tackle obesity can have some benefit, but evidence of how to operationalise a WSA to address public health problems is still in its infancy. Future research should: (a) develop an agreed definition of a WSA in relation to obesity, (b) look across multiple sectors to ensure consistency of language and definition, (c) include detailed descriptions of the approaches, and (d) include process and economic evaluations.
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Affiliation(s)
- Anne-Marie Bagnall
- Centre for Health Promotion Research, School of Health & Community Studies, Leeds Beckett University, Portland 519, Leeds, LS1 3HE UK
| | - Duncan Radley
- School of Sport, Leeds Beckett University, Leeds, UK
| | - Rebecca Jones
- Centre for Health Promotion Research, School of Health & Community Studies, Leeds Beckett University, Portland 519, Leeds, LS1 3HE UK
| | - Paul Gately
- School of Sport, Leeds Beckett University, Leeds, UK
| | - James Nobles
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Margie Van Dijk
- Diet & Obesity, Health Improvement Directorate, Public Health England, London, UK
| | - Jamie Blackshaw
- Diet & Obesity, Health Improvement Directorate, Public Health England, London, UK
| | - Sam Montel
- Diet & Obesity, Health Improvement Directorate, Public Health England, London, UK
| | - Pinki Sahota
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, UK
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14
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Mahoney S, Bryant M, Sahota P, Barber S. Dietary intake in the early years and its relationship to BMI in a bi-ethnic group: the Born in Bradford 1000 study. Public Health Nutr 2018; 21:2242-2254. [PMID: 29607793 DOI: 10.1017/s1368980018000654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess relationships between dietary intake at age 12, 18 and 36 months and BMI Z-scores at age 36 months in a bi-ethnic group. DESIGN A prospective cohort study comparing cross-sectional and longitudinal data. Exposures included dietary intake at 12, 18 and 36 months (FFQ) with an outcome of BMI Z-score at age 36 months. SETTING Born in Bradford 1000 study, Bradford, UK. SUBJECTS Infants at age 12 months (n 722; 44 % White British, 56 % Pakistani), 18 months (n 779; 44 % White British, 56 % Pakistani) and 36 months (n 845; 45 % White British, 55 % Pakistani). RESULTS Diet at age 12 months was not associated with BMI Z-score at age 36 months. Higher consumption of vegetables at 18 and 36 months was associated with a lower BMI Z-score at 36 months (model coefficient (95 % CI): -0·20 (-0·36, -0·03) and -0·16 (-0·31, -0·02), respectively). Higher consumption of high-fat chips at age 36 months was associated with a lower BMI Z-score at age 36 months (-0·16 (-0·32, 0·00)). Overall, White British children had higher 36-month BMI Z-scores than Pakistani children (adjusted mean difference (95 % CI): 0·21 (0·02, 0·41)). CONCLUSIONS Our findings indicate that dietary intake at 18 and 36 months was somewhat related to BMI Z-score at age 36 months and suggest the importance of early interventions aimed at establishing healthy eating behaviours.
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Affiliation(s)
- Samuel Mahoney
- 1School of Mathematics,University of Leeds,Leeds LS2 9JT,UK
| | - Maria Bryant
- 2Leeds Institute for Clinical Trials Research,University of Leeds,Leeds,UK
| | - Pinki Sahota
- 3Institute for Health & Wellbeing,Faculty of Health and Social Sciences,Leeds Beckett University,Leeds,UK
| | - Stuart Barber
- 1School of Mathematics,University of Leeds,Leeds LS2 9JT,UK
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15
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Singh S, Thakkar M, Bollu P, Goyal M, Sivaraman M, Bhartee H, Johnson J, Smith D, Sahota P. 0606 Can qEEG Be Used For Evaluation Of Cognitive Decline In OSA Patients? Sleep 2018. [DOI: 10.1093/sleep/zsy061.605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Singh
- University of Missouri, Columbia, MO
| | - M Thakkar
- University of Missouri, Columbia, MO
| | - P Bollu
- University of Missouri, Columbia, MO
| | - M Goyal
- University of Missouri, Columbia, MO
| | | | - H Bhartee
- University of Missouri, Columbia, MO
| | - J Johnson
- University of Missouri, Columbia, MO
| | - D Smith
- University of Missouri, Columbia, MO
| | - P Sahota
- University of Missouri, Columbia, MO
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16
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Bhartee H, Sahota P, Sivaraman M, Govindarajan R, Bollu PC, Thakkar M, Goyal M, Johnson J, Singh S. 0668 Small Fiber Neuropathy in Patients with Refractory RLS: A Case Series. Sleep 2018. [DOI: 10.1093/sleep/zsy061.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Bhartee
- University of Missouri-Columbia, Columbia, MO
| | - P Sahota
- University of Missouri-Columbia, Columbia, MO
| | - M Sivaraman
- University of Missouri-Columbia, Columbia, MO
| | | | - P C Bollu
- University of Missouri-Columbia, Columbia, MO
| | - M Thakkar
- University of Missouri-Columbia, Columbia, MO
| | - M Goyal
- University of Missouri-Columbia, Columbia, MO
| | - J Johnson
- University of Missouri-Columbia, Columbia, MO
| | - S Singh
- University of Missouri-Columbia, Columbia, MO
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17
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McCrae CS, Chan WS, Deroche CB, Munoz M, McLean D, Davenport M, Muckerman J, Takahashi N, McCann D, McGovney K, Sahota P, Mazurek M. 0802 CBT for Insomnia in Children with Autism Spectrum Disorder (ASD). Sleep 2018. [DOI: 10.1093/sleep/zsy061.801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C S McCrae
- University of Missouri-Columbia, Columbia, MO
| | | | - C B Deroche
- University of Missouri-Columbia, Columbia, MO
- University of Missouri-Columbia, Columbia, MO
| | - M Munoz
- University of Missouri-Columbia, University of Missouri, MO
| | - D McLean
- University of Missouri, Columbia, MO
| | | | | | | | - D McCann
- University of Missouri, Columbia, MO
| | | | - P Sahota
- University of Missouri, Columbia, MO
| | - M Mazurek
- University of Virginia, Charlottesville, VA
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18
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Davenport M, Munoz M, Mazurek M, McClean D, Sahota P, McCrae CS. 0804 Behavioral and Sleep Problems in Children with ASD: Examining the Associated Risk of Poor Health in Caregivers. Sleep 2018. [DOI: 10.1093/sleep/zsy061.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Davenport
- Department of Educational, School, and Counseling, University of Missouri, Columbia, MO
| | - M Munoz
- Department of Educational, School, and Counseling, University of Missouri, Columbia, MO
| | - M Mazurek
- Department of Human Services, University of Virginia, Charlottesville, VA
| | - D McClean
- Department of Educational, School, and Counseling, University of Missouri, Columbia, MO
| | - P Sahota
- Department of Neurology, University of Missouri School of Medicine, Columbia, MO
| | - C S McCrae
- Department of Psychiatry, University of Missouri School of Medicine, Columbia, MO
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19
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GOYAL MK, Thakkar M, Taylor N, Yin L, Bollu P, Sivaraman M, Sahota P. 0664 The Effect Of Gabapentin Enacarbil On Dopaminergic Augmentation In Patients With Primary Restless Legs Syndrome. Sleep 2018. [DOI: 10.1093/sleep/zsy061.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M K GOYAL
- UNIVERSITY OF MISSOURI-COLUMBIA, COLUMBIA, MO
| | - M Thakkar
- University of Missouri - Columbia, Columbia, MO
| | - N Taylor
- UNIVERSITY OF MISSOURI-COLUMBIA, Columbia, MO
| | - L Yin
- UNIVERSITY OF MISSOURI-COLUMBIA, Columbia, MO
| | - P Bollu
- UNIVERSITY OF MISSOURI-COLUMBIA, Columbia, MO
| | - M Sivaraman
- University of Missouri - Columbia, Columbia, MO
| | - P Sahota
- University of Missouri - Columbia, Columbia, MO
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20
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Sharma R, Sahota P, Thakkar MM. 0223 A Single Episode Of Binge Alcohol Drinking Disrupts Sleep Homeostasis To Cause Sleep Disruptions. Sleep 2018. [DOI: 10.1093/sleep/zsy061.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Yang TC, Sahota P, Pickett KE, Bryant M. Association of food security status with overweight and dietary intake: exploration of White British and Pakistani-origin families in the Born in Bradford cohort. Nutr J 2018; 17:48. [PMID: 29690871 PMCID: PMC5916586 DOI: 10.1186/s12937-018-0349-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/22/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Food insecurity has been associated with dietary intake and weight status in UK adults and children although results have been mixed and ethnicity has not been explored. We aimed to compare prevalence and trajectories of weight and dietary intakes among food secure and insecure White British and Pakistani-origin families. METHODS At 12 months postpartum, mothers in the Born in Bradford cohort completed a questionnaire on food security status and a food frequency questionnaire (FFQ) assessing their child's intake in the previous month; at 18 months postpartum, mothers completed a short-form FFQ assessing dietary intake in the previous 12 months. Weights and heights of mothers and infants were assessed at 12-, 24-, and 36-months postpartum, with an additional measurement of children taken at 4-5 years. Associations between food security status and dietary intakes were assessed using Wilcoxon-Mann-Whitney for continuous variables and χ2 or Fisher's exact tests for categorical variables. Quantile and logistic regression were used to determine dietary intakes adjusting for mother's age. Linear mixed effects models were used to assess longitudinal changes in body mass index (BMI) in mothers and BMI z-scores in children. RESULTS At 12 months postpartum, White British mothers reported more food insecurity than Pakistani-origin mothers (11% vs 7%; p < 0.01) and more food insecure mothers were overweight. Between 12 and 36 months postpartum, BMI increased more among food insecure Pakistani-origin mothers (β = 0.77 units, [95% Confidence Interval [CI]: 0.40, 1.10]) than food secure (β = 0.44 units, 95% CI: 0.33, 0.55). This was also found in Pakistani-origin children (BMI z-score: food insecure β = 0.40 units, 95% CI: 0.22, 0.59; food secure β = 0.25 units, 95% CI: 0.20, 0.29). No significant increases in BMI were observed for food secure or insecure White British mothers while BMI z-score increased by 0.17 (95% CI: 0.13, 0.21) for food secure White British children. Food insecure mothers and children had dietary intakes of poorer quality, with fewer vegetables and higher consumption of sugar-sweetened drinks. CONCLUSIONS Food security status is associated with body weight and dietary intakes differentially by ethnicity. These are important considerations for developing targeted interventions.
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Affiliation(s)
- T. C. Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Trust, Bradford, BD9 6RJ UK
| | - P. Sahota
- School of Clinical & Applied Sciences, Leeds Beckett University, Leeds, LS1 3HE UK
| | - K. E. Pickett
- Department of Health Sciences, University of York, York, YO10 5DD UK
| | - M. Bryant
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
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22
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Affiliation(s)
- Stuart W Flint
- School of Sport, Leeds Beckett University, Leeds LS6 3QS, UK.
| | - James Nobles
- School of Sport, Leeds Beckett University, Leeds LS6 3QS, UK; MoreLife, Leeds, UK
| | - Paul Gately
- School of Sport, Leeds Beckett University, Leeds LS6 3QS, UK; MoreLife, Leeds, UK
| | - Pinki Sahota
- School of Sport, Leeds Beckett University, Leeds LS6 3QS, UK
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23
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Tapp RJ, Hughes AD, Kähönen M, Wong TY, Witt N, Lehtimäki T, Hutri-Kähönen N, Sahota P, Juonala M, Raitakari OT. Cardiometabolic Health Among Adult Offspring of Hypertensive Pregnancies: The Cardiovascular Risk in Young Finns Study. J Am Heart Assoc 2018; 7:JAHA.117.006284. [PMID: 29306901 PMCID: PMC5778953 DOI: 10.1161/jaha.117.006284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Cardiometabolic health among adult offspring of hypertensive disorders of pregnancy (HDP) is relatively unknown. We hypothesized that offspring of HDP would have abnormalities in the retinal microvasculature and cardiac structure by midadulthood. Methods and Results The Cardiovascular Risk in Young Finns Study included randomly selected children from 5 Finnish university cities. The mean age of participants was 40 years (range 34–49 years) at the time of retinal photography and cardiac assessment. Offspring born ≥37 weeks of gestation and appropriate for gestational age (n=1006) were included. Offspring of HDP had higher systolic blood pressure (β=4.68, P<0.001), body mass index (β=1.25, P=0.009), and waist circumference (β=0.25, P=0.042), compared with offspring of normotensive pregnancies. However, no differences in fasting glucose, insulin, lipid profile, carotid intima media thickness, or brachial artery flow‐mediated dilatation were shown. Retinal arteriolar diameters were narrower (β=−0.43, P=0.009) and longer (β=32.5, P=0.023) and the arteriolar length‐to‐diameter ratio was higher (β=2.32, P=0.006) among offspring of HDP, after adjustment for age and sex. Left atrial volume indexed to body surface area (β=1.34, P=0.040) was increased. Adjustment for the confounding effects of birth weight, body mass index, smoking and socioeconomic status, and the mediating effect of hypertension had little impact on the associations. Conclusions Abnormalities of the retinal microvasculature and cardiac structure are seen in offspring of HDP in midadulthood. These findings may need to be considered in future primary prevention strategies of cardiovascular disease among offspring of HDP.
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Affiliation(s)
- Robyn J Tapp
- Melbourne School of Population and Global Health University of Melbourne, Australia .,School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom.,Department of Optometry and Vision Sciences, The University of Melbourne, Australia
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and the University of Tampere, Finland
| | - Tien Yin Wong
- Singapore National Eye Center, Singapore & Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Nicholas Witt
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and School of Medicine, University of Tampere, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Pinki Sahota
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds, United Kingdom
| | - Markus Juonala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
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24
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Newey CR, Le NM, Ahrens C, Sahota P, Hantus S. The Safety and Effectiveness of Intravenous Lacosamide for Refractory Status Epilepticus in the Critically Ill. Neurocrit Care 2017; 26:273-279. [PMID: 27844464 DOI: 10.1007/s12028-016-0322-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Status epilepticus (SE) often does not respond to initial treatment. A second-line agent with a less established safety and efficacy profile is then required. This study examined the safety of intravenous (IV) lacosamide (LCM) in a critically ill population and obtained an estimate of effectiveness in patients with refractory SE on continuous video EEG monitoring (cEEG). METHODS Retrospective review of critically ill patients in SE on cEEG treated with IV LCM from June 2009 to April 2011. RESULTS Eighty-four patients in SE (43 F/41 M), mean age 59.6 years, were identified; and 59.5 % had nonconvulsive SE. The most common etiologies were ischemic and hemorrhagic strokes. There were no significant changes in serial blood pressure monitoring, PR prolongation, aspartate aminotransferase (AST), or creatinine pre- and post-LCM. There was a significant increase in alanine aminotransferase (ALT) from days 1-7 (p = 0.031). Fifty-one patients were LCM-naïve. In these patients, cessation of SE on cEEG after LCM occurred in 15.7, 25.5, 58.8, and 82.4 % by 4, 12, 24, and 48 h, respectively. CONCLUSION IV LCM appears safe short term in critically ill patients with SE. The retrospective estimate of effectiveness for LCM appears promising for management in SE. Prospective, randomized controlled studies are needed to better determine the role of LCM in treating SE.
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Affiliation(s)
- C R Newey
- Department of Neurology, University of Missouri, 5 Hospital Drive, CE 540, Columbia, MO, 65211, USA.
| | - N M Le
- Pediatric Neurology, Orlando Health System, 7485 Sand Lake Commons Blvd, Orlando, FL, 32819, USA
| | - C Ahrens
- Department of Pharmacy, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195-5245, USA
| | - P Sahota
- Department of Neurology, University of Missouri, 5 Hospital Drive, CE 540, Columbia, MO, 65211, USA
| | - S Hantus
- Cerebrovascular Center, Neurologic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195-5245, USA.,Epilepsy Center, Neurologic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195-5245, USA
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Thurlow S, Taylor-Covill G, Sahota P, Oldroyd B, Hind K. Effects of procedure, upright equilibrium time, sex and BMI on the precision of body fluid measurements using bioelectrical impedance analysis. Eur J Clin Nutr 2017; 72:148-153. [PMID: 28722029 DOI: 10.1038/ejcn.2017.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 04/30/2017] [Accepted: 06/12/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Extensive work has addressed the validity of bioimpedance (BIA) measurements and the effect of posture on fluid homeostasis. However, limited research has investigated effects of subject preparation. This study aimed to determine the precision of total body water (TBW) and extracellular water (ECW) measurements using a stand-on multifrequency BIA (MFBIA seca mBCA 514/515), in three pre-test procedures: supine, sitting, and following walking, with specific reference to the influence of sex and body mass index (BMI). SUBJECTS/METHODS Fifty three healthy, ambulatory men (n=26, age:32.5±9.4 years) and women (n=27, age:35.2±10.3 years) received repeat MFBIA measurements (six measurements from 0 to 15 min). Agreement and precision were evaluated for each condition and paired time points. RESULTS Significant TBW sex differences from supine posture were observed for walking (females) and sitting (males) postures. For BMI (⩽24.9 kg m-2) significant TBW differences from supine were observed for both sitting and walking and significant ECW differences from sitting were also observed with both supine and walking. There was no significant effect of sex or BMI (⩾25.0 kg m-2) on ECW measures. Irrespective of sex or BMI, there was close agreement in TBW and ECW precision over the three protocols. CONCLUSIONS Practitioners can have confidence in the precision of TBW and ECW measurements within a 15 min time period and pre-testing conditions (supine, sitting or walking) in healthy subjects, though must be cautious in assessments when pre-test postures change. Further research to examine the impact of pre-testing procedures on stand-on MFBIA BIA measurements, including subjects with fluid disturbance, is warranted.
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Affiliation(s)
- S Thurlow
- Bone and Body Composition Research Group, Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - G Taylor-Covill
- Faculty of Health and Social Sciences, Leeds Beckett University, City Campus, UK
| | - P Sahota
- Faculty of Health and Social Sciences, Leeds Beckett University, City Campus, UK
| | - B Oldroyd
- Bone and Body Composition Research Group, Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - K Hind
- Bone and Body Composition Research Group, Carnegie School of Sport, Leeds Beckett University, Headingley Campus, Leeds, UK
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Wright J, Fairley L, McEachan R, Bryant M, Petherick E, Sahota P, Santorelli G, Barber S, Lawlor DA, Taylor N, Bhopal R, Cameron N, West J, Hill A, Summerbell C, Farrin A, Ball H, Brown T, Farrar D, Small N. Development and evaluation of an intervention for the prevention of childhood obesity in a multiethnic population: the Born in Bradford applied research programme. Programme Grants Appl Res 2016. [DOI: 10.3310/pgfar04060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BackgroundThere is an absence of evidence about interventions to prevent or treat obesity in early childhood and in South Asian populations, in whom risk is higher.ObjectivesTo study patterns and the aetiology of childhood obesity in a multiethnic population and develop a prevention intervention.DesignA cohort of pregnant women and their infants was recruited. Measures to compare growth and identify targets for obesity prevention, sensitive to ethnic differences, were collected. A feasibility randomised controlled trial (RCT) was undertaken.SettingBradford, UK.ParticipantsA total of 1735 mothers, 933 of whom were of South Asian origin.InterventionA feasibility trial of a group-based intervention aimed at overweight women, delivered ante- and postnatally, targeting key modifiable lifestyle behaviours to reduce infant obesity.Main outcome measuresThe feasibility and acceptability of the pilot intervention.Data sourcesRoutine NHS data and additional bespoke research data.Review methodsA systematic review of diet and physical activity interventions to prevent or treat obesity in South Asian children and adults.ResultsRoutine measures of growth were accurate. The prevalence of risk factors differed between mothers of white British ethnicity and mothers of Pakistani ethnicity and weight and length growth trajectories differed between Pakistani infants and white British infants. Prediction equations for risk of childhood obesity were developed. An evidence-based intervention was evaluated in a pilot RCT and was found to be feasible and acceptable.LimitationsThis was a single-centre observational study and a pilot evaluation.ConclusionsThe programme has been successful in recruiting a unique multiethnic childhood obesity cohort, which has provided new evidence about modifiable risk factors and biethnic growth trajectories. A novel group-based behavioural change intervention has been developed and successfully piloted. A multisite cluster RCT is required to evaluate effectiveness.Trial registrationCurrent Controlled Trials ISRCTN56735429.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- John Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Lesley Fairley
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Maria Bryant
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Emily Petherick
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Pinki Sahota
- School of Health and Wellbeing, Leeds Beckett University, Leeds, UK
| | - Gillian Santorelli
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Sally Barber
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Debbie A Lawlor
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Natalie Taylor
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Raj Bhopal
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jane West
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Andrew Hill
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Carolyn Summerbell
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Amanda Farrin
- Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Helen Ball
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Tamara Brown
- Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
| | - Diane Farrar
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Neil Small
- Faculty of Health Studies, University of Bradford, Bradford, UK
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McEachan RRC, Santorelli G, Bryant M, Sahota P, Farrar D, Small N, Akhtar S, Sargent J, Barber SE, Taylor N, Richardson G, Farrin AJ, Bhopal RS, Bingham DD, Ahern SM, Wright J. The HAPPY (Healthy and Active Parenting Programmme for early Years) feasibility randomised control trial: acceptability and feasibility of an intervention to reduce infant obesity. BMC Public Health 2016; 16:211. [PMID: 26931491 PMCID: PMC4774160 DOI: 10.1186/s12889-016-2861-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 02/12/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The prevalence of infant obesity is increasing, but there is a lack of evidence-based approaches to prevent obesity at this age. This study tested the acceptability and feasibility of evaluating a theory-based intervention aimed at reducing risk of obesity in infants of overweight/obese women during and after pregnancy: the Healthy and Active Parenting Programme for Early Years (HAPPY). METHODS A feasibility randomised controlled trial was conducted in Bradford, England. One hundred twenty overweight/obese pregnant women (Body Mass Index [BMI] ≥25 kg/m(2)) were recruited between 10-26 weeks gestation. Consenting women were randomly allocated to HAPPY (6 antenatal, 6 postnatal sessions: N = 59) or usual care (N = 61). Appropriate outcome measures for a full trial were explored, including: infant's length and weight, woman's BMI, physical activity and dietary intake of the women and infants. Health economic data were collected. Measurement occurred before randomisation and when the infant was aged 6 months and 12 months. Feasibility outcomes were: recruitment/attrition rates, and acceptability of: randomisation, measurement, and intervention. Intra-class correlations for infant weight were calculated. Fidelity was assessed through observations and facilitator feedback. Focus groups and semi-structured interviews explored acceptability of methods, implementation, and intervention content. RESULTS Recruitment targets were met (~20 women/month) with a recruitment rate of 30 % of eligible women (120/396). There was 30 % attrition at 12 months; 66 % of recruited women failed to attend intervention sessions, but those who attended the first session were likely to continue to attend (mean 9.4/12 sessions, range 1-12). Reaction to intervention content was positive, and fidelity was high. Group clustering was minimal; an adjusted effect size of -0.25 standard deviation scores for infant weight at 12 months (95 % CI: -0.16-0.65) favouring the intervention was observed using intention to treat analyses. No adverse events were reported. CONCLUSIONS The HAPPY intervention appeared feasible and acceptable to participants who attended and those delivering it, however attendance was low; adaptations to increase initial attendance are recommended. Whilst the study was not powered to detect a definitive effect, our results suggest a potential to reduce risk of infant obesity. The evidence reported provides valuable lessons to inform progression to a definitive trial. TRIAL REGISTRATION Current Controlled Trials ISRCTN56735429.
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Affiliation(s)
- Rosemary R. C. McEachan
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Gillian Santorelli
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Maria Bryant
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Pinki Sahota
- />Institute for Health and Wellbeing, Leeds Beckett University, Leeds, LS1 3HE UK
| | - Diane Farrar
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Department of Health Sciences, University of York, York, YO10 5DD UK
| | - Neil Small
- />Faculty of Health Studies, University of Bradford, Bradford, BD7 1DP UK
| | - Shaheen Akhtar
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | | | - Sally E. Barber
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - Natalie Taylor
- />Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109 Australia
| | - Gerry Richardson
- />Centre for Health Economics, University of York, York, YO10 5DD UK
| | - Amanda J. Farrin
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - Raj S. Bhopal
- />Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Daniel D. Bingham
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />School of Sport, Health and Exercise Science, Loughborough University, Leicestershire, LE11 3TT UK
| | - Sara M. Ahern
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - John Wright
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
| | - on behalf of the BiB childhood obesity scientific group
- />Bradford Institute for Health Research, Bradford Teaching Hospital NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ UK
- />Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
- />Institute for Health and Wellbeing, Leeds Beckett University, Leeds, LS1 3HE UK
- />Department of Health Sciences, University of York, York, YO10 5DD UK
- />Faculty of Health Studies, University of Bradford, Bradford, BD7 1DP UK
- />Barnardo’s, Bradford, BD8 7BS UK
- />Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2109 Australia
- />Centre for Health Economics, University of York, York, YO10 5DD UK
- />Edinburgh Migration, Ethnicity and Health Research Group, Centre for Population Health Sciences, Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
- />School of Sport, Health and Exercise Science, Loughborough University, Leicestershire, LE11 3TT UK
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Ensaff H, Homer M, Sahota P, Braybrook D, Coan S, McLeod H. Food Choice Architecture: An Intervention in a Secondary School and its Impact on Students' Plant-based Food Choices. Nutrients 2015; 7:4426-37. [PMID: 26043039 PMCID: PMC4488793 DOI: 10.3390/nu7064426] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 04/30/2015] [Accepted: 05/25/2015] [Indexed: 11/16/2022] Open
Abstract
With growing evidence for the positive health outcomes associated with a plant-based diet, the study’s purpose was to examine the potential of shifting adolescents’ food choices towards plant-based foods. Using a real world setting of a school canteen, a set of small changes to the choice architecture was designed and deployed in a secondary school in Yorkshire, England. Focussing on designated food items (whole fruit, fruit salad, vegetarian daily specials, and sandwiches containing salad) the changes were implemented for six weeks. Data collected on students’ food choice (218,796 transactions) enabled students’ (980 students) selections to be examined. Students’ food choice was compared for three periods: baseline (29 weeks); intervention (six weeks); and post-intervention (three weeks). Selection of designated food items significantly increased during the intervention and post-intervention periods, compared to baseline (baseline, 1.4%; intervention 3.0%; post-intervention, 2.2%) χ2(2) = 68.1, p < 0.001. Logistic regression modelling also revealed the independent effect of the intervention, with students 2.5 times as likely (p < 0.001) to select the designated food items during the intervention period, compared to baseline. The study’s results point to the influence of choice architecture within secondary school settings, and its potential role in improving adolescents’ daily food choices.
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Affiliation(s)
- Hannah Ensaff
- Nutrition & Dietetics, School of Health & Wellbeing, Leeds Beckett University, Leeds, LS1 3HE, UK.
| | - Matt Homer
- School of Education, University of Leeds, Leeds, LS2 9JT, UK.
| | - Pinki Sahota
- Nutrition & Dietetics, School of Health & Wellbeing, Leeds Beckett University, Leeds, LS1 3HE, UK.
| | - Debbie Braybrook
- Nutrition & Dietetics, School of Health & Wellbeing, Leeds Beckett University, Leeds, LS1 3HE, UK.
| | - Susan Coan
- Nutrition & Dietetics, School of Health & Wellbeing, Leeds Beckett University, Leeds, LS1 3HE, UK.
| | - Helen McLeod
- Health & Wellbeing Service, Leeds City Council, Leeds, LS12 1DB, UK.
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Ensaff H, Homer M, Sahota P, Braybrook D, Coan S, McLeod H. Nudging Adolescents towards Plant‐Based Foods within a School Food Environment. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- H Ensaff
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - M Homer
- School of Education University of LeedsUnited Kingdom
| | - P Sahota
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - D Braybrook
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - S Coan
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - H McLeod
- Health & Wellbeing ServiceLeeds City CouncilUnited Kingdom
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Ensaff H, Coan S, Sahota P, Braybrook D, Akter H, McLeod H. Plant‐Based Foods: Adolescents' Perceptions and the Consequent Implications for Policy and Practice. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- H Ensaff
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - S Coan
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - P Sahota
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - D Braybrook
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - H Akter
- School of Health & Wellbeing Leeds Beckett UniversityUnited Kingdom
| | - H McLeod
- Health & Wellbeing ServiceLeeds City CouncilUnited Kingdom
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Fairley L, Santorelli G, Lawlor DA, Bryant M, Bhopal R, Petherick ES, Sahota P, Greenwood DC, Hill AJ, Cameron N, Ball H, Barber S, Wright J. The relationship between early life modifiable risk factors for childhood obesity, ethnicity and body mass index at age 3 years: findings from the Born in Bradford birth cohort study. BMC Obes 2015. [PMID: 26217524 PMCID: PMC4510905 DOI: 10.1186/s40608-015-0037-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background Many modifiable risk factors in early infancy have been shown to be associated with childhood overweight and obesity. These risk factors have not been studied within children of South Asian origin in the UK. The aims of this paper are to describe differences in the prevalence of modifiable risk factors for childhood obesity between children of White British and Pakistani origin and investigate the association between these risk factors and childhood BMI measured at age 3 years. We used data from a sub-study of the Born in Bradford birth cohort with detailed follow-up visits throughout early childhood. 987 participants with a BMI measurement at age 3 were included; 39% were White British, 48% were of Pakistani origin and 13% were of other ethnicities. Linear and Poisson regression models were used to assess the association between risk factors and two outcomes at age 3; BMI z-scores and child overweight. Results Compared to Pakistani mothers, White British mothers were more likely to smoke during pregnancy, have higher BMI, breastfeed for a shorter duration and wean earlier, while Pakistani mothers had higher rates of gestational diabetes and were less active. There was no strong evidence that the relationship between risk factors and BMI z-score differed by ethnicity. There were associations between BMI z-score and maternal smoking (mean difference in BMI z-score 0.33 (95% CI 0.13, 0.53)), maternal obesity (0.37 (0.19, 0.55)), indulgent feeding style (0.15 (−0.06, 0.36)), lower parental warmth scores (0.21 (0.05, 0.36)) and higher parental hostility scores (0.17 (0.01, 0.33)). Consistent associations between these risk factors and child overweight were found. Mean BMI and the relative risk of being overweight were lower in children of mothers with lower parental self-efficacy scores and who watched more hours of TV. Other risk factors (gestational diabetes, child diet, child sleep, child TV viewing and maternal physical activity) were not associated with BMI. Conclusions Whilst the prevalence of risk factors that have been associated with childhood greater BMI differ between White British and Pakistani the magnitude of their associations with BMI are similar in the two groups. Electronic supplementary material The online version of this article (doi:10.1186/s40608-015-0037-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lesley Fairley
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, BD9 6RJ Bradford, UK ; Faculty of Health Studies, University of Bradford, Bradford, UK
| | | | - Debbie A Lawlor
- MRC Integrated Epidemiology Unit at the University of Bristol, Bristol, UK ; School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Maria Bryant
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, BD9 6RJ Bradford, UK ; Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Raj Bhopal
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Emily S Petherick
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, BD9 6RJ Bradford, UK ; Faculty of Health Studies, University of Bradford, Bradford, UK
| | - Pinki Sahota
- Institute of Health and Well-being, Leeds Metropolitan University, Leeds, UK
| | | | - Andrew J Hill
- Institute of Health Sciences, Leeds University School of Medicine, Leeds, UK
| | - Noel Cameron
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Helen Ball
- Parent-Infant Sleep Lab, Department of Anthropology, Durham University, Durham, UK
| | - Sally Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, BD9 6RJ Bradford, UK
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, BD9 6RJ Bradford, UK
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Sahota P, Woodward J, Molinari R, Pike J. Factors influencing take-up of free school meals in primary- and secondary-school children in England. Public Health Nutr 2014; 17:1271-9. [PMID: 23578731 PMCID: PMC10282406 DOI: 10.1017/s136898001300092x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 11/05/2012] [Accepted: 02/26/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study sought to explore the factors that influence registration for free school meals and the subsequent take-up following registration in England. DESIGN The research design consisted of two phases, a qualitative research phase followed by an intervention phase. Findings are presented from the qualitative research phase, which comprised interviews with head teachers, school administrators, parents and focus groups with pupils. SETTING The study took place in four primary schools and four secondary schools in Leeds, UK. SUBJECTS Participants included head teachers, school administrators, parents and pupils. RESULTS Findings suggested that parents felt the registration process to be relatively straightforward although many secondary schools were not proactive in promoting free school meals. Quality and choice of food were regarded by both pupils and parents as significant in determining school meal choices, with stigma being less of an issue than originally anticipated. CONCLUSIONS Schools should develop proactive approaches to promoting free school meals and attention should be given not only to the quality and availability of food, but also to the social, cultural and environmental aspects of dining. Processes to maintain pupils' anonymity should be considered to allay parents' fear of stigma.
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Affiliation(s)
- Pinki Sahota
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Calverley Street, Leeds LS1 3HE, UK
| | - Jenny Woodward
- Faculty of Health and Social Sciences, Leeds Metropolitan University, Calverley Street, Leeds LS1 3HE, UK
| | | | - Jo Pike
- School of Education, University of Leeds, Leeds, UK
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Skouteris H, Nagle C, Fowler M, Kent B, Sahota P, Morris H. Interventions designed to promote exclusive breastfeeding in high-income countries: a systematic review. Breastfeed Med 2014; 9:113-27. [PMID: 24568270 DOI: 10.1089/bfm.2013.0081] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Worldwide, women fail to reach the recommended exclusive breastfeeding target of 6 months postpartum. The objective of this study was to present a conceptual and methodological synthesis of interventions designed to promote exclusive breastfeeding to 6 months in high-income countries. MATERIALS AND METHODS A systematic search of leading databases was conducted for scholarly peer-reviewed randomized trials published between January 2000 and June 2013. Seventeen articles were identified as relevant; all were published in English and assessed exclusive breastfeeding with a follow-up period extending beyond 4 months postpartum. Articles were analyzed for overall quality of evidence, regarding duration of exclusive breastfeeding, using the Grading and Recommendations Assessment, Development, and Evaluation approach. RESULTS A significant increase in the duration of exclusive breastfeeding was found in eight of the 17 studies, with most interventions using supportive or educational approaches. Interventions in pregnancy focused on educating mothers on the benefits of exclusive breastfeeding. Fifteen interventions took place, at least in part, in the postnatal period and provided educational and emotional support to mothers. Of the eight successful interventions, five took part in the postnatal period in the mothers' own homes. The quality of the evidence for duration of exclusive breastfeeding was moderate. CONCLUSIONS The most successful interventions were conducted in the postnatal period and over a long period of time; however, the findings were inconsistent. No study assessed intervention fidelity, and only two studies noted maternal body mass index, a variable known to affect exclusive breastfeeding rates. Further research is needed to provide a robust evidence base to inform future interventions.
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Affiliation(s)
- Helen Skouteris
- 1 School of Psychology, Deakin University , Melbourne, Victoria, Australia
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Taylor NJ, Sahota P, Sargent J, Barber S, Loach J, Louch G, Wright J. Using intervention mapping to develop a culturally appropriate intervention to prevent childhood obesity: the HAPPY (Healthy and Active Parenting Programme for Early Years) study. Int J Behav Nutr Phys Act 2013; 10:142. [PMID: 24373301 PMCID: PMC3895739 DOI: 10.1186/1479-5868-10-142] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 11/28/2013] [Indexed: 11/10/2022] Open
Abstract
Introduction Interventions that make extensive use of theory tend to have larger effects on behaviour. The Intervention Mapping (IM) framework incorporates theory into intervention design, implementation and evaluation, and was applied to the development of a community-based childhood obesity prevention intervention for a multi-ethnic population. Methods IM was applied as follows: 1) Needs assessment of the community and culture; consideration of evidence-base, policy and practice; 2) Identification of desired outcomes and change objectives following identification of barriers to behaviour change mapped alongside psychological determinants (e.g. knowledge, self-efficacy, intention); 3) Selection of theory-based methods and practical applications to address barriers to behaviour change (e.g., strategies for responsive feeding); 4) Design of the intervention by developing evidence-based interactive activities and resources (e.g., visual aids to show babies stomach size). The activities were integrated into an existing parenting programme; 5) Adoption and implementation: parenting practitioners were trained by healthcare professionals to deliver the programme within Children Centres. Results HAPPY (Healthy and Active Parenting Programme for Early Years) is aimed at overweight and obese pregnant women (BMI > 25); consists of 12 × 2.5 hr. sessions (6 ante-natal from 24 weeks; 6 postnatal up to 9 months); it addresses mother’s diet and physical activity, breast or bottle feeding, infant diet and parental feeding practices, and infant physical activity. Conclusion We have demonstrated that IM is a feasible and helpful method for providing an evidence based and theoretical structure to a complex health behaviour change intervention. The next stage will be to assess the impact of the intervention on behaviour change and clinical factors associated with childhood obesity. The HAPPY programme is currently being tested as part of a randomised controlled feasibility trial.
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Affiliation(s)
- Natalie J Taylor
- Bradford Institute of Health Research, Bradford Teaching Hospitals NHS Trust, Bradford BD9 6RJ, UK.
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Affiliation(s)
| | - Mark Johnson
- Centre for Pain Research, Leeds Metropolitan University
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Busch SJ, Hoffmann P, Sahota P, Johnson R, Kothny W, Meyer F, Foley JE. Studies in rodents with the dipeptidyl peptidase-4 inhibitor vildagliptin to evaluate possible drug-induced pancreatic histological changes that are predictive of pancreatitis and cancer development in man. Diabetes Obes Metab 2013; 15:72-6. [PMID: 22882290 DOI: 10.1111/j.1463-1326.2012.01678.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Revised: 12/11/2011] [Accepted: 08/01/2012] [Indexed: 01/06/2023]
Abstract
AIM The present report summarizes rodent studies with vildagliptin, relevant to predicting pancreatitis or pancreatic cancer in man. METHODS As part of the regulatory development program for vildagliptin, a rodent toxicity program included two 104-week rodent (mouse and rat) carcinogenicity studies that were conducted according to guidelines assigned in Food and Drug Administration's Draft Guidance for Industry. RESULTS Vildagliptin exposure in animals was evaluated for its effects on endocrine and exocrine pancreas. Two-year carcinogenicity studies were conducted in rats at oral doses up to 900 mg/kg (approximately 200 times the human exposure at the maximum recommended dose) and in mice at oral doses up to 1000 mg/kg (up to 240 times the human exposure at the maximum recommended dose). The results from these studies show the expected preservation and growth of the endocrine β-cells with no significant findings in the exocrine acinar pancreas. There was no evidence of inflammatory infiltrates characteristic of pancreatitis, no palpable mass detection based on gross examination or any microscopic findings indicative of pancreatic islet cell (endocrine), acinar cell (exocrine) or ductal (exocrine) neoplasia in rat or mouse. CONCLUSIONS Evaluation of vildagliptin in 2-year preclinical carcinogenicity studies in both rats and mice indicates that while vildagliptin results in pharmacological benefits to the endocrine pancreas, this was not associated with any evidence of pancreatitis, pancreatic islet cell, acinar cell or ductal neoplasia. These data predict no increased risk of pancreatic cancer in man.
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Affiliation(s)
- S J Busch
- Novartis Institutes of Biomedical Research, East Hanover, NJ, USA
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Hunter R, Bahl D, Lardizabal D, Lanigar S, Sahota P. The Use of Seizure Videos in Educating Medical Students in Differentiating Non-Epileptic Seizures (Motor Events) from Epileptic Seizures (P07.244). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sandhu D, Nanda A, Vellipuram A, Sahota P. Endovascular Treatment of Posterior Circulation Strokes Presenting More Than 10 Hours after Symptom Onset: A Case Series (P05.268). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lardizabal D, Bahl D, Lanigar S, Sahota P. Descriptive Analysis of the Posture and Movement in Psychogenic Non-Epileptic Seizures (P02.168). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Thakkar MM, Engemann SC, Sharma R, Mohan RR, Sahota P. Sleep-wakefulness in alcohol preferring and non-preferring rats following binge alcohol administration. Neuroscience 2010; 170:22-7. [PMID: 20621165 DOI: 10.1016/j.neuroscience.2010.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 06/30/2010] [Accepted: 07/01/2010] [Indexed: 10/19/2022]
Abstract
The alcohol-preferring (P) rat is a valid animal model of alcoholism. However, the effect of alcohol on sleep in P or alcohol non-preferring (NP) rats is unknown. Since alcohol consumption has tremendous impact on sleep, the present study compared the effects of binge alcohol administration on sleep-wakefulness in P and NP rats. Using standard surgical procedures, the P and NP rats were bilaterally implanted with sleep recording electrodes. Following post-operative recovery and habituation, pre-ethanol (baseline) sleep-wakefulness was electrographically recorded for 48 h. Subsequently, ethanol was administered beginning with a priming dose of 5 g/Kg followed by two doses of 2 g/Kg every 8 h on the first day and three doses of 3 g/Kg/8 h on the second day. On the following day (post-ethanol), undisturbed sleep-wakefulness was electrographically recorded for 24 h. Our initial results suggest that, during baseline conditions, the time spent in each of the three behavioral states: wakefulness, non-rapid eye movement (NREM) sleep and REM sleep, was comparable between P and NP rats. However, the P rats were more susceptible to changes in sleep-wakefulness following 2 days of binge ethanol treatment. As compared to NP rats, the P rats displayed insomnia like symptoms including a significant reduction in the amount of time spent in NREM sleep coupled with a significant increase in wakefulness on post-ethanol day. Subsequent analysis revealed that binge ethanol induced increased wakefulness and reduced NREM sleep in P rats occurred mainly in the dark period. This is the first study that: (1) demonstrates spontaneous sleep-wake profile in P and NP rats, and (2) compares the effects of binge ethanol treatment on sleep in P and NP rats. Our results suggest that, as compared to NP rats, the P rats were more susceptible to sleep disruptions after binge ethanol treatment. In addition, the P rats exhibited insomnia-like symptoms observed during abstinence from alcohol in human subjects.
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Affiliation(s)
- M M Thakkar
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO 65201-5297,USA.
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Sahota P, Pandove G, Achal V, Vikal Y. Evaluation of a BWTK for detection of total coliforms, E. coli and emerging pathogens from drinking water: comparison with standard MPN method. Water Sci Technol 2010; 62:676-683. [PMID: 20706015 DOI: 10.2166/wst.2010.330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A defined substrate method media in bacteriological water testing kit (BWTK) has been developed to recover and detect the presence/absence of total coliforms and emerging pathogens from drinking water without the need for the confirmatory or complete tests. This method is based on technology that uses a hydrolysable substrate as a specific indicator- nutrient for the target microbes. To perform the test, one only has to add water to the ingredients in the BWTK and incubate at room temperature for a time period of 48 hrs. The target microbes remain viable in the positive kit for at least 10 days and further bacterial isolates from BWTK were characterized phenotypically, molecular identified by sequencing of 16SrRNA gene and antibiotic sensitivity was determined. All of the emerging bacterial isolates were haemolytic and multiple resistant to antibiotics. The epidemiological surveillance of drinking water revealed the occurrence of emerging pathogens responsible for causing acute gastrointestinal illness, soft tissue infections, meningitis, enteritis to acute mesenteric lymphadenitis as Yersinia enterocolitica (94%) and Aeromonas hydrophila (79%). The conventional methods (IS-10500-1991 BIS New Delhi, India) cannot predict the presence of these potentially enteropathogenic microorganisms in drinking water. There are currently no suitable microbiological criteria for the detection of emerging pathogens. In response to these limitations a BWTK has been developed for regularly monitoring of drinking water quality for appraisal to public health officials and take corrective measures regarding health risk when desired.
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Affiliation(s)
- P Sahota
- Department of Microbiology, Punjab Agricultural University, Ludhiana 141004, Punjab, India
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Affiliation(s)
- Rachael Dixey
- Faculty of Health and Environment, Leeds Metropolitan University, Leeds, UK,
| | - Pinki Sahota
- Faculty of Health and Environment, Leeds Metropolitan University, Leeds, UK,
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Levine RS, Nugent ZJ, Rudolf MCJ, Sahota P. Dietary patterns, toothbrushing habits and caries experience of schoolchildren in West Yorkshire, England. Community Dent Health 2007; 24:82-7. [PMID: 17615822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE AND METHOD The present study followed a group of 608 children, aged 7-11 years from six primary schools, for whom detailed dietary information was available. These children were traced four years later when they were in secondary school. The aim of the study was to investigate the relationship between the original dietary pattern, current dietary pattern, toothbrushing habit and oral health. Of the original children, 500 were traced to 32 secondary schools over a wide geographic area. For logistical reasons those in 18 schools were selected and positive consent and full data was obtained for 315 together with an additional group of 122 of their classmates. Three-day, self-reported dietary data was obtained, together with information on toothbrushing habits. A dental examination was carried out using BASCD survey methodology. RESULTS The children in this study had a lower DMFT (0.82) than found in the most recent survey for the area (1.39). No significant relationship was found between sugar-sweetened foods or drinks at age 7-11 and caries in the first permanent molar teeth at age 11-15 years, however a significant relationship was found between current sugar-sweetened drinks consumption and caries. Significantly less caries was associated with the reported moderate consumption of dairy products by the children when aged 11-15 years. The bedtime consumption of NMES drinks at 7-11 was significantly associated with an increase in caries as was the bedtime consumption of non-milk extrinsic sugars (NMES) foods at 11-15 years. A significant inverse relationship was found between claimed toothbrushing frequency and caries. Of those children aged 11-15 years claiming to brush at least once a day, 69% were caries-free with a mean DMFT of 0.69. Of the children who claimed to brush only occasionally or never, 52% were caries-free and they had a mean DMFT of 1.05. CONCLUSION The reported consumption of sugar-sweetened drinks and the lack of regular toothbrushing were found to be the factors most strongly linked to caries and this finding is consistent with other recent studies.
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Affiliation(s)
- R S Levine
- Academic Unit of Paediatrics, University of Leeds, UK.
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Rudolf M, Christie D, McElhone S, Sahota P, Dixey R, Walker J, Wellings C. WATCH IT: a community based programme for obese children and adolescents. Arch Dis Child 2006; 91:736-9. [PMID: 16531453 PMCID: PMC2082903 DOI: 10.1136/adc.2005.089896] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2006] [Indexed: 11/04/2022]
Abstract
BACKGROUND The WATCH IT programme was developed to address the needs of obese children from disadvantaged communities in Leeds and has been running since January 2004. Results of the pilot phase, prior to a randomised controlled trial, are presented. METHODS A process evaluation to assess success of implementation was conducted in December 2004. User views (parent and child) were obtained by semi-structured interviews and focus groups. Change in BMI SD score was calculated for children attending between January 2004 and November 2005. RESULTS A total of 94 children (49 girls, 45 boys), mean age (SD) 12.2 (2.0) years attended. They were moderately to severely obese (mean BMI SDS 3.09 (0.45), with low quality of life and self-image scores. There was a significant reduction in overweight at 6 months (DeltaBMI SD -0.07), especially for teenagers (DeltaBMI SD -0.13) and girls (DeltaBMI SD -0.07). The programme was successfully implemented. By December 2004 mean attendance was 2.1 (0.7) clinics per month, and sports sessions 3.3 (1.7) sessions per month. Fourteen children dropped out and non-attendance was low (only 7.5% sessions missed in 12 months). Qualitative research indicated significant appreciation of the service, with reported increase in self-confidence and friendships, and reduction in self-harm. CONCLUSION WATCH IT offers a model for a community based service for obese children. The programme suggests that effective care can be delivered by health trainers supervised by health professionals, and so potentially provides a cost effective programme within children's communities. These findings are encouraging, and need to be substantiated by extension to other locations and evaluation by randomised controlled trial.
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Affiliation(s)
- M Rudolf
- University of Leeds and East Leeds PCT, Leeds, UK.
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Handa R, Sahota P, Kumar M, Jagannathan NR, Bal CS, Gulati M, Tripathi BM, Wali JP. In vivo proton magnetic resonance spectroscopy (MRS) and single photon emission computerized tomography (SPECT) in systemic lupus erythematosus (SLE). Magn Reson Imaging 2004; 21:1033-7. [PMID: 14684208 DOI: 10.1016/s0730-725x(03)00200-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Neuropsychiatric involvement in SLE (NP-SLE) may not be picked up by routine neuroimaging procedures like computerized tomography (CT) or magnetic resonance imaging (MRI). We prospectively studied the role of single photon emission computerized tomography (SPECT) and magnetic resonance spectroscopy (MRS) in detection of NP-SLE in 20 patients with lupus (10 with clinical NP involvement and 10 without) and 9 healthy controls. MRI abnormalities were seen in 5/10 patients with NP-SLE while the MRI was normal in all the lupus patients without clinical NP involvement. Perfusion defects on SPECT were seen in as many as 8/10 patients with NP-SLE while only 1/10 lupus patients without clinical NP involvement and none of the healthy controls demonstrated perfusion defects. MRS revealed abnormal metabolite ratios in all patients with NP-SLE and as many as 8 lupus patients without clinical NP features. Normal metabolite ratios were observed in healthy controls. SPECT and MRS can help detect changes not evident on MRI and may serve as useful supplements to existing neuroimaging techniques in the diagnosis of NP-SLE. The precise significance of alterations in regional cerebral blood flow on SPECT and neurometabolite ratios on MRS needs larger, longitudinal studies.
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Affiliation(s)
- R Handa
- Department of Medicine, All India Institute of Medical Sciences, New Delhi-110029, India
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Rudolf MCJ, Greenwood DC, Cole TJ, Levine R, Sahota P, Walker J, Holland P, Cade J, Truscott J. Rising obesity and expanding waistlines in schoolchildren: a cohort study. Arch Dis Child 2004; 89:235-7. [PMID: 14977700 PMCID: PMC1719814 DOI: 10.1136/adc.2002.020552] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A cohort of schoolchildren was followed up over 6 years from 1996 to 2001. In the final year, 315 of 500 targeted children were measured. Body mass index (BMI) increased substantially over time (p<0.001), indicating a further rise in obesity into the secondary school years. Two new indicators of obesity were also measured. Waist circumference scores rose as substantially as BMI (p<0.001), and may be of particular significance given the association between abdominal girth in adults and cardiovascular morbidity. International Obesity Task Force measures were found to be more stringent than previous criteria, with no significant change noted over the time period.
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Affiliation(s)
- M C J Rudolf
- Leeds Community and Mental Health Trust, Leeds, UK.
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Bhatia R, Prabhakar S, Shedde D, Gopalan S, Sahota P, Shukla R. Coexistent cranial tuberculomas and tuberculosis of the cervix in a postmenopausal woman. Sex Transm Infect 2003; 79:496-7. [PMID: 14663130 PMCID: PMC1744777 DOI: 10.1136/sti.79.6.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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