Kappa: Preliminary Results on a Novel Technique for Pelvic Fixation in Adult Spinal Deformity Correction.

Study Design: Retrospective cohort study. Objectives: Pelvic fixation in degenerative spinal deformation is as crucial as demanding. Several pelvic anchoring technics have been described, but loosening rates remain high for most solutions. Here is described the "Kappa" technic, combining ilio-sacral screws to S2A1 screws at 2 years of follow-up. Methods: Thirteen patients that underwent a spinal deformity correction with "Kappa" fixation to the pelvis and with more than 2 years of follow-up were prospectively included in this study. The surgical technic is described, and clinical and radiographic data have been collected for all patients. Results: The population exhibited an important pre-operative sagittal imbalance (mean SVA of 104,4 mm, mean PI-LL mismatch of 22,8°) that had improved significatively after surgery (mean SVA of 75,5 mm and mean PI-LL mismatch of 4,9°). No loosening of pull-out of the implants was to deplore at 2 years of follow-up. Conclusions: The association of ilio-sacral screw, resistant to pull-out because of the traction axis perpendicular to the construct, to S2A1 screws, known to be effective in sagittal balance restoration seems to be an effective and safe option to pelvic fixation for adult spinal deformity correction. Level of Evidence: IV.

Motor competence across the life span: A cross-sectional study of Iranians aged 5 to 85 years.

OBJECTIVES: To measure motor competence among a representative sample of Iranians aged 5-85 years. DESIGN: Cross-sectional. METHODS: Motor competence was assessed quantitatively by the Test of Motor Competence; two fine motor skills (placing and building bricks) and two gross motor skills (heel-to-toe-walking and walking/running in slopes) to assess dynamic balance. Task scores were summed and transformed into standardized scores (z-scores). Data were stratified by 12 chronological age groups and sex. RESULTS: Participants were 500 Iranians aged 5-85 years (females = 64%, age 5-35 years = 82%). There were significant age differences in motor competence and the distribution between age and z-score distribution was u-shaped. Between childhood and adolescence there was a rapid improvement in motor competence with maximal speed (-2 standard deviations) occurring among 19-25-year-olds. For each decade after age 25 years, z-scores progressively decreased approximately 1 standard deviations until age ≥56 years when performance decreased to approximately the same speeds as children (> +3 standard deviations). Sex differences were observed between children and adolescents. CONCLUSIONS: The sample characteristics constrain the generalizability of our findings. The Test of Motor Competence is easy to administer, uses a standardized test battery for people aged 5-85 years, and the quantitative outcome enables longitudinal monitoring of motor competence across the life course. As life expectancy and the proportion of populations aged >65 years increases, understanding how to maintain health in older age is an important public health issue in 21st century.

Group-based physical activity interventions for postpartum women with children aged 0-5 years old: a systematic review of randomized controlled trials.

BACKGROUND: It is estimated that less than one third of women (28%) worldwide, are not sufficiently active, and there is evidence indicating physical activity (PA) participation is lower during pregnancy and the postpartum period. Despite the importance of educating and encouraging postpartum women to engage in PA, existing systematic reviews have only focused on examining the impact of individually tailored PA interventions and on specific postpartum populations such as women who are inactive (i.e., do not meet PA recommendations) or women at risk of gestational diabetes mellitus or postnatal depression. This review aims to fill this gap by examining the impact of group-based PA interventions on postpartum women's PA levels or other health behavior outcomes. METHODS: A systematic literature search was conducted using four electronic databases (MEDLINE, CINAHL, EMBASE and PsychInfo) of published studies between 1st January 2000 and 31st October 2020. Studies were included if they targeted postpartum women with no current health conditions, had children aged 0-5 years, and engaged postpartum women in a group-based PA program that reported PA or other health behavior outcomes. Out of a total of 1091 articles that were initially identified, six were included. RESULTS: Group-based PA interventions were moderately successful in changing or increasing postpartum women's self-reported PA levels and psychological wellbeing in the first 2 years of their offspring's life. Overall, group-based PA interventions were not successful in changing or increasing postpartum women's objectively measured PA levels, but only one study objectively measured postpartum women's PA levels. Narrative synthesis highlights the heterogeneity of the outcomes and methodologies used, and the low to medium risk of bias in the included studies. CONCLUSION: To strengthen the evidence-base for group-based PA programs with postpartum women there is an on-going need for more rigorous randomised controlled trials of appropriate length (at least 3 months in duration) with an adequate dose of group-based PA sessions per week (to meet PA guidelines), and that utilise objective measures of PA. In addition, future PA interventions for this population should include, at the very least, fidelity and process data to capture the characteristics or design features that appeal most to postpartum women.

Order out of chaos: Sense of coherence and the mediating role of coping resources in explaining mental health during COVID-19 in 7 countries.

In the midst of the COVID-19 pandemic and the universal chaos created by it, this study explores the role of sense of coherence (Soc, Antonovsky, 1979) and how it enables coping with a stressful situation and staying well. SOC is a generalized orientation which allows one to perceive the world as comprehensible, manageable, and meaningful. In an attempt to understand 'how does the SOC work' we employed the salutogenic assumption that a strong SOC allows one to reach out in any given situation and find those resources appropriate to the specific stressor. Thus, we hypothesized that the positive impact of SOC on mental health outcomes would be mediated through coping resources that are particularly salient in times of crisis. One resource is related to the micro level (perceived family support) and the other concerns the macro level (trust in leaders and social-political institutions). Data collection was conducted in different countries during May-June 2020 via online platforms. The data included 7 samples of adult participants (age 18-90) from Israel (n â€‹= â€‹669), Italy (n â€‹= â€‹899), Spain (n â€‹= â€‹476), Germany (n â€‹= â€‹708), Austria (n â€‹= â€‹1026), Switzerland (n â€‹= â€‹147), and the U.S. (n â€‹= â€‹506). The questionnaires included standard tools (MHC-SF, SOC-13) as well as questionnaires of perceived family support and trust that were adapted to the pandemic context. As expected, SOC was associated with mental health in all the samples. Perceived family support and trust in leaders and social-political institutions mediated the relationships between SOC and mental health, controlling for age, gender, and level of financial risk. It appears that SOC has a universal meaning, not limited by cultural and situational characteristics. The discussion focuses on the theoretical, social, and political applications of the salutogenic model - and its core concept of SOC - in the context of coping with a global pandemic across different cultural contexts and countries.

Degenerative cervical myelopathy.

Degenerative cervical myelopathy (DCM) frequently leads to severe neurologic disability but is still frequently underdiagnosed. One explanation may be the variability of the symptoms presented by the patients, from paresthesia to quadriplegia, making it another great masquerader. What do we know? How can we manage better these patients? We will review the keys points concerning its challenging diagnosis (clinical and radiologic), some of the recent discoveries about DCM, notably the underlying genetic mutations identified, linked to its pathophysiology, before addressing the consensual points concerning its management and the major evolutive risk: acute decompensation.

Dealing with loss: food and eating in women with ovarian cancer on parenteral nutrition.

BACKGROUND: Malignant bowel obstruction is a common complication of ovarian cancer, resulting in limited oral intake. Home parenteral nutrition (HPN) may be offered to patients in this condition to meet nutritional requirements. However, it is not known how they experience being unable to eat. The present study reports how patients related to food when receiving HPN. METHODS: The investigation was a qualitative study underpinned by phenomenology with women with advanced ovarian cancer in bowel obstruction receiving parenteral nutrition. Interview transcripts were analysed thematically guided by the techniques of Van Manen. RESULTS: We recruited 20 women to the study. Participants were interviewed a maximum of four times and a total of 39 in-depth longitudinal interviews were conducted. Participants could tolerate minimal amounts of food, if they had a venting gastrostomy. Not being able to eat engendered a sense of sadness and loss, and most women found it challenging to be in the presence of others eating. They adopted strategies to cope, which included fantasising about food and watching cookery programmes. These approaches were not a long-term solution; either participants came to terms with their loss or the strategies became less effective in providing relief. CONCLUSIONS: Home parenteral nutrition meets the nutritional requirements of patients with malignant bowel obstruction but cannot replace the non-nutritive functions of food. Healthcare professionals can offer a patient-centred approach by acknowledging the difficulties that patients may face and, wherever possible, encourage them to focus on the positive benefits of interacting with people rather than the loss of eating on social occasions.

Feasibility of a school-based exercise intervention for children with intellectual disability to reduce cardio-metabolic risk.

BACKGROUND: People with intellectual disabilities (ID) are at increased risk of secondary health conditions, reduced quality of life and life expectancy. Children with ID demonstrate low levels of physical activity in association with a higher prevalence of obesity, a modifiable risk factor associated with secondary health conditions including type 2 diabetes and cardiovascular disease. Despite this, physical activity interventions addressing weight and weight-related complications in this population are limited. This study aimed to establish the feasibility of a school-based group exercise intervention for children with moderate to severe ID. METHODS: A single-arm intervention study was used to establish the feasibility of a 16-week exercise intervention. Children attending a School for Specific Purposes in Sydney, Australia, participated in two 30-min exercise sessions per week across the intervention period in addition to their regular physical education class. Each exercise session was 60% aerobically based, 20% strength based and 20% targeted towards fundamental movement skill development. We used two facilitation strategies to assist the delivery of the intervention, including the implementation of a variety of communication resources and promotion of social interaction. Feasibility was assessed through recruitment rates, program retention, adverse effects, attendance, group size feasibility and non-compliance. Anthropometric measures included height (m), weight (kg) and waist circumference (cm; umbilicus), with body mass index (BMI) and waist-to-height ratios (WtHR) used to determine cardio-metabolic risk. Aerobic capacity was assessed using the submaximal 6-min walk test (6-MWT). Intensity of physical activity sessions was measured through the use of tri-axial accelerometers and compared to physical activity recommendations. RESULTS: Ten children aged between 9 and 13 years completed the 16-week intervention, with a 55% recruitment rate, 91% program retention, 86% attendance and with no adverse effects reported. Sessions commenced as 1:1 supervisor to child ratios before progressing to established small groups of 2:7 (supervisor : child). Children spent 38.4% (11.5 min) of each session in moderate to vigorous physical activity (MVPA), equating to 20% of their MVPA recommended daily physical activity levels (twice per week). There was a significant change in weight across the intervention period, with a trend towards increased weight between mid-intervention and 3-month follow-up time points. There were no significant changes in child BMI, WtHR or aerobic capacity. CONCLUSIONS: A school-based group exercise intervention for children with moderate to severe ID is feasible and safe, with high retention rates and physical activity participation. No significant improvements in body composition or aerobic capacity were determined. The present study demonstrates that engaging children with moderate-severe ID in school-based group exercise is feasible to assist in physical activity participation.

Do Curve Characteristics Influence Stenosis Location and Occurrence of Radicular Pain in Adult Degenerative Scoliosis?

STUDY DESIGN: Retrospective cohort. OBJECTIVE: The aim of this study was to describe the various locations of spinal stenosis (LSS) in lumbar scoliosis and its related clinical symptoms. INTRODUCTION: Adults with lumbar scoliosis often present with pain and disability. Association of scoliosis and stenosis is not rare, but remains sparsely explored. Consequences of scoliosis on stenosis location and treatment remain debatable. METHODS: Patients operated for symptomatic LSS with lumbar scoliosis (Cobb angle >20°) from 2015 to 2016 were included. All patients completed preoperative clinical and neurologic examination. Coronal and sagittal radiographic parameters, rotatory subluxation (RS), and spondylolisthesis were analyzed on full spine radiographs. Computed tomographic scan multiplanar reconstructions were performed to measure central, foraminal, and lateral recess stenosis, from T10 to the sacrum. RESULTS: A total of 76 patients were included (69 ± 9 years old, 77% female). Sixty percent had neurogenic claudication, and L5 was the most common radicular pain (41%). The mean Cobb angle was 33° ± 16°. Overall, 35 (46%) patients had coronal malalignment; in 69%, side of the coronal tilt corresponded to side of the concavity of the lumbosacral curve. Sixty patients had RS (most frequent level L3-L4). In 50% of the cohort, RS was located at the junction between the lumbar and lumbosacral curves. In 70% (n = 53) of the patients, central stenosis occurred at the junction between the lumbar and lumbosacral curves. Foraminal and lateral stenosis were most frequently observed in the concavity of the distal lumbosacral curve. L5 radicular pain was significantly more frequent in case of lumbosacral contra-curve and right coronal malalignment. CONCLUSION: LSS is frequent in lumbar scoliosis. Relationships exist between curve characteristics and symptomatic LSS in lumbar scoliosis; especially, concavity of the lumbosacral contra-curve and the junctional level between the lumbar curve and the lumbosacral contra-curve. Therefore, accurate analysis of stenosis in ASD seems mandatory, to at least perform decompression because perfect planned treatment for stenosis and scoliosis correction might not always be possible because of the patient's general health status. LEVEL OF EVIDENCE: Level 4.

30-year cross-sectional trends in waist-to-height ratio in Australian school age children; 1985 to 2015.

AIM: To report 30-year changes in the proportion of children with abdominal obesity measured by waist-to-height ratio (WHtR) ≥ 0.5. METHODS: Secondary analysis of WHtR ≥ 0.5 data on Australian children age 7 to 15 years from five national cross-sectional population surveys conducted in 1985, 1995, 2007, 2012 and 2015. Changes in the proportions of children with a WHtR ≥ 0.5 across survey years, by age and sex were assessed using chi-squared tests. RESULTS: Between 1985 and 2012, the proportion of children with WHtR ≥ 0.5 increased from 8.6% [95%CI: 8.0, 9.2] to 25.1% [95%CI: 23.5, 26.7]. An increase of ~5% each decade was observed between 1985 and 2007, and a 6.6% increase was observed between 2007 and 2012. Overall, there was a non-significant decrease in the proportion of children with WHtR ≥ 0.5 between 2012 (25.1% [95%CI: 23.5, 26.7] and 2015 (23.3% [95%CI: 21.6, 25.2]. CONCLUSION: Abdominal obesity has increased over the last 30 years in Australian children. In 2015, one in five children had WHtR ≥ 0.5, a marker of cardiometabolic risk in children. Our finding highlights the importance of including WHtR as a routine measurement in primary health care and population health surveys. This information is needed to guide policy and practice to manage long-term cardiovascular risk in children.

Evaluation of a peer education program on student leaders' energy balance-related behaviors.

BACKGROUND: Few studies have reported energy balance-related behavior (EBRB) change for peer leaders delivering health promotion programs to younger students in secondary schools. Our study assessed the impact of the Students As LifeStyle Activists (SALSA) program on SALSA peer leaders' EBRBs, and their intentions regarding these behaviors. METHODS: We used a pre-post study design to assess changes in EBRBs and intentions of Year 10 secondary school students (15-16 year olds) who volunteered to be peer leaders to deliver the SALSA program to Year 8 students (13-14 year olds). This research is part of a larger study conducted during 2014 and 2015 in 23 secondary schools in Sydney, Australia. We used an online questionnaire before and after program participation to assess Year 10 peer leaders' fruit and vegetable intake, daily breakfast eating, sugar sweetened beverage (SSB) intake, moderate-to-vigorous physical activity (MVPA) participation and school-day recreational screen time behaviors and intentions regarding these EBRBs. Generalized estimating equations with a robust variance structure and exchangeable correlation structure were used to estimate the individual-level summary statistics and their 95% CIs, adjusted for clustering. We further assessed the effect of covariates on EBRB changes. RESULTS: There were significant increases in the proportion of Year 10 peer leaders (n = 415) who reported eating ≥2 serves fruit/day fruit from 54 to 63% (P < 0.01); eating ≥5 serves vegetables/day from 8 to 12% (P < 0.01); and drinking <1 cup/day of SSBs from 56 to 62% (P < 0.01). Change in ≥60 min MVPA participation/day depended on gender (P < 0.01): Boys increased 14% while girls decreased -2%. Changes in eating breakfast daily also depended on gender (P < 0.004): Boys increased 13% while girls decreased -0.4%. The change in peer leaders recreational screen time differed by socio-economic status (P < 0.05): above average communities decreased by -2.9% while below average communities increased 6.0%. Significant shifts were seen in peer leaders' intentions, except MVPA which remained stable. CONCLUSIONS: The SALSA program had a positive impact on peer leaders' EBRBs, with gender and socio-economic status moderating some outcomes. TRIAL REGISTRATION: ACTRN12617000712303 retrospectively registered.

Assessing junk food consumption among Australian children: trends and associated characteristics from a cross-sectional study.

BACKGROUND: The ubiquitous supply of junk foods in our food environment has been partly blamed for the increased rates in overweight and obesity. However, consumption of these foods has generally been examined individually perhaps obscuring the true extent of their combined consumption and impact on health. An overall measure of children's junk food consumption may prove useful in the development of child obesity prevention strategies. We describe the development of a children's Junk Food Intake Measure (JFIM) to summarise temporal change in junk food consumption and examine the association between the JFIM and health-related behaviours. METHODS: Cross-sectional population surveillance survey of Australian children age 5-16 years collected in 2010 and 2015. Data were collected by questionnaire with parent's proxy reporting for children in years K, 2 and 4 and children in years 6, 8 and 10 by self-report. Information on diet, screen-time and physical activity was collected using validated questionnaires. The JFIM comprised consumption of fried potato products, potato crisps/salty snacks, sweet and savoury biscuits/cakes/doughnuts, confectionary and, ice cream/ice blocks. RESULTS: A total of 7565 (missing = 493, 6.1%) and 6944 (missing n = 611, 8.1%) children had complete data on consumption of junk foods, in 2010 and 2015, respectively. The 2015 survey data showed that among students from high socio-economic status neighbourhoods, there were fewer high junk food consumers than low junk food consumers. Children from Middle Eastern cultural backgrounds had higher junk food consumption. High junk food consumers were more likely to consume take-away ≥3/week, eat dinner in front of the television, receive sweet rewards, be allowed to consume snacks anytime, have soft drinks available at home and a TV in their bedroom. There was a lower proportion of high junk food consumers in 2015 compared to 2010. CONCLUSION: This is the first study to provide and examine a summary measure of overall junk food consumption among Australian children. The results indicate that junk food consumption among Australian children is lower in 2015, compared with 2010. Still, the public health workforce must continue their efforts as levels of junk food consumption remain of concern among Australian children.

30-year trends in overweight, obesity and waist-to-height ratio by socioeconomic status in Australian children, 1985 to 2015.

BACKGROUND/OBJECTIVE: To report 30-year (1985-2015) prevalence trends in overweight, obesity and abdominal obesity among children by school level and socioeconomic status (SES). SUBJECTS/METHODS: Five cross-sectional, population child surveys (age 4-18 years; n=27 808) conducted in 1985-1997-2004-2010-2015 in New South Wales, Australia. Outcomes were prevalence of measured overweight, obesity and waist-to-height ratio (WHtR⩾0.5) by sex, school level (children (primary) and adolescents (high)) and SES tertile. RESULTS: In 2015, the prevalences of overweight, obesity and WHtR⩾0.5 in children were 16.4%, 7.0% and 14.6%, respectively, and in adolescents 21.9%, 17.2% and 4.6%, respectively. Obesity prevalence has not significantly changed in children or adolescents since 1997, nor since 2010 (children, P=0.681; adolescents, P=0.21). Overweight has not significantly changed in children since 1997, but has in adolescents since 1985, with a relative increase of 16 percentage points (P<0.001) between 2010 and 2015. WHtR⩾0.5 prevalence has significantly changed since 1985, except in adolescent girls between 2010 and 2015. Between 2010 and 2015 the relative increase in WHtR⩾0.5 was 17 and 40 percentage points in children and adolescent boys, respectively. Significant disparities in prevalence rates between children and adolescents from low and high SES backgrounds began in 2010 for overweight, since 1997 for obesity and since 2004 for WHtR⩾0.5. Differences between SES groups have become larger over the past 18 years. CONCLUSIONS: Since 1997, obesity has remained stable, and overweight has stabilized in children, not in adolescents. WHtR⩾0.5 significantly increased between 1985 and 2015, with prevalence rates at each survey around twice the obesity prevalence. Compared with high SES children and adolescents, the risk of overweight, obesity and WHtR⩾0.5 was significantly higher for low SES children and adolescents. The findings are highly relevant to policy makers involved in child obesity prevention interventions and highlight the need for better targeted interventions among children and adolescents from low SES backgrounds, and adolescents in particular.

Defining a reference range for vital signs in healthy term pregnant women undergoing caesarean section.

Early warning systems (EWS), used to identify deteriorating hospitalised patients, are based on measurement of vital signs. When the patients are pregnant, most EWS still use non-pregnant reference ranges of vital signs to determine trigger thresholds. There are no published reference ranges for all vital signs in pregnancy. We aimed to define vital signs reference ranges for term pregnancy in the preoperative period, and to determine the appropriateness of EWS trigger criteria in pregnancy. We conducted a one-year retrospective study in a tertiary referral obstetric hospital. The study sample was healthy term women undergoing planned caesarean section (CS). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), oxygen saturation (SpO2) and temperature were all measured automatically and data was extracted from the medical record. Two hundred and fifty-eight women met inclusion criteria. Results were (mean ± SD [standard deviation]) SBP 118 ± 11.2 mmHg, DBP 75 ± 10.3 mmHg, HR 84 ± 10.2 /minute, respiratory rate 18 ± 1.5 /minute, SpO2 99% ± 1.0% and temperature 36.4°C ± 0.43°C. The reference ranges (mean ± 2SD) determined were SBP 96-140 mmHg, DBP 54-96 mmHg, HR 64-104/minute, RR 15-21 /minute, SpO2 97%-100% and temperature 35.5°C-37.3°C. This study defined a reference range for vital signs in healthy term pregnant women undergoing CS. Study findings suggest that currently used criteria for EWS triggers, based on non-pregnant values, may be too extreme for timely detection of deteriorating pregnant patients. Further research examining the modified HR triggers of ≤50 and ≥110 /minute in pregnant women and their relationship to clinical outcomes is required.

A radio-pulsing white dwarf binary star.

White dwarfs are compact stars, similar in size to Earth but approximately 200,000 times more massive. Isolated white dwarfs emit most of their power from ultraviolet to near-infrared wavelengths, but when in close orbits with less dense stars, white dwarfs can strip material from their companions and the resulting mass transfer can generate atomic line and X-ray emission, as well as near- and mid-infrared radiation if the white dwarf is magnetic. However, even in binaries, white dwarfs are rarely detected at far-infrared or radio frequencies. Here we report the discovery of a white dwarf/cool star binary that emits from X-ray to radio wavelengths. The star, AR Scorpii (henceforth AR Sco), was classified in the early 1970s as a δ-Scuti star, a common variety of periodic variable star. Our observations reveal instead a 3.56-hour period close binary, pulsing in brightness on a period of 1.97 minutes. The pulses are so intense that AR Sco's optical flux can increase by a factor of four within 30 seconds, and they are also detectable at radio frequencies. They reflect the spin of a magnetic white dwarf, which we find to be slowing down on a 107-year timescale. The spin-down power is an order of magnitude larger than that seen in electromagnetic radiation, which, together with an absence of obvious signs of accretion, suggests that AR Sco is primarily spin-powered. Although the pulsations are driven by the white dwarf's spin, they mainly originate from the cool star. AR Sco's broadband spectrum is characteristic of synchrotron radiation, requiring relativistic electrons. These must either originate from near the white dwarf or be generated in situ at the M star through direct interaction with the white dwarf's magnetosphere.

Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta-analysis.

Sedentary behaviour has emerged as a unique determinant of health in adults. Studies in children and adolescents have been less consistent. We reviewed the evidence to determine if the total volume and patterns (i.e. breaks and bouts) of objectively measured sedentary behaviour were associated with adverse health outcomes in young people, independent of moderate-intensity to vigorous-intensity physical activity. Four electronic databases (EMBASE MEDLINE, Ovid EMBASE, PubMed and Scopus) were searched (up to 12 November 2015) to retrieve studies among 2- to 18-year-olds, which used cross-sectional, longitudinal or experimental designs, and examined associations with health outcomes (adiposity, cardio-metabolic, fitness, respiratory, bone/musculoskeletal, psychosocial, cognition/academic achievement, gross motor development and other outcomes). Based on 88 eligible observational studies, level of evidence grading and quantitative meta-analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate-intensity to vigorous-intensity physical activity or focusing on studies with low risk of bias. Quality evidence from studies with robust designs and methods, objective measures of sitting, examining associations for various health outcomes, is needed to better understand if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents.

Exploiting coherence for real-time studies by single-bunch imaging.

First real-time studies of ultra-fast processes by single-bunch imaging at the European Synchrotron Radiation Facility are reported. By operating the storage ring of the ESRF in single-bunch mode with its correspondingly increased electron bunch charge density per singlet, the polychromatic photon flux density at insertion-device beamlines is sufficient to capture hard X-ray images exploiting the light from a single bunch (the corresponding bunch length is 140 ps FWHM). Hard X-ray imaging with absorption contrast as well as phase contrast in combination with large propagation distances is demonstrated using spatial samplings of 11 µm and 35 µm pixel size. The images acquired allow one to track crack propagation in a bursting piece of glass, breaking of an electrical fuse as well as cell wall rupture in an aqueous foam. Future developments and their potential in the frame of the proposed Phase II of the ESRF Upgrade Program are discussed.