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BACKGROUND: The online BeUpstanding™ program is an eight-week workplace-delivered intervention for desk-based workers to raise awareness of the benefits of sitting less and moving more and build a supportive culture for change. A workplace representative (the "champion") delivers the program, which includes a workshop where teams collectively choose their sit less/move more strategies. A toolkit provides the champion with a step-by-step guide and associated resources to support program uptake, delivery, and evaluation. Here we report on the main findings from the Australian national implementation trial of BeUpstanding. METHODS: Recruitment (12/06/2019 to 30/09/2021) was supported by five policy and practice partners, with desk-based work teams from across Australia targeted. Effectiveness was measured via a single arm, repeated-measures trial. Data were collected via online surveys, toolkit analytics, and telephone calls with champions. The RE-AIM framework guided evaluation, with adoption/reach (number and characteristics); effectiveness (primary: self-reported workplace sitting time); implementation (completion of core components; costs); and, maintenance intentions reported here. Linear mixed models, correcting for cluster, were used for effectiveness, with reach, adoption, implementation, and maintenance outcomes described. RESULTS: Of the 1640 website users who signed-up to BeUpstanding during the recruitment period, 233 were eligible, 198 (85%) provided preliminary consent, and 118 (50.6%) champions consented and started the trial, with 94% (n = 111 champions) completing. Trial participation was from across Australia and across industries, and reached 2,761 staff, with 2,248 participating in the staff survey(s): 65% female; 64% university educated; 17% from a non-English speaking background. The program effectively changed workplace sitting (-38.5 [95%CI -46.0 to -28.7] minutes/8-hour workday) and all outcomes targeted by BeUpstanding (behaviours and culture), with small-to-moderate statistically-significant effects observed. All participating teams (n = 94) completed at least 5/7 core steps; 72.4% completed all seven. Most champions spent $0 (72%) or >$0-$5 (10%) per team member; most (67/70 96%) intended to continue or repeat the program. CONCLUSIONS: BeUpstanding can be adopted and successfully implemented by a range of workplaces, reach a diversity of staff, and be effective at creating a supportive culture for teams of desk-based workers to sit less and move more. Learnings will inform optimisation of the program for longer-term sustainability. TRIAL REGISTRATION: ACTRN12617000682347.
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Promoción de la Salud , Lugar de Trabajo , Humanos , Femenino , Masculino , Australia , Adulto , Promoción de la Salud/métodos , Persona de Mediana Edad , Sedestación , Conducta Sedentaria , Ejercicio Físico , Evaluación de Programas y Proyectos de Salud/métodos , Encuestas y Cuestionarios , Salud LaboralRESUMEN
BACKGROUND: Higher educational attainment is important for economic wellbeing and associated with better health and longevity. Previous research focused on intelligence, socioeconomic status and mental health or individual risk behaviours as predictors of educational attainment, but the role of multiple domains of adolescent risk behaviours is less clear. This study examined the association between multiple domains of risk behaviour in adolescence and educational attainment by 22 years-of-age. METHODS: Young people (Generation 2, Gen2) and their parents (Generation 1, Gen1) participating in the Raine Study completed questionnaires at years 1, 5, 8, 10 (Gen1 only), 14, 17 (both) and 22 (Gen2 only). The Raine Study is an ongoing longitudinal study initiated in Perth, Western Australia, between 1989 and 1991. The 1,102 Gen2 participants who responded to questions about highest educational attainment were included in this study. The association between Gen2 self-reported risk behaviours (including age at commencement of drinking alcohol, smoking, sexual intercourse and drug use) and educational attainment (defined as self-reported years of completed high school: ≤10, 11, 12 or tertiary education (> 12)) at year 22, after adjusting for mother's age and combined parental education level, participant sex, and family income, educational performance and adolescent mental health, was explored using ordinal regression models and presented as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Ordinal models suggested that never smoking or starting older than 18 compared with smoking before age 15 (OR 2.02, 95%CI: 1.28-2.14); first drinking alcohol between 15 and 17 years compared with younger than 15 (OR 1.52, 95%CI: 1.08-2.14); and, first sexual intercourse aged ≥ 18 years compared with under 15 (OR 1.67, 95%CI: 1.08-2.57) were associated with higher levels of educational attainment at 22-year follow-up. Additionally, lower ("better") behavioural scores increased the odds of higher levels of attainment. CONCLUSIONS: Absence of health risk behaviours at a younger age or later commencement was associated with higher educational attainment. Evidence-based interventions that address the societal influences underpinning risk behaviours in adolescents may support longer school retention.
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Conducta del Adolescente , Escolaridad , Asunción de Riesgos , Humanos , Adolescente , Masculino , Femenino , Adulto Joven , Conducta del Adolescente/psicología , Estudios Longitudinales , Australia Occidental/epidemiología , Encuestas y CuestionariosRESUMEN
BACKGROUND: ActiMotus, a thigh-accelerometer-based software used for the classification of postures and movements (PaMs), has shown high accuracy among adults and school-aged children; however, its accuracy among younger children and potential differences between sexes are unknown. This study aimed to evaluate the accuracy of ActiMotus to measure PaMs among children between 3 and 14 years and to assess if this was influenced by the sex or age of children. METHOD: Forty-eight children attended a structured ~1-hour data collection session at a laboratory. Thigh acceleration was measured using a SENS accelerometer, which was classified into nine PaMs using the ActiMotus software. Human-coded video recordings of the session provided the ground truth. RESULTS: Based on both F1 scores and balanced accuracy, the highest levels of accuracy were found for lying, sitting, and standing (63.2-88.2%). For walking and running, accuracy measures ranged from 48.0 to 85.8%. The lowest accuracy was observed for classifying stair climbing. We found a higher accuracy for stair climbing among girls compared to boys and for older compared to younger age groups for walking, running, and stair climbing. CONCLUSIONS: ActiMotus could accurately detect lying, sitting, and standing among children. The software could be improved for classifying walking, running, and stair climbing, particularly among younger children.
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Acelerometría , Movimiento , Postura , Programas Informáticos , Humanos , Niño , Femenino , Masculino , Adolescente , Postura/fisiología , Movimiento/fisiología , Preescolar , Acelerometría/métodos , Caminata/fisiología , Carrera/fisiologíaRESUMEN
BACKGROUND: Poor health in passenger rail drivers, resulting from perceived highly sedentary work and leisure time, has implications for public safety. To date, no studies have described the physical behaviors of passenger rail drivers. This study aimed to characterize the physical behaviors of passenger rail drivers by investigating the volume, pattern, variation, and composition of behaviors at and outside of work. METHODS: A convenience sample of 31 rail drivers (77% male, median age 51.0 [12.5] y) in South Australia wore an activity monitor on their right thigh for 8 days and completed a work logbook. Physical behaviors (sitting, standing, light-intensity physical activity, moderate- to vigorous-intensity physical activity [MVPA], and steps) were recorded for workdays and nonworkdays, and work and nonwork time on workdays. The volume, bouts, between-participants variation, and 3-way composition were compared across the 4 time periods. RESULTS: Drivers sat for 10.6 (1.5) hours, did 76.3 (38.8) minutes of MVPA, and took 9727.3 (4088.4) steps daily. At work, drivers were sitting 369.3 (41.8) minutes (187.1 [54.2] min in prolonged bouts) and doing MVPA 31.7 (10.0) minutes. Between-participants variation in sitting time during work (11%) was lower than both nonwork on a workday (19%) and on a nonworkday (24%; P < .001). Compositions at work differed from nonwork on workdays (F = 27.7, P < .001), as did compositions on workdays compared with nonworkdays (F = 6.8, P = .002). CONCLUSIONS: Passenger rail drivers were highly sedentary, but also surprisingly active. At work, drivers were more sedentary and had lower variation in behaviors, suggesting work constraints play an important role. Therefore, work may be the most appropriate domain to intervene for promoting healthy physical behavior profiles among these passenger rail drivers.
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Ejercicio Físico , Vías Férreas , Sedestación , Posición de Pie , Humanos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Australia del Sur , Conducta Sedentaria , Conducción de AutomóvilRESUMEN
BACKGROUND: Previous studies have indicated that standing may be beneficially associated with surrogate metabolic markers, whereas more time spent sitting has an adverse association. Studies assessing the dose-response associations of standing, sitting and composite stationary behaviour time with cardiovascular disease (CVD) and orthostatic circulatory disease are scarce and show an unclear picture. OBJECTIVE: To examine associations of daily sitting, standing and stationary time with CVD and orthostatic circulatory disease incidence. METHODS: We used accelerometer data from 83â013 adults (mean age ± standard deviation = 61.3 ± 7.8; female = 55.6%) from the UK Biobank to assess daily time spent sitting and standing. Major CVD was defined as coronary heart disease, heart failure and stroke. Orthostatic circulatory disease was defined as orthostatic hypotension, varicose vein, chronic venous insufficiency and venous ulcers. To estimate the dose-response hazard ratios (HR) we used Cox proportional hazards regression models and restricted cubic splines. The Fine-Gray subdistribution method was used to account for competing risks. RESULTS: During 6.9 (±0.9) years of follow-up, 6829 CVD and 2042 orthostatic circulatory disease events occurred. When stationary time exceeded 12 h/day, orthostatic circulatory disease risk was higher by an average HR (95% confidence interval) of 0.22 (0.16, 0.29) per hour. Every additional hour above 10 h/day of sitting was associated with a 0.26 (0.18, 0.36) higher risk. Standing more than 2 h/day was associated with an 0.11 (0.05, 0.18) higher risk for every additional 30 min/day. For major CVD, when stationary time exceeded 12 h/day, risk was higher by an average of 0.13 (0.10, 0.16) per hour. Sitting time was associated with a 0.15 (0.11, 0.19) higher risk per extra hour. Time spent standing was not associated with major CVD risk. CONCLUSIONS: Time spent standing was not associated with CVD risk but was associated with higher orthostatic circulatory disease risk. Time spent sitting above 10 h/day was associated with both higher orthostatic circulatory disease and major CVD risk. The deleterious associations of overall stationary time were primarily driven by sitting. Collectively, our findings indicate increasing standing time as a prescription may not lower major CVD risk and may lead to higher orthostatic circulatory disease risk.
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Enfermedades Cardiovasculares , Hipotensión Ortostática , Modelos de Riesgos Proporcionales , Conducta Sedentaria , Posición de Pie , Humanos , Masculino , Femenino , Persona de Mediana Edad , Enfermedades Cardiovasculares/epidemiología , Anciano , Incidencia , Hipotensión Ortostática/epidemiología , Reino Unido/epidemiología , Sedestación , Acelerometría , Factores de RiesgoRESUMEN
INTRODUCTION: Industrial workers with physically demanding work have increased risk of musculoskeletal pain. The present 12-week Goldilocks Work intervention aimed to organize work among industrial workers to comprise a 'just right' ergonomic balance of physical behaviors (i.e., sit, stand and active) intended to promote musculoskeletal health. The paper investigates the effectiveness of the intervention in reducing low back pain after work. METHODS: 83 workers across 28 workteams in a biotech organization were recruited. Workteams were randomly allocated to receive the intervention or work as usual (control). Intervention workteams implemented the Goldilocks Work planning tool to organize their work tasks towards a predefined 'just right' ergonomic balance (i.e., composition of 60% sitting, 30% standing, 10% active work and hourly task alternation). The primary outcome was low back pain intensity. Secondary outcomes were bodily pain, fatigue, physical exertion, productivity and energy after work measured in the survey, and composition and alternations of physical behaviors measured using wearable sensors. RESULTS: The intervention was delivered almost as planned, with good quality and high adherence among most workteams. However, the intervention did not change physical behaviors towards the intended 'just right' ergonomic balance. No significant reduction in low back pain (0.07, CI 95%: -0.68; 0.82), bodily pain (0.10, CI 95%: -0.57; 0.76), tiredness (-0.53, CI 95%: -1.24; 0.19), physical exertion (-0.18, CI 95%: -0.83; 0.48), or improvement in energy (0.39, CI 95%: -1.02; 0.23) or productivity (-0.03, CI 95%: -0.77; 0.72) were found. CONCLUSION: This Goldilocks Work intervention did not promote musculoskeletal health among industrial workers and did not change physical behaviors as intended. Thus, more research is needed into implementation strategies to change physical behaviors during productive work towards an evidence-based 'just right' ergonomic balance.
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Ergonomía , Dolor de la Región Lumbar , Salud Laboral , Humanos , Masculino , Adulto , Femenino , Dolor de la Región Lumbar/prevención & control , Persona de Mediana Edad , Promoción de la Salud/métodos , Enfermedades Profesionales/prevención & controlRESUMEN
BACKGROUND: Although widely accessible digital technology (DT) provided multiple opportunities for young children's play, learning, and development, it also raised parents and professionals' concerns regarding its impact on children's physical activity. This study aimed to identify practices involving DT that were valued by parents in helping their young child to be physically active. METHODS: Participants were parents of ambulatory young children (less than 5 y of age) engaged with a playgroup. The study involved representatives from 3 service organizations, who compiled a list of digital resources related to using DT to promote children's physical activity that were suitable to be shared and trialed by parents and young children. During a pretrial workshop, researchers, participants, and organization representatives collaboratively developed the intervention, which involved the delivery of selected resources by weekly email, over a 12-week period. Participants provided weekly feedback about their experiences and participated in a postintervention semistructured qualitative interview. RESULTS: Thirteen families, with children aged between 15 and 36 months, completed the trial. Participants reported several valued practices to promote their children's physical activity, including those where the child was active while engaging with DT, where child engagement with DT acted as a prompt for later physical activity, where DT assisted parents in planning physical activity, where DT assisted parents in integrating movement with learning and play, and where DT was used to reinforce the child's enthusiasm for physical activity. CONCLUSIONS: Parents reported several valued practices where children were physically active, rather than sedentary, while using digital technology.
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Ejercicio Físico , Promoción de la Salud , Padres , Humanos , Preescolar , Padres/psicología , Masculino , Femenino , Lactante , Promoción de la Salud/métodos , Tecnología Digital , Adulto , Investigación Cualitativa , Entrevistas como AsuntoRESUMEN
Importance: The multifaceted nature of screen use has been largely overlooked in favor of a simplistic unidimensional measure of overall screen time when evaluating the benefits and risks of screen use to early childhood development. Objective: To conduct a systematic review and meta-analysis to examine associations of screen use contexts in early childhood with cognitive and psychosocial outcomes. Data Sources: PsycINFO, Embase, MEDLINE Ovid, ProQuest, CINAHL, Web of Science, and Scopus were searched from inception to December 31, 2023. Study Selection: A total of 7441 studies were initially identified. Studies were included if they examined associations between a contextual factor of screen use among children aged 0 to 5.99 years and cognitive or psychosocial development. Observational, experimental, and randomized clinical trial study designs were included. Data Extraction and Synthesis: All studies were independently screened in duplicate following PRISMA guidelines. Effect sizes of associations (r) from observational studies were pooled using random-effects 3-level meta-analyses. The remaining study designs were narratively synthesized. Main Outcomes and Measures: Screen use contexts included content (child directed and age inappropriate), type (program viewing and game or app use), co-use (or solo use), background television, caregiver screen use during child routines, and purpose. Outcomes were cognitive (executive functioning, language, and academic skills) or psychosocial (internalizing and externalizing behavior problems and socioemotional competence). Results: Overall, 100 studies (176â¯742 participants) were included, and of these, 64 observational studies (pooled sample sizes ranging from 711 to 69â¯232) were included in meta-analyses. Program viewing (n = 14; k = 48; r, -0.16; 95% CI, -0.24 to -0.08) and background television (n = 8; k = 18; r, -0.10; 95% CI, -0.18 to -0.02) were negatively associated with cognitive outcomes, while program viewing (n = 6; k = 31; r, -0.04; 95% CI, -0.07 to -0.01), age-inappropriate content (n = 9; k = 36; r, -0.11; 95% CI, -0.17 to -0.04), and caregiver screen use during routines (n = 6; k = 14; r, -0.11; 95% CI, -0.20 to -0.03) were negatively associated with psychosocial outcomes. Co-use was positively associated with cognitive outcomes (n = 8; k = 28; r, 0.14; 95% CI, 0.03 to 0.25). Conclusions and Relevance: Findings show small to moderate effect sizes that highlight the need to consider screen use contexts when making recommendations for families, clinicians, and educators beyond screen time limits; including encouraging intentional and productive screen use, age-appropriate content, and co-use with caregivers.
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Cognición , Tiempo de Pantalla , Humanos , Preescolar , Lactante , Desarrollo Infantil , Televisión/estadística & datos numéricosRESUMEN
The role and potential impact of digital screen technology in the lives of children is heavily debated. Current evidence is limited by the weakness of measures typically used to characterise screen use, predominantly proxy- or self-reports with known inaccuracy and bias. However, robust and detailed evidence is needed to provide practical trustworthy guidance to families and professionals working with families. The purpose of this paper is to support researchers to select measurement method(s) that will provide robust and detailed evidence. The paper outlines the challenges in measuring contemporary screen use by children, using a child-technology interaction model to organise considerations. A range of different methods used to measure digital screen technology use in children and adolescents (i.e., questionnaires, diaries, electronically prompted sampling, direct observation, fixed room cameras, wearable/portable cameras, audio recorders, screen-device onboard logging, remote digital trace logging and proximity logging) are described along with examples of their use and constructs typically measured as well as a summary of the advantages and disadvantages of each method. A checklist and worked examples are provided to support researchers determining the best methods or combination of methods for a research project.
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The clear public messaging from international health authorities is that individuals should "sit less and move more." While it is acknowledged that this guidance needs to be tailored to the age of people and also to their health, and abilities, the guidance is not tailored to their current level of physical behaviors. This opinion piece aims to highlight that although people with excessive sitting and insufficient moderate-to-vigorous physical activity should sit more and move less, for other people their health would be promoted by sitting more and moving less. Thus, physical behaviors are not always "poison" or "medicine," but rather the health impact of changes in physical behaviors depends on people's initial levels. Policy, research, and practice implications of this realization are presented. Only tailoring messaging to age and health status could be far from optimal for people with very different current levels of physical behaviors. Policy, research, and practice will be enhanced when the potential for physical behaviors to be either health hindering or health promoting is adequately considered.
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Ejercicio Físico , Promoción de la Salud , Conducta Sedentaria , Sedestación , Humanos , Promoción de la Salud/métodos , Conductas Relacionadas con la Salud , Política de SaludRESUMEN
Sleep is essential to life. Accurate measurement and classification of sleep/wake and sleep stages is important in clinical studies for sleep disorder diagnoses and in the interpretation of data from consumer devices for monitoring physical and mental well-being. Existing non-polysomnography sleep classification techniques mainly rely on heuristic methods developed in relatively small cohorts. Thus, we aimed to establish the accuracy of wrist-worn accelerometers for sleep stage classification and subsequently describe the association between sleep duration and efficiency (proportion of total time asleep when in bed) with mortality outcomes. We developed a self-supervised deep neural network for sleep stage classification using concurrent laboratory-based polysomnography and accelerometry. After exclusion, 1448 participant nights of data were used for training. The difference between polysomnography and the model classifications on the external validation was 34.7 min (95% limits of agreement (LoA): -37.8-107.2 min) for total sleep duration, 2.6 min for REM duration (95% LoA: -68.4-73.4 min) and 32.1 min (95% LoA: -54.4-118.5 min) for NREM duration. The sleep classifier was deployed in the UK Biobank with 100,000 participants to study the association of sleep duration and sleep efficiency with all-cause mortality. Among 66,214 UK Biobank participants, 1642 mortality events were observed. Short sleepers (<6 h) had a higher risk of mortality compared to participants with normal sleep duration of 6-7.9 h, regardless of whether they had low sleep efficiency (Hazard ratios (HRs): 1.58; 95% confidence intervals (CIs): 1.19-2.11) or high sleep efficiency (HRs: 1.45; 95% CIs: 1.16-1.81). Deep-learning-based sleep classification using accelerometers has a fair to moderate agreement with polysomnography. Our findings suggest that having short overnight sleep confers mortality risk irrespective of sleep continuity.
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OBJECTIVE: Poor cardiorespiratory fitness and health is common among childcare workers. We designed the `Goldilocks-games` according to the Goldilocks Work principle to provide high-intensity physical activity for childcare workers. We investigated the effectiveness of this Goldilocks Work intervention in increasing occupational high-intensity physical activity and improving work-related health. METHODS: In a two-arm cluster randomized trial, 16 childcare institutions with 142 workers were randomly allocated to either an 8-week Goldilocks Work intervention or a control group. The primary outcome was occupational time in high-intensity physical activity. Secondary outcomes were occupational time in active physical behaviors, heart rate during sleep, pain, physical exhaustion, energy at work, work productivity, and need for recovery. RESULTS: The intervention was successfully delivered and received. Both groups had a low amount of occupational high-intensity physical activity at baseline, and the intervention group reported playing the games 3.1 [standard deviation (SD) 1.5] times/week for a duration of 112.2 (SD 175.0) min/week. However, the intervention did not increase high-intensity physical activity or the secondary outcomes, except for energy at work, measured on a scale from 0-10, increasing 0.65 [95% confidence interval (CI) 0.08-1.21], and need for recovery, measured on a scale from 1-5, decreasing -0.32 (95% CI, -0.54- -0.09). CONCLUSION: The intervention was successfully delivered and received, but did not increase high-intensity physical activity. The intervention group increased their energy at work and decreased their need for recovery, but not the other health-related outcomes. Further research on how to design and implement health-promoting work environment interventions in childcare is needed.
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Cuidado del Niño , Ejercicio Físico , Niño , Humanos , Ejercicio Físico/fisiología , Dolor , Fatiga , Conducta SedentariaRESUMEN
Nutrition-related variables including lower body mass index (BMI), lower bone mineral density (BMD), altered body composition and hormone levels have been reported in adolescent idiopathic scoliosis (AIS). The aims of this study were to determine if physiological and behavioral nutrition-related factors differ between people with and without AIS, and to quantify their relationship with AIS, in unbiased cohort sample. BMI, presence of an eating disorder, leptin, adiponectin, BMD, vitamin D, lean mass, and fat mass were compared between those with and without AIS at ages 8, 10, 14, 17, and 20 years, and multiple logistic regression was performed between these variables and AIS. Lower total body BMD (median, 1.0 g/cm2 vs 1.1 g/cm2; p = .03) and lean mass (median, 38.8 kg vs 46.0 kg; p = .04) at age 20 years were observed in those with AIS compared to those without scoliosis. At age 20, the odds of AIS were 3.23 times higher for adolescents with an eating disorder compared to those with no eating disorder (95% CI, 1.02-8.63) when adjusted for BMI. Every 1 kg/m2 increase in BMI decreased the odds of AIS by 0.88 times (95% CI, 0.76-0.98), after adjusting for eating disorder diagnosis. In conclusion, lower BMI in mid-adolescence and presence of eating disorder outcomes, lower BMD, and lower lean mass in late adolescence were associated with the presence of AIS. Current data do not explain the mechanisms for these associations but suggest that serum leptin, adiponectin, and vitamin D are unlikely to be contributing factors. Conclusive determination of the prevalence of eating disorders in AIS will require further studies with larger sample sizes.
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In the wake of 3 years of societal disruptions related to COVID-19 many workers and organisations are reflecting on the value of work. Despite work generally being good for individuals, it is often framed negatively by individuals. Occupational professionals may have inadvertently contributed to this negative perception by focussing on reducing occupational risks. This editorial outlines 5 issues and invites researchers and practitioners involved in work design to reflect on the contribution they can make in a post-pandemic world.
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COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Salud Laboral , Pandemias , SARS-CoV-2RESUMEN
BACKGROUND: Parents commonly seek information to support the health and well-being of their children. The increasing availability of health information online and social changes related to the COVID-19 pandemic may have changed what information is sought, from whom, where, and why. This qualitative study explored parents' practices and perspectives on seeking health and digital technology use information for their young children. METHODS: Twenty parents, living in Australia (7 rural, 3 remote, and 10 metropolitan), with children aged 0-36 months completed a semi-structured interview. RESULTS: Parents commonly turned to friends and family and online sources to access health information for their young children. For all types of health information, including digital technology use, themes were identified surrounding aspects of information sources participants valued and accessibility of health services. Perceived credibility and trustworthiness, relatability with other parents, ease of accessibility and convenience, and actionable, bite-sized information were valued. Reduced accessibility to health services due to COVID-19 and geographical location, and need for agency in managing their child's health influenced parents' choice of source of information. Few participants actively sought information about digital technology use for their young child, with the main focus on screen time. CONCLUSION: Interactions with family and friends and online sources are important to parents when accessing health information for their child. Parents valued information sources which they considered trustworthy, credible, and relatable, as well as easily accessible and convenient. SO WHAT?: Dissemination of health information reflecting these values may empower parents during this early stage of parenthood.
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COVID-19 , Tecnología Digital , Conducta en la Búsqueda de Información , Padres , Investigación Cualitativa , Humanos , Lactante , Padres/psicología , Femenino , Masculino , Preescolar , COVID-19/epidemiología , Australia , SARS-CoV-2 , Recién Nacido , Adulto , Entrevistas como AsuntoRESUMEN
There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants (n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems: parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring, and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.
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PURPOSE: Artery dysfunction is an early, integral stage in atherogenesis that predicts future cardiovascular events. Sedentary behavior, such as TV watching, is highly prevalent and associated with increased risk of developing cardiovascular diseases. This study investigated whether patterns of TV watching throughout childhood and adolescence were associated with artery function in adulthood. METHODS: TV watching data were collected when participants of the Raine Study were aged 5, 8, 10, 14, 17, and 20 yr. Previous latent class analysis indicated three trajectory groups of TV watching: low TV (<14 h·wk -1 ), high TV (>14 h·wk -1 ), and increasing TV (change from low TV to high TV). At age 28 yr, participants were invited to undergo tests of brachial and femoral artery function by flow-mediated dilation (FMD). General linear models examined differences in artery function between TV trajectory groups for men and women. RESULTS: Five hundred sixty participants (n = 261 women, n = 299 men) were included in the study. In women, the low TV group had significantly greater femoral artery FMD (10.8 ± 1.6%) than both High TV (9.0 ± 1.3%, P = 0.005) and Increasing TV groups (8.5 ± 1.3%, P < 0.001); these results were maintained following mediation analysis, including contemporaneous risk factors. There were no significant differences in femoral artery FMD between TV trajectory groups in men ( P = 0.955). CONCLUSIONS: This study suggests that TV watching behaviors during childhood and adolescence may have legacy impacts on artery function at age 28 yr, particularly in women. This may increase the risk of atherosclerotic vascular pathologies in later life.