Participation in physical activity and sport in adolescent girls from Middle Eastern backgrounds.

OBJECTIVES: This study investigated the barriers and facilitators to physical activity and sport participation among adolescent girls from Middle Eastern backgrounds. These factors were explored through the perspectives of both adolescent girls and parents of adolescent girls, living in Australia. DESIGN: A qualitative study design was used to understand perceived barriers and facilitators to physical activity and sport in adolescent girls. Participants were 18 adolescent girls and 9 parents of adolescent girls, all of Middle Eastern backgrounds, living in Western Sydney, Australia. Data were collected through five focus groups and four one-on-one interviews, separated for girls and parents. Data were analysed using an inductive approach and thematic analysis. RESULTS: Three main themes (family, social support, religion and culture) and nine subthemes were identified. The main facilitators for physical activity and sport included the values and presence of an active family role model, religion to encourage lifelong physical activity skills, and promotion of physical activity from peers, school, and social media. The predominant barriers to physical activity and sport included established cultural norms and traditional gender roles, which were often influenced by religion and culture, and extended time using technology. CONCLUSION: The findings of the current study show the complex relationships between family, religion, and culture when promoting physical and sport participation. Such factors highlight the need to develop culturally tailored physical activity interventions that consider the perceived barriers and facilitators for adolescent girls' participation from Middle Eastern backgrounds.

An Umbrella Review of Body Image Concerns, Disordered Eating, and Eating Disorders in Elite Athletes.

Background/Objectives: Several systematic reviews and meta-analyses have been conducted to date indicating a high prevalence of disordered eating in elite athletes and associated risk factors. However, the substantial time burden associated with locating and comparing these reviews, which are varied in methodology and sampling focus, may be a barrier for informing policy and best practice as well as directing future research. This umbrella review aimed to provide a summary of evidence across published reviews regarding the prevalence and risk factors for disordered eating (including body image concerns and eating disorders) in elite athletes. Methods: Five databases (CINAHL, PsycINFO, MEDLINE, Scopus, and SPORTDiscus) were systematically searched for peer-reviewed systematic reviews and meta-analyses that met the following inclusion criteria: (1) investigated prevalence and risk factors for disordered eating, (2) included a sample of elite athletes, and (3) available in English. The included studies underwent data extraction and risk of bias assessment using the AMSTAR 2. Results: The initial search identified 1828 articles that were screened for title and abstract and then full text, leaving 24 systematic reviews (including 10 meta-analyses). Disordered eating was prevalent across elite athletes, including males and females and across sport type. Elite athletes were at elevated risk for disordered eating and eating disorders but at lower risk for body image concerns versus non-athlete controls. Several risk factors were identified, including female gender, competing in lean sports, and experiencing career changes. Few reviews or meta-analyses examined perceived pressures within the sporting environment, and most had substantial risk of bias concerns. Conclusions: Elite athletes are at risk for the spectrum of disordered eating, and all should be considered for primary prevention and screening. Further research is needed regarding sport-specific versus general pressures and mediators of risk to better inform interventions.

Implementing 'Closing the Gap' policy through mainstream service provision: A South Australian case study.

ISSUE ADDRESSED: The Australian government's 'Closing the Gap' (CTG) strategy has been implemented via multiple strategies. We examined CTG policy in early childhood within Southern Adelaide during the first decade of implementation (2008-2018) and critiqued the complexity and challenges of policy that is designed to promote health and well-being of Aboriginal and Torres Strait Islander children but lacked Aboriginal control. METHODS: A qualitative case study was conducted in Southern Adelaide, and we interviewed 16 policy actors from health and early childhood education sectors. Thematic analysis revealed key themes to show how policy had been implemented through mainstream structures. RESULTS: The rapid roll out of the CTG strategy, the limitations of short-term funding, cuts to Aboriginal health services, tokenistic consultation, and the mainstreaming of service provision were key features of policy implementation. The influence of Aboriginal leaders varied across implementation contexts. Participants advocated for services in health and education that are culturally safe to improve health of children, families, and communities. CONCLUSIONS: The implementation of the CTG strategy in Southern Adelaide was rushed, complex, and lacking Aboriginal control. This contributed to the marginalisation of Aboriginal leaders, and disengagement of families and communities. A more collaborative and Aboriginal led process for policy implementation is essential to reform policy implementation and address health inequity. SO WHAT?: Findings from this study suggest that policy has continued to be implemented I ways that reflect colonial power imbalances. Alternative processes that promote the recognition of Indigenous rights must be considered if we are to achieve the targets set within the CTG strategy.

The impact of caregiving on the roles and valued activities of stroke carers: A systematic review of qualitative studies.

OBJECTIVE: To understand the experiences of informal carers and the impact of role and activity changes on their health and wellbeing. METHODS: A systematic search of CINHAL, MEDLINE, Embase, APA PsycInfo, and Web of Science was conducted. Studies were eligible if they included informal stroke carers (≥18 years), used a qualitative methodology, explored the roles and valued activities of stroke carers, and were published in English. The 10-item Critical Appraisal Skills Programme checklist for qualitative studies was used to assess methodological quality. The results of the included studies were thematically synthesised. RESULTS: A total of 36 qualitative studies were included and four overarching themes were identified: (1) Life adjustment; (2) Changing role and identity; (3) Changing activities: From meaningful to purposeful; and (4) Understanding and supporting carers. CONCLUSION: The sudden nature of stroke requires major readjustment in the carers life that has implications on their relationships, roles, and activities, subsequently impacting on their health and wellbeing. Health professionals and researchers should collaborate with stroke carers to identify their valued activities and implement realistic strategies to maintain these activities. Future interventions designed for carers should implement education about the importance of participating in valued activities and strategies to maintain these activities.

"Listen with your ears and eyes and heart and your minds and your soul": Implications for decolonising consultation and occupational therapy from case studies on "Closing the Gap" policy implementation.

BACKGROUND: Including Aboriginal and Torres Strait Islander people and communities through consultation has been a key feature of policy implementation throughout the Australian Government's "Closing the Gap" (CTG) strategy. However, consultation often reinforces power imbalances between government and local community and can undervalue or marginalise Indigenous knowledge and leadership. Occupational therapy has a short history of examining colonial power structures within the profession, but there has been limited progress to decolonise consultation and practice. METHODS: Drawing on decolonising research methodology and positioned at the interface of knowledge, comparative case studies were used to understand policy implementation in two regions. In Shepparton, Victoria, CTG policy was implemented predominately through an Aboriginal Community Controlled Health Organisation, and in Southern Adelaide, South Australia, CTG policy was implemented through mainstream state government and non-government providers in the absence of a local Aboriginal-controlled organisation. Findings were examined critically to identify implications for occupational therapy. RESULTS: Our case studies showed that policy stakeholders perceived consultation to be tokenistic and partnerships were viewed differently by Aboriginal and non-Indigenous participants. Participants identified the need to move beyond a rhetoric of "working with" Aboriginal and Torres Strait Islander people, to promote Aboriginal leadership and really listen to community so that policy can respond to local need. The findings of this research show that Aboriginal-controlled services are best positioned to conduct and respond to community consultation. CONCLUSION: A decolonising approach to consultation would shift the status quo in policy implementation in ways that realign power away from colonial structures towards collaboration with Indigenous leadership and the promotion of Aboriginal-controlled services. There are lessons for occupational therapy from this research on policy implementation on authentic, decolonised consultation as a key feature of policy implementation. Shifting power imbalances through prioritising Indigenous leadership and honouring what is shared can drive change in CTG policy implementation processes and outcomes.

A systematic review of culturally adapted physical activity interventions for culturally and linguistically diverse children and adolescents.

OBJECTIVE: Limited evidence shows culturally and linguistically diverse (CALD) children and adolescents are less active, compared to the general population. It is unclear, how physical activity interventions have been adapted for CALD children and adolescents to enhance engagement. This study aimed to review culturally adapted physical activity interventions targeting CALD children and adolescents. METHODS: All studies recruited children and adolescents (i.e., aged ≥5 to <18 years old) from CALD backgrounds, targeted physical activity, and included cultural adaptations. Cultural adaptations were defined as surface structures (i.e., observable characteristics of a targeted population) or deep structures (i.e., rooted in core ethnic values derived from individual cultures. RESULTS: Twenty studies were included. Ten studies used a combination of surface and deep structure adaptations. Of these 10 studies, 3 found a significant between-group difference in physical activity favouring the intervention group. Among studies (n = 6) that used surface structure adaptations (e.g., language adjustments to information sheets, consent forms, and resources), 1 found a significant intervention effect on physical activity. With studies (n = 4) that used deep structure adaptations (e.g., incorporating traditional songs and dances relevant to cultural groups), 1 study found a significant intervention effect on physical activity. CONCLUSION: A small number of studies found significant changes to increase physical activity levels. We found there is a lack of consistent evidence indicating that incorporating surface and/or deep structure adaptations result in significant changes in physical activity. Future research should focus on establishing higher quality methodology when developing culturally adapted interventions for CALD populations.

A systematic review and meta-synthesis of qualitative research investigating disordered eating and help-seeking in elite athletes.

OBJECTIVE: Elite athletes are at elevated risk for disordered eating and eating disorders; however, little is known about risk and maintaining factors, or barriers and facilitators of help-seeking in this cohort. This systematic review synthesized qualitative findings regarding possible risk and maintaining factors for disordered eating, as well as barriers to and facilitators of help-seeking in elite athletes. METHOD: We conducted a search for qualitative studies that included experiences with body image concerns or disordered eating in elite athletes. A systematic search of CINAHL, PsychINFO, MEDLINE, and Scopus databases identified 828 articles, with 87 retained after title and abstract screening, and 38 included in the review. Quality appraisal was conducted using the checklist for appraising qualitative research (CASP). Data were extracted from each article, including demographic information (e.g., biological sex, age, sport type, level of competition, current, or former athlete) and the text under the "results" or "findings" section. Meta-themes were identified using inductive thematic meta-synthesis. RESULTS: The extracted data indicated that most studies sampled female athletes from the United States and UK. Eight meta-themes were identified: (1) the power imbalance; (2) hyperfocus on body, food, and exercise; (3) rigidity; (4) the athlete's balance; (5) the athlete identity; (6) overvaluation and oversimplification; (7) shame, fear, and stigma; and (8) knowledge, education, and self-identification. DISCUSSION: These findings highlighted gaps in the demographic representation of specific groups in this research (e.g., males, para-athletes, and ethnic diversity) and propose hypotheses of how sport pressure might contribute to athletes' experiences with disordered eating. PUBLIC SIGNIFICANCE: Disordered eating and body image concerns are prevalent and can have debilitating impacts for elite athletes; however, help-seeking is rare for this population. It remains unclear what factors contribute to disordered eating and/or inhibit help-seeking among elite athletes versus the general population. Understanding athletes' perspectives will inform the modification of prevention and treatment strategies to address athlete-specific factors.

OBJETIVO: Los atletas de élite tienen un riesgo elevado de presentar patrones alimentarios disfuncionales y trastornos de la conducta alimentaria; sin embargo, se sabe poco sobre los factores de riesgo y mantenimiento, así como las barreras y facilitadores para buscar ayuda en esta cohorte. Esta revisión sistemática sintetizó hallazgos cualitativos sobre posibles factores de riesgo y mantenimiento para conductas alimentarias disfuncionales, así como barreras y facilitadores para búsqueda de ayuda en atletas de élite. MÉTODO: Realizamos una búsqueda de estudios cualitativos que incluyeran experiencias con preocupaciones sobre la imagen corporal o conductas alimentarias disfuncionales en atletas de élite. Una búsqueda sistemática en las bases de datos CINAHL, PsychINFO, MEDLINE y Scopus identificó 828 artículos, quedándonos con 87 después de la revisión de títulos y resúmenes, y 38 quedaron incluidos en la revisión. Se realizó una evaluación de calidad utilizando la lista de verificación para evaluar la investigación cualitativa (CASP). Se extrajeron datos de cada artículo, incluyendo información demográfica (por ejemplo, sexo biológico, edad, tipo de deporte, nivel de competencia, atleta actual o retirado) y el texto bajo la sección de "resultados" o "hallazgos". Se identificaron meta­temas utilizando la meta­síntesis temática inductiva. RESULTADOS: Los datos extraídos indicaron que la mayoría de los estudios incluyeron atletas femeninas de EE. UU. y Reino Unido. Se identificaron ocho meta­temas: (1) el desequilibrio de poder; (2) hiperenfoque en el cuerpo, la comida y el ejercicio; (3) rigidez; (4) el equilibrio del atleta; (5) la identidad del atleta; (6) sobrevaloración y simplificación excesiva; (7) vergüenza, miedo y estigma; y (8) conocimiento, educación y auto­identificación. DISCUSIÓN: Estos hallazgos destacaron brechas en la representación demográfica de grupos específicos en esta investigación (por ejemplo, hombres, para­atletas, diversidad étnica) y proponen hipótesis sobre cómo la presión deportiva podría contribuir a las experiencias de los atletas con conductas alimentarias disfuncionales.

Telehealth as a Strategy for Health Equity: A Scoping Review of Telehealth in India During and Following the COVID-19 Pandemic for People with Disabilities.

Introduction: Telehealth in India is growing rapidly and represents a strategy to promote affordable, inclusive, timely and safe access to healthcare. Yet there is a risk that telehealth increases inequity due to the digital divide and existing poor health literacy. Methods: A scoping review was conducted to explore use of telehealth in India during and following the COVID-19 pandemic by people with disabilities to inform strategies to increase equity of telehealth for people with disabilities. Of 1966 studies from the initial search in four databases and three specific telehealth journals, 20 sources met the inclusion criteria, limited to a focus on physical disability in India. Results: Findings showed examples of how people with disabilities can exercise increased control in the timing of appointments, convenience of receiving services from home and not having to travel to clinics or hospitals, and platform preference through tools and applications already familiar to them. Carers and families of people with disabilities were described as highly valued stakeholders with important roles in the uptake and effectiveness of telehealth for people with disabilities. The identified benefits of telehealth resulted in high levels of user satisfaction due to increased control and convenience, however, systemic barriers for accessibility remain. Conclusion: This review suggested that if telehealth is not designed intentionally to change the status quo for people with disabilities and prioritize equity, then the benefits may not be sustainable. Recommendations for telehealth India are provided, based on both findings from the literature and analysis of results.

Determining priority areas for health promotion amongst Australian professional sporting organisations.

OBJECTIVES: Professional sporting organisations (PSOs) are well-positioned to promote health through their reach and standing within communities. However, the health promotion (HP) priority areas of interest of PSOs are unknown. The objectives of this study were to: identify HP priority areas amongst Australian PSOs and explore the development, implementation, and evaluation of HP programming within the identified priority areas. DESIGN: Delphi procedure with qualitative interviews. METHODS: Participants were community-focussed employees from PSOs across Australia. To identify HP priory areas, three rounds of surveys were used in a Delphi procedure. Participants were then invited to participate in semi-structured interviews focussed on the development, implementation, and evaluation of HP programmes. RESULTS: Of the 103 community employees invited to participate in the Delphi, 28 participated in at least one round and 16 completed all rounds. Overall, HP priorities fell under five main areas: access/participation in sport; general HP; physical activity promotion; community, culture, and inclusion; and support for HP initiatives. Eleven interviews were conducted, and central themes included needing support with programme design and evaluation, and the need to build employee capacity and greater inter-organisational collaboration. CONCLUSIONS: This study determined HP priority areas amongst PSOs using a consensus-generating approach. Interview findings demonstrated that community-focussed employees are committed to delivering HP programmes, but encounter difficulty with funding, employee capacity, and programme design and evaluation expertise. The findings from these interviews reveal potential avenues of collaboration between organisations that can provide expertise in design and evaluation and sporting organisations for HP programming.

A single cryptomonad cell harbors a complex community of organelles, bacteria, a phage, and selfish elements.

Symbiosis between prokaryotes and microbial eukaryotes (protists) has broadly impacted both evolution and ecology. Endosymbiosis led to mitochondria and plastids, the latter spreading across the tree of eukaryotes by subsequent rounds of endosymbiosis. Present-day endosymbionts in protists remain both common and diverse, although what function they serve is often unknown. Here, we describe a highly complex community of endosymbionts and a bacteriophage (phage) within a single cryptomonad cell. Cryptomonads are a model for organelle evolution because their secondary plastid retains a relict endosymbiont nucleus, but only one previously unidentified Cryptomonas strain (SAG 25.80) is known to harbor bacterial endosymbionts. We carried out electron microscopy and FISH imaging as well as genomic sequencing on Cryptomonas SAG 25.80, which revealed a stable, complex community even after over 50 years in continuous cultivation. We identified the host strain as Cryptomonas gyropyrenoidosa, and sequenced genomes from its mitochondria, plastid, and nucleomorph (and partially its nucleus), as well as two symbionts, Megaira polyxenophila and Grellia numerosa, and one phage (MAnkyphage) infecting M. polyxenophila. Comparing closely related endosymbionts from other hosts revealed similar metabolic and genomic features, with the exception of abundant transposons and genome plasticity in M. polyxenophila from Cryptomonas. We found an abundance of eukaryote-interacting genes as well as many toxin-antitoxin systems, including in the MAnkyphage genome that also encodes several eukaryotic-like proteins. Overall, the Cryptomonas cell is an endosymbiotic conglomeration with seven distinct evolving genomes that all show evidence of inter-lineage conflict but nevertheless remain stable, even after more than 4,000 generations in culture.

Viral predation pressure on coral reefs.

BACKGROUND: Predation pressure and herbivory exert cascading effects on coral reef health and stability. However, the extent of these cascading effects can vary considerably across space and time. This variability is likely a result of the complex interactions between coral reefs' biotic and abiotic dimensions. A major biological component that has been poorly integrated into the reefs' trophic studies is the microbial community, despite its role in coral death and bleaching susceptibility. Viruses that infect bacteria can control microbial densities and may positively affect coral health by controlling microbialization. We hypothesize that viral predation of bacteria has analogous effects to the top-down pressure of macroorganisms on the trophic structure and reef health. RESULTS: Here, we investigated the relationships between live coral cover and viruses, bacteria, benthic algae, fish biomass, and water chemistry in 110 reefs spanning inhabited and uninhabited islands and atolls across the Pacific Ocean. Statistical learning showed that the abundance of turf algae, viruses, and bacteria, in that order, were the variables best predicting the variance in coral cover. While fish biomass was not a strong predictor of coral cover, the relationship between fish and corals became apparent when analyzed in the context of viral predation: high coral cover (> 50%) occurred on reefs with a combination of high predator fish biomass (sum of sharks and piscivores > 200 g m-2) and high virus-to-bacteria ratios (> 10), an indicator of viral predation pressure. However, these relationships were non-linear, with reefs at the higher and lower ends of the coral cover continuum displaying a narrow combination of abiotic and biotic variables, while reefs at intermediate coral cover showed a wider range of parameter combinations. CONCLUSIONS: The results presented here support the hypothesis that viral predation of bacteria is associated with high coral cover and, thus, coral health and stability. We propose that combined predation pressures from fishes and viruses control energy fluxes, inhibiting the detrimental accumulation of ecosystem energy in the microbial food web.

The microbiome of a bacterivorous marine choanoflagellate contains a resource-demanding obligate bacterial associate.

Microbial predators such as choanoflagellates are key players in ocean food webs. Choanoflagellates, which are the closest unicellular relatives of animals, consume bacteria and also exhibit marked biological transitions triggered by bacterial compounds, yet their native microbiomes remain uncharacterized. Here we report the discovery of a ubiquitous, uncultured bacterial lineage we name Candidatus Comchoanobacterales ord. nov., related to the human pathogen Coxiella and physically associated with the uncultured marine choanoflagellate Bicosta minor. We analyse complete 'Comchoano' genomes acquired after sorting single Bicosta cells, finding signatures of obligate host-dependence, including reduction of pathways encoding glycolysis, membrane components, amino acids and B-vitamins. Comchoano encode the necessary apparatus to import energy and other compounds from the host, proteins for host-cell associations and a type IV secretion system closest to Coxiella's that is expressed in Pacific Ocean metatranscriptomes. Interactions between choanoflagellates and their microbiota could reshape the direction of energy and resource flow attributed to microbial predators, adding complexity and nuance to marine food webs.

Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities.

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in the geriatric post-surgical population, and its prevention is a public health priority. The aim of this study was to assess the use of VTE risk screening and training protocols, and VTE awareness in the Australian residential aged care sector. A cross-sectional survey was conducted that was directed at facility and policy managers of community aged care facilities with ≥10 residents in two Australian states and territories. Forty-nine of 301 (16.3%) providers responded, representing 249/871 (28.6%) aged care facilities and 20,958/66,121 (31.7%) residents. VTE risk screening protocols were used by 1.2% of facilities (3/249), and 79.5% (198/249) were unaware that VTE is an issue in this population. Only 0.8% (2/249) were aware that risk screening and prophylaxis is required to prevent VTE; none were acting upon this. No facility had specific VTE risk assessment or prevention processes in place. Most residential aged care facilities surveyed do not have VTE risk screening protocols and were unaware of the risk that may be associated with this omission. These results have implications for development and implementation of national and international VTE risk screening guidelines in community care.

All essential endosymbionts of the ciliate Euplotes are cyclically replaced.

Symbiotic systems vary in the degree to which the partners are bound to each other1. At one extreme, there are intracellular endosymbionts in mutually obligate relationships with their host, often interpreted as mutualistic. The symbiosis between the betaproteobacterium Polynucleobacter and the ciliate Euplotes (clade B) challenges this view2: although freshwater Euplotes species long ago became dependent on endosymbionts, the many extant Polynucleobacter lineages they harbour arose recently and in parallel from different free-living ancestors2. The host requires the endosymbionts for reproduction and survival3, but each newly established symbiont is ultimately driven to extinction in a cycle of establishment, degeneration, and replacement. Similar replacement events have been observed in sap-feeding insects4-6, a model for bacteria-eukaryote symbioses7, but usually only affect a small subset of the host populations. Most insects retain an ancient coevolving symbiont, suggesting that long-term mutualism and permanent integration remain the rule and symbiont turnovers are mere evolutionary side-stories. Here we show that this is not the case for Euplotes. We examined all known essential Euplotes symbionts and found that none are ancient or coevolving; rather, all are recently established and continuously replaced over relatively short evolutionary time spans, making the symbiosis ancient for the host but not for any bacterial lineage.

Gene Transfer Agents in Bacterial Endosymbionts of Microbial Eukaryotes.

Gene transfer agents (GTAs) are virus-like structures that package and transfer prokaryotic DNA from donor to recipient prokaryotic cells. Here, we describe widespread GTA gene clusters in the highly reduced genomes of bacterial endosymbionts from microbial eukaryotes (protists). Homologs of the GTA capsid and portal complexes were initially found to be present in several highly reduced alphaproteobacterial endosymbionts of diplonemid protists (Rickettsiales and Rhodospirillales). Evidence of GTA expression was found in polyA-enriched metatranscriptomes of the diplonemid hosts and their endosymbionts, but due to biases in the polyA-enrichment methods, levels of GTA expression could not be determined. Examining the genomes of closely related bacteria revealed that the pattern of retained GTA head/capsid complexes with missing tail components was common across Rickettsiales and Holosporaceae (Rhodospirillales), all obligate symbionts with a wide variety of eukaryotic hosts. A dN/dS analysis of Rickettsiales and Holosporaceae symbionts revealed that purifying selection is likely the main driver of GTA evolution in symbionts, suggesting they remain functional, but the ecological function of GTAs in bacterial symbionts is unknown. In particular, it is unclear how increasing horizontal gene transfer in small, largely clonal endosymbiont populations can explain GTA retention, and, therefore, the structures may have been repurposed in endosymbionts for host interactions. Either way, their widespread retention and conservation in endosymbionts of diverse eukaryotes suggests an important role in symbiosis.

Effectiveness of Adult Health Promotion Interventions Delivered Through Professional Sport: Systematic Review and Meta-Analysis.

BACKGROUND: Researchers are capitalising on the strong connections that sport fans have with their teams for health promotion programmes, yet no existing systematic reviews have evaluated the effectiveness of interventions delivered through professional sport. OBJECTIVE: The aim of this study was to systematically collate, evaluate, and synthesise the evidence on health promotion interventions implemented in professional sport settings. METHODS: Randomised controlled trials reporting on adult health promotion initiatives delivered in professional sport settings were identified through electronic database searches in CINAHL, MEDLINE, SPORTDiscus, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. Data on health-related outcomes (e.g., weight, physical activity, dietary intake) were extracted and synthesised, and random effects meta-analyses were conducted to examine effects for weight and waist circumference. Risk of bias was examined using the Cochrane risk-of-bias tool for randomised controlled trials (RoB 2). RESULTS: Six studies reporting on five unique interventions met the inclusion criteria, and all included studies were gender-sensitised and exclusively targeted men. Intervention effects were observed for several health outcomes, including physical activity, dietary intake, and psychosocial health. All studies aimed to reduce weight, and for most studies (n = 4), weight was a primary outcome, either of the included study or to inform a future definitive trial. Findings from the meta-analysis revealed an overall significant difference in change in weight of - 3.2 kg (95% confidence interval [CI] - 4.6 to - 1.8) and waist circumference of - 3.9 cm (95% CI - 4.9 to - 2.8), both in favour of the intervention group at 12 weeks. Intervention effects were also reported for several other health outcomes (e.g., physical activity, dietary intake, psychosocial health); however, they were not consistently measured across the studies and thus were not meta-analysed. CONCLUSION: Health promotion interventions delivered through professional sporting organisations can significantly improve weight- and lifestyle-related health outcomes. Representation across the socioeconomic spectrum and across culturally and linguistically diverse groups was limited. As only a limited number of studies met the inclusion criteria for this review, a need exists for rigorously designed interventions, standardised intervention approaches, with long-term follow-up, and the potential for scalability. PROSPERO REGISTRATION NUMBER: CRD42019123295.

Unhealthy Lifestyle Behaviours and Psychological Distress: A Longitudinal Study of Australian Adults Aged 45 Years and Older.

Individual associations between lifestyle behaviours and mental health have been established; however, evidence on the clustering of these behaviours and the subsequent impact on mental health is limited. The purpose of this study was to examine cross-sectional and longitudinal associations between combined unhealthy lifestyle behaviours (physical activity, sitting time, sleep duration, processed meat consumption, vegetable consumption, fruit consumption, smoking status, alcohol consumption) and the development of psychological distress (measured using the Kessler Psychological Distress Scale) in a large Australian sample. Participants were 163,707 Australian adults from the 45 and Up Study. Data from baseline (2006-2009) and follow-up wave 1 (2012) were analysed using binary logistic regression. The odds of reporting high or very high psychological distress at follow-up were significantly higher for those reporting five (AOR = 2.36; 95% CI 1.41-3.97, p = 0.001) or six or more (AOR = 3.04; 95% CI 1.62-5.69, p = 0.001) unhealthy lifestyle behaviours, in comparison to those reporting no unhealthy lifestyle behaviours at baseline. These findings suggest that a holistic, multi-faceted lifestyle approach addressing multiple behaviours may be required to support and promote positive mental health and to reduce the likelihood of psychological distress.

Diplonemids - A Review on "New" Flagellates on the Oceanic Block.

Diplonemids are a group of flagellate protists, that belong to the phylum Euglenozoa alongside euglenids, symbiontids and kinetoplastids. They primarily inhabit marine environments, though are also found in freshwater lakes. Diplonemids have been considered as rare and unimportant eukaryotes for over a century, with only a handful of species described until recently. However, thanks to their unprecedented diversity and abundance in the world oceans, diplonemids now attract increased attention. Recent improvements in isolation and cultivation have enabled characterization of several new genera, warranting a re-examination of all available knowledge gathered so far. Here we summarize available data on diplonemids, focusing on the recent advances in the fields of diversity, ecology, genomics, metabolism, and endosymbionts. We illustrate the life stages of cultivated genera, and summarise all reported interspecies associations, which in turn suggest lifestyles of predation and parasitism. This review also includes the latest classification of diplonemids, with a taxonomic revision of the genus Diplonema. Ongoing efforts to sequence various diplonemids suggest the presence of large and complex genomes, which correlate with the metabolic versatility observed in the model species Paradiplonema papillatum. Finally, we highlight its successful transformation into one of few genetically tractable marine protists.