A gap in perceived accessibility to play spaces for physical activity in Arizona elementary schools.

BACKGROUND: The Physical Activity Guidelines for Americans states all children should be provided with various physical activity opportunities; however, school play spaces are often unaccommodating to students with disabilities and this limitation may be exacerbated in lower-income schools. OBJECTIVE: The purpose of the study was to compare elementary school play space accessibility among children with and without disabilities at lower- and higher-income schools. METHODS: This cross-sectional study utilized an online survey assessing the perceived accessibility of play spaces for students with and without disabilities in low- and high-income schools administered to 178 physical education teachers across Arizona. Chi-square analyses were conducted to assess reported play space adequacy among students with and without disabilities, and associations by school-level income. RESULTS: There was a significant association between disability status and reported playground and play field inadequacy (p < 0.05). Without considering school income, reported inadequacy was 3x greater for students with disabilities compared to those without for both playgrounds and play fields. Among low-income schools, reported inadequacy was 3x greater for playgrounds and 7x greater for play fields for students with disabilities compared to those without. CONCLUSIONS: These results suggest a gap in access to school play spaces for students with disabilities and highlight the lack of inclusive play areas specifically among schools serving low-income populations. Our findings underscore the need for students with disabilities to be considered in the development of play spaces to ensure this at-risk population receives maximum opportunities for accessible movement and social engagement during the school day.

A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools.

BACKGROUND: In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS: PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS: Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS: Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

The Relationship Between Policy Strength and Physical Activity Practices in Arizona Public Elementary Schools.

BACKGROUND: Many school-based physical activity statutes and regulations have been enacted, with the expectation that schools will comply. However, policy alone does not equate to implementation, and many policies fail for a variety of reasons. The purpose of the study was to determine whether the strength of reported state, district, and school-level physical activity policies were associated with reported recess, physical education, and other school-based physical activity practices at elementary schools in Arizona. METHODS: A modified Comprehensive School Physical Activity Program (CSPAP) Questionnaire was administered to staff at elementary schools across Arizona (N = 171). Summative indices of the number of school physical activity policies and best practices at the state, district, and school levels were created. Relationships between policy strength and best practices were examined using linear regression analyses stratified by recess, physical education, and other school-based physical activity practices. RESULTS: Stronger physical activity-related policies were associated with a greater number of recess (F1,142 = 9.87, P < .05), physical education (F4,148 = 4.58, P < .05, Adj. R2 = .09), and other school-based physical activity (F4,148 = 4.04, P < .05, Adj. R2 = .07) best practices at all levels while controlling for school-level demographic factors. CONCLUSIONS: The strength of policies may improve opportunities for comprehensive physical activity for children in schools. Strengthening policy language (eg, specifying duration and frequency) may contribute to better physical activity practices in schools, improving children's health at the population level.

Promoting children's health and well-being through structured recreation during online recess.

Recess is a critical source of physical, social and emotional health and well-being for children, but generally not prioritized during online learning. A 13-week structured recreation intervention was delivered virtually during recess to students in the fifth and sixth grades (age 10-12 years; N = 71) at one elementary school (Phoenix, AZ, USA). We used embedded mixed method with a prospective pre-/post-design to measure change in student-reported emotion and qualities of engagement in an online setting. Students completed an online pre-/post-survey to measure emotion and motivational responses (enjoyment, competence and relatedness). We used narrative notes to qualitatively assess student engagement during programming. Differences in student-reported emotion were analyzed using paired t-tests. The effect of motivational responses on emotion was analyzed using multiple regression analyses. In vivo coding and concept coding were used to analyze qualitative data. We found no statistically significant differences in student-reported emotion; however, student relationships with peers predicted increased positive and decreased negative emotions after the intervention. Seven categories promoted student engagement: challenging, enjoyable, experiential, practical, purposeful, relatable and relevant. School-based health practitioners can offer structured activities virtually during recess, when in-person learning is interrupted and in all-online settings, to promote emotional well-being.

A direct observation tool to measure interactions between shade, nature, and children's physical activity: SOPLAY-SN.

BACKGROUND: Most physical activity (PA) during school occurs at recess; however, recess PA may be influenced by children's thermal comfort and interaction with nature, neither of which have concurrently been measured reliably in previous studies. This study tests the reliability of SOPLAY-SN, an adaption of the validated System for Observing Play and Leisure Activity in Youth (SOPLAY) to measure Shade and Nature (SN) alongside PA, and associations between children's PA and interaction with shade and nature during recess to highlight the utility of the tool. METHODS: Interactions with shade and nature were measured using systematic direct observation at two playgrounds (primary-grade = ages 5-8, upper-grade = ages 9-12) during recess at an elementary school in Phoenix, Arizona (USA). Pairs conducted observations over four warm days (primary = 29-34 °C, upper-grade = 32-36 °C) in May 2021 (N = 179 scans). Intraclass correlation coefficients (ICC) were used to calculate inter-rater reliability. Mean counts, frequencies, and Kendall rank correlation coefficient tests were used to assess relations between PA level and interactions with shade and nature. RESULTS: Reliability was good for sedentary behavior (ICC = 0.98); light PA (LPA; ICC = 0.80) and moderate-to-vigorous PA (MVPA; ICC = 0.94); shade interaction (ICC = 0.95); and nature interaction (ICC = 0.80) and average agreement was good (86% overall PA, 88% shade, 90% nature). Most (60%) primary-grade children were observed in the shade, with 64% under a covered play structure where children were mainly (47%) sedentary. Of the 11% of primary-grade students observed interacting with nature, 90% occurred in a grass field with trees. Among upper-grade children, 23% were observed in the shade with 53% in grass fields where 48% of play was light. Few (7%) upper-grade children were observed interacting with nature, with most instances (76%) in a grass field with trees. Among primary-grade children, shade was correlated with sedentary behavior (τb = 0.63, p < .05); LPA (τb = 0.39, p < .05); MVPA (τb = 0.56, p < .05); and nature interactions with sedentary behavior (τb = 0.16, p < .05). Among upper-grade children, shade was correlated with sedentary behavior (τb = 0.27, p < .05) and LPA (τb = 0.21, p < .05). CONCLUSIONS: SOPLAY-SN is a reliable tool for measuring children's interaction with shade and nature and participation in PA. Understanding how shade and nature impact movement during recess can inform playground design for children's health and well-being.

Building School Connectedness Through Structured Recreation During School: A Concurrent Mixed-Methods Study.

BACKGROUND: School connectedness (SC) is associated with improved health and academic outcomes. The purposes of this study were to explore factors contributing to students' perceptions of SC and if participation in structured recreation at school was associated with SC. METHODS: We used concurrent mixed-methods including cross-sectional qualitative data to explore factors contributing to SC among fifth- and sixth-grade students at 2 schools in Phoenix, AZ, USA (N = 330), and quantitative measures to explore the association between SC and recreation participation (N = 129). Students completed a journaling activity to identify factors contributing to feelings of SC. Responses were analyzed using both deductive and inductive approaches. Student surveys were analyzed using 1-way analyses of variance to assess differences between participation level and SC. RESULTS: Eight themes contributing to SC emerged: Relationships (peer, adult), Competence (competence), Autonomy (choice), Relax (relax), Recreation (structured, play), Fun (fun), Academics (academic learning), and Environment (food and safety). Participation in structured recreation programming in the classroom and at recess were associated with higher levels of SC (p < .05). CONCLUSIONS: School practitioners can integrate opportunities for structured recreation in the classroom and at recess as a fun and engaging strategy to foster adult support and peer relationships, enhancing SC.

Shifts in Self-Reported Physical Activity, Sedentary Behavior, and Play Among Lower-Socioeconomic Children During the COVID-19 Pandemic: A Repeated Cross-Sectional Study.

PURPOSE: The lack of in-person schooling and participation in structured recreation activities during the COVID-19 pandemic may have altered children's movement behaviors. This study assessed changes in children's self-reported in school and out of school physical activity, sedentary behavior, and play before and during the pandemic. DESIGN: A repeated cross-sectional online survey was administered in February 2020 (pre-pandemic, in-person) and 2021 (during pandemic, remote). SETTING: Children attended an urban public school district in Phoenix (AZ) serving a low-income population. SUBJECTS: Students in grades 4-8 completed the survey in 2020 (n = 253, 62% response rate) and 2021 (n = 261, 77% response rate). MEASURES: The survey included items from the Youth Activity Profile and three additional questions about play. ANALYSIS: Differences in mean scores and mean scores by gender were analyzed using one-way and two-way ANOVAs. RESULTS: Students reported less physical activity during remote recess in 2021 (M = 3.42, SD = .80 v. M = 2.99, SD = .86, p < .05). Physical activity outside of school decreased during the pandemic (M = 2.76, SD = 1.26 v. M = 2.53, SD = 1.18, p < .05). Most students (55%) reported playing less during the pandemic, but playing in new ways (67%). CONCLUSION: Children may benefit from interventions to counter reduced movement experienced during the pandemic, particularly in under-resourced areas.

Asymmetric diosmium sawhorse complexes.

Three asymmetric diosmium(I) carbonyl sawhorse complexes have been prepared by microwave heating. One of these complexes is of the type Os2(µ-O2CR)(µ-O2CR')(CO)4L2, with two different bridging carboxylate ligands, while the other two complexes are of the type Os2(µ-O2CR)2(CO)5L, with one axial CO ligand and one axial phosphane ligand. The mixed carboxylate complex Os2(µ-acetate)(µ-propionate)(CO)4[P(p-tolyl)3]2, (1), was prepared by heating Os3(CO)12 with a mixture of acetic and propionic acids, isolating Os2(µ-acetate)(µ-propionate)(CO)6, and then replacing two CO ligands with two phosphane ligands. This is the first example of an Os2 sawhorse complex with two different carboxylate bridges. The syntheses of Os2(µ-acetate)2(CO)5[P(p-tolyl)3], (3), and Os2(µ-propionate)2(CO)5[P(p-tolyl)3], (6), involved the reaction of Os3(CO)12 with the appropriate carboxylic acid to initially produce Os2(µ-carboxylate)2(CO)6, followed by treatment with refluxing tetrahydrofuran (THF) to form Os2(µ-carboxylate)2(CO)5(THF), and finally addition of tri-p-tolylphosphane to replace the THF ligand with the P(p-tolyl)3 ligand. Neutral complexes of the type Os2(µ-O2CR)2(CO)5L had not previously been subjected to X-ray crystallographic analysis. The more symmetrical disubstituted complexes, i.e. Os2(µ-formate)2(CO)4[P(p-tolyl)3]2, (8), Os2(µ-acetate)2(CO)4[P(p-tolyl)3]2, (4), and Os2(µ-propionate)2(CO)4[P(p-tolyl)3]2, (7), as well as the previously reported symmetrical unsubstituted complexes Os2(µ-acetate)2(CO)6, (2), and Os2(µ-propionate)2(CO)6, (5), were also prepared in order to examine the influence of axial ligand substitution on the Os-Os bond distance in these sawhorse molecules. Eight crystal structures have been determined and studied, namely µ-acetato-1κO:2κO'-µ-propanoato-1κO:2κO'-bis[tris(4-methylphenyl)phosphane]-1κP,2κP'-bis(dicarbonylosmium)(Os-Os) dichloromethane monosolvate, [Os2(C2H3O2)(C3H5O2)(C21H21P)2(CO)4]·CH2Cl2, (1), bis(µ-acetato-1κO:2κO')bis(tricarbonylosmium)(Os-Os), [Os2(C2H3O2)2(CO)6], (2) (redetermined structure), bis(µ-acetato-1κO:2κO')pentacarbonyl-1κ2C,2κ3C-[tris(4-methylphenyl)phosphane-1κP]diosmium(Os-Os), [Os2(C2H3O2)2(C21H21P)(CO)5], (3), bis(µ-acetato-1κO:2κO')bis[tris(4-methylphenyl)phosphane]-1κP,2κP-bis(dicarbonylosmium)(Os-Os) p-xylene sesquisolvate, [Os2(C2H3O2)2(C21H21P)2(CO)4]·1.5C8H10, (4), bis(µ-propanoato-1κO:2κO')bis(tricarbonylosmium)(Os-Os), [Os2(C3H5O2)2(CO)6], (5), pentacarbonyl-1κ2C,2κ3C-bis(µ-propanoato-1κO:2κO')[tris(4-methylphenyl)phosphane-1κP]diosmium(Os-Os), [Os2(C3H5O2)2(C21H21P)(CO)5], (6), bis(µ-propanoato-1κO:2κO')bis[tris(4-methylphenyl)phosphane]-1κP,2κP-bis(dicarbonylosmium)(Os-Os) dichloromethane monosolvate, [Os2(C3H5O2)2(C21H21P)2(CO)4]·CH2Cl2, (7), and bis(µ-formato-1κO:2κO')bis[tris(4-methylphenyl)phosphane]-1κP,2κP-bis(dicarbonylosmium)(Os-Os), [Os2(CHO2)2(C21H21P)2(CO)4], (8).

Crystal structure of [µ-1κ2C1,C4:2(1,2,3,4-η)-1,2,3,4-tetra-phenyl-buta-1,3-diene-1,4-di-yl]bis-(tri-carbonyl-osmium)(Os-Os).

In the title complex C34H20O6Os2 or (µ-η4-C4Ph4)Os2(CO)6, one Os atom is part of a metalla-cyclo-penta-diene ring, while the second Os atom is π-bonded to the organic portion of this ring. The distance of 2.7494 (2) Šbetween the two Os atoms is typical of an Os-Os single bond. Three carbonyl ligands are attached to each Os atom and these six carbonyls adopt an eclipsed conformation. There are no bridging or semibridging CO groups. Two carbonyl ligands and all four phenyl groups are disordered over two slightly different positions for which each atom in the minor components is displaced less than 1 Šfrom the corresponding atom in the major components. The refined occupancies of the major com-ponents of the carbonyl ligands are 0.568 (16) and 0.625 (13), while those for the phenyl rings are 0.50 (3), 0.510 (12), 0.519 (18), and 0.568 (12).

Trauma reception and resuscitation in Sri Lanka: the Health for the South Capacity-Building project.

In response to the Indian Ocean tsunami of 2004, the Health for the South project, Capacity-Building programme was implemented in Galle, Sri Lanka. The objectives of the Capacity-Building programme were to develop the emergency and trauma service capability at Teaching Hospital Karapitiya in Galle. Over 15 months, ED clinicians, from the Alfred Hospital and Royal Children's Hospital in Melbourne, provided training in the Emergency Treatment Unit of the main referral hospital for the south of Sri Lanka. This programme, completed in June 2008, significantly improved the hospital's ability to conduct trauma resuscitation, and to attain an increased level of disaster preparedness. In addition, valuable lessons were noted that will guide future initiatives in trauma care training in similar contexts.

Effects of CNS site-directed carotid arterial infusions of bupivacaine, levobupivacaine, and ropivacaine in sheep.

BACKGROUND: Previous preclinical safety studies in ewes have found intravenous levobupivacaine and ropivacaine to be less potent toward causing central nervous system (CNS) and cardiac toxicity than bupivacaine. Analogous cardiotoxicity has been demonstrated directly in various cardiac preparations ex vivo. Moreover, drug-related arrhythmogenicity has been demonstrated from direct CNS injection of local anesthetic agents in vivo, suggesting CNS-related cardiotoxicity. This study investigated whether CNS site-directed blood-borne drug administration (with minimal systemic recirculation) would demonstrate drug-related cardiotoxicity. METHODS: Direct CNS effects and indirect cardiotoxic sequelae were determined after bilateral carotid arterial infusions of levobupivacaine, bupivacaine, or ropivacaine in ewes. After pilot studies to validate the procedures, equimolar doses (24-96 micromol, approximately 7.5-30 mg) were infused over 3 min using a crossover design. Behavioral CNS signs, quantitative electroencephalographic (EEG), cardiovascular, and electrocardiographic effects were recorded. Drug blood concentrations in superior sagittal sinus and aorta were measured serially. RESULTS: Blood drug concentrations in the superior sagittal sinus were 5-10 times those concurrently in the aorta, confirming highly selective CNS delivery with minimal systemic recirculation. Dose-dependent CNS excitatory behavior and EEG changes, with increased mean arterial blood pressure, heart rate, cardiac output, and myocardial contractility, were found, consistent with sympathetic nervous system stimulation. The overall rank order of potency for these effects was ropivacaine < levobupivacaine < bupivacaine. Nonfatal cardiac arrhythmias were observed, but the type or frequency did not differ between drugs. CONCLUSIONS: Although CNS site-selective drug delivery produced quantitative differences between bupivacaine, levobupivacaine, and ropivacaine in some CNS effects and cardiac sequelae, no differences were found in their arrhythmogenic potential.