Pre-service Physical Education teachers and concerns regarding their ability to successfully facilitate school-based physical activity promotion strategies

Regular physical activity (PA) in youth has numerous immediate and long-term health benefits. With several studies indicating low levels of youth PA globally, schools settings have become increasingly critical settings for youth health promotion strategies. The role of physical education (PE) teachers has long been considered central to the facilitation of such strategies. However, PE teachers have a selfreported lack of knowledge, skills, understanding, and competence to successfully implement these strategies. Tertiary education programs are fundamental to adequately preparing, and shaping the attitudes and philosophies of future PE teachers towards their involvement within these programs. The aim of this investigation was to explore the beliefs and perceptions of future secondary school PE teachers, regarding their potential roles in future school-based programs designed to promote student PA. Fifty-seven (21 males and 36 females) pre-service PE teachers completed a series of open-ended survey questions concerning their perceptions towards participating in school-based PA promotion programs both as preservice during practicum, and prospectively as practising teachers. Responses were analysed thematically. Participants responded both positively and enthusiastically to both questions. Concerns regarding time, and the intention or expectation to participate in such programs were also key themes for pre-service and practicing teacher participation respectively. Critically in this study, participants did not identify any limitations which may impact upon their ability to successfully promote youth PA in school settings. This may indicate that participants have misconceptions regarding their ability to fulfil this role, or conversely, the deficiency of current PE teachers regarding school-based PA promotion has been recognised by the tertiary institution, and addressed to adequately prepare its students. School-based PA promotion is an integral element of pre-service PE teacher education, and ongoing professional development of practicing PE teachers. This trend is expected to continue in the future, in order to address ongoing public health concerns.

Bringing the real world into university learning

Introduction: As part of ongoing quality assurance, all university programs must be regularly reviewed to ensure curriculum is current, meets university and national standards, and for medical science, criteria for AIMS Accreditation. With recent developments at the national and international level also signaling change, a course design team (CDT) was assembled and tasked with developing and implementing a new four year Bachelor of Medical Laboratory Science (BMLS) course at QUT. Method: A whole-of-course approach was adopted, incorporating inverted curriculum and Capstone experience. First, course vision and desired graduate profile are defined as course learning outcomes (CLO), i.e. skills, knowledge, behaviours and attributes graduates must demonstrate. CLO are then back-mapped into introductory, developmental and expected phases from fourth to first year on a course plan and assessment map. Unit learning outcomes (ULO) are then defined, and finally, each unit (subject) designed, directly aligned with assessment. Results: The resulting BMLS course represents a deliberate program of study across four years, which from day one, focuses on the professional aspects of MLS, clinical pathology disciplines, and incrementally developing and assessing the skills, knowledge, behaviours and attributes required to undertake the Work Integrated Learning Internship (WILI) and Capstone experience in final year, and subsequently, graduate from the program. Conclusions: At the start of the year, the BMLS commenced with higher than anticipated enrolments. To date, survey data and feedback is positive, with particular emphasis on the directed nature of the course. The method of course design also ensures university/national standards, and criteria for AIMS Accreditation have been met.

The effect of olive leaf extract on platelet function

Background Epidemiological studies have shown a reduced incidence of cardiovascular disease in the Mediterranean population attributed to the consumption of dietary olive oil rich in antioxidants. This has lead to increased interest in the antioxidant properties of other phenolic compounds of olive tree products. It has been suggested that olive leaf extract may also have health benefits due to its antioxidant and anti-inflammatory activities. Antioxidants can prevent the effects of oxidative metabolism by scavenging free radicals and decreasing the hyperactivity of platelets associated with the development of occlusive thrombosis. No studies to date have investigated the effects of olive leaf extract on platelet function to our knowledge. Improved understanding of the antioxidant properties of olive leaf extract and its effect on platelet function could lead to improved cardiovascular health. Objective The current study used an olive leaf extract prepared from the Olea europaea L. tree. The aim was to determine if polyphenols in olive leaf extract would reduce platelet activity and, to establish an optimal dose in vitro that would reduce platelet aggregation and ATP release. Design Eleven subjects with normal platelet counts (150–400 x 109/L) were recruited for the current in vitro study. Olive leaf extract was added to citrated whole blood to obtain five concentrations ranging from 5.4 ug/mL to 54.0 ug/mL for a dose response curve. Baseline samples, without olive leaf extract were used as a negative control for each subject. After 2 hours incubation with olive leaf extract samples were analyzed for platelet aggregation and ATP release from platelets stimulated by the addition of collagen. Results Whole blood analysis (n=11) showed a clear dose-dependant reduction in platelet aggregation with the increasing olive leaf extract concentrations (p<0.0001). There was also a similar decrease in ATP release from collagen stimulated platelets (p=0.02). Conclusion In the current study the olive leaf extract obtained from Olea europaea L. inhibited platelet aggregation and ATP release from collagen stimulated platelets in vitro. This study suggests olive leaf extract may prevent occlusive thrombosis by reducing platelet hyperactivity.

Does a 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine prevent respiratory exacerbations in children with recurrent protracted bacterial bronchitis, chronic suppurative lung disease and bronchiectasis : protocol for a randomised controlled trial

Background Recurrent protracted bacterial bronchitis (PBB), chronic suppurative lung disease (CSLD) and bronchiectasis are characterised by a chronic wet cough and are important causes of childhood respiratory morbidity globally. Haemophilus influenzae and Streptococcus pneumoniae are the most commonly associated pathogens. As respiratory exacerbations impair quality of life and may be associated with disease progression, we will determine if the novel 10-valent pneumococcal-Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) reduces exacerbations in these children. Methods A multi-centre, parallel group, double-blind, randomised controlled trial in tertiary paediatric centres from three Australian cities is planned. Two hundred six children aged 18 months to 14 years with recurrent PBB, CSLD or bronchiectasis will be randomised to receive either two doses of PHiD-CV or control meningococcal (ACYW(135)) conjugate vaccine 2 months apart and followed for 12 months after the second vaccine dose. Randomisation will be stratified by site, age (<6 years and >= 6 years) and aetiology (recurrent PBB or CSLD/bronchiectasis). Clinical histories, respiratory status (including spirometry in children aged >= 6 years), nasopharyngeal and saliva swabs, and serum will be collected at baseline and at 2, 3, 8 and 14 months post-enrolment. Local and systemic reactions will be recorded on daily diaries for 7 and 30 days, respectively, following each vaccine dose and serious adverse events monitored throughout the trial. Fortnightly, parental contact will help record respiratory exacerbations. The primary outcome is the incidence of respiratory exacerbations in the 12 months following the second vaccine dose. Secondary outcomes include: nasopharyngeal carriage of H. influenzae and S. pneumoniae vaccine and vaccine-related serotypes; systemic and mucosal immune responses to H. influenzae proteins and S. pneumoniae vaccine and vaccine-related serotypes; impact upon lung function in children aged >= 6 years; and vaccine safety. Discussion As H. influenzae is the most common bacterial pathogen associated with these chronic respiratory diseases in children, a novel pneumococcal conjugate vaccine that also impacts upon H. influenzae and helps prevent respiratory exacerbations would assist clinical management with potential short- and long-term health benefits. Our study will be the first to assess vaccine efficacy targeting H. influenzae in children with recurrent PBB, CSLD and bronchiectasis.

New strategy toward dioxin risk reduction for local residents surrounding severe dioxin hotspots in Vietnam

Background A public health intervention program with active involvement of local related stakeholders was piloted in the Bien Hoa dioxin hot spot (2007-2009), and then expanded to the Da Nang dioxin hot spot in Vietnam (2009-2011). It aimed to reduce the risk of dioxin exposure through foods for local residents. This article presents the results of the intervention in Da Nang. Methodology To assess the results of this intervention program, pre-intervention and post-intervention knowledge-attitude-practice (KAP) surveys were implemented in 400 households, randomly selected from four wards surrounding Da Nang Airbase in 2009 and 2011, respectively. Results After the intervention, the knowledge on the existence of dioxin in food, dioxin exposure pathways, potential high risk foods and preventive measures significantly increased (p < 0.05). 98% were willing to follow advice on preventing dioxin exposure. Practices to reduce the risk of dioxin exposure also statistical significantly improved (p<0.05). After intervention, 60.4% of households undertook exposure preventive measures, significantly higher than that of the pre-intervention survey (39.6%; χ2 =40.15 , P<0.001). High risk foods had quite low rates of daily consumption (from 0% to 2.5%) and were significantly reduced (p<0.05). Conclusions This is seen as an effective intervention strategy toward reducing the risk of human exposure to dioxin at dioxin hot spots. While greater efforts are needed for remediating dioxin polluted areas inside airbases, there is also evidence to suggest that, during the past four decades, pollution has been expanding to the surrounding areas. For this reason, this model should be quickly expanded to the remaining dioxin hot spots in Vietnam to further reduce the exposure risk in these areas.

The baby boomers and beyond report : physical activity levels of older Western Australians 2006

Participation in sufficient levels of physical activity provides significant health benefits, particularly in older adults. The monitoring of physical activity levels in the Western Australian population is therefore necessary for developing and implementing strategies and programs for increasing participation. The Premier’s Physical Activity Taskforce (PATF) conducted a survey in 2006 to measure physical activity levels among Western Australian adults to follow-up the 1999 and 2002 state physical activity surveys. There is now widespread agreement that many health problems of older life – including the onset of frailty and disability – can be postponed or delayed by adopting health-enhancing habits such as physical activity. Adults over 65 years are the most rapidly growing age group and will continue to rise as more persons turn 65. If older adults could be encouraged to be more active as they age, frailty and disability associated with falls would be reduced, and function and physical and mental health in older people would be improved thereby reducing the burden of disease and injury. Given that physical inactivity is one of the most important and modifiable risk factors contributing to ill health, particularly for people as they age, the overall aim of this study was to examine patterns of physical activity in those aged 45 years and over – referred to hereafter as baby boomers+ – in more detail.

Examining correlates of self-reported and objectively measured physical activity among retirement village residents

Aim Physical activity (PA) patterns of retirement village residents were investigated using self-report and objective measures. Methods Residents (n = 323) from retirement villages in Perth, Australia, were surveyed on PA behaviour and various demographic, residency, health-related and mobility factors. Most participants wore accelerometers for 7 days. Retirement village managers (n = 32) were surveyed on village descriptive characteristics, including the provision of amenities and facilities. Logistic regression models examined village and resident characteristics associated with PA. Results Based on objective measurement, only 27.1% of participants were sufficiently active (n = 288). Walking was one of the most popular PA modes. Few village characteristics were associated with PA; however, villages located in more walkable neighbourhoods increased participants’ odds of transport walking. Travelling outside the village daily also increased PA odds. Conclusions Most residents were insufficiently active to gain health benefits. Considering individual and environmental factors, within the retirement village and neighbourhood settings, and associations with PA, warrants attention.

Measurement of energy expenditure of daily tasks among mothers of young children

There is currently some debate about whether the energy expenditure of domestic tasks is sufficient to confer health benefits. The aim of this study was therefore to measure the energy cost of five activities commonly undertaken by mothers of young children. Seven women with at least one child younger than five years of age spent 15 minutes in each of the following activities: sitting quietly, vacuum cleaning, washing windows, walking at moderate pace (approx 5km/hour), walking with a stroller and grocery shopping in a super-market. Each of the six 'trials' was completed on the same day, in random order. A carefully calibrated portable gas analyser was used to measure oxygen uptake during each activity, and data were converted to units of energy expenditure (METS). Vacuum cleaning, washing windows and walking with and without a stroller were found to be 'moderate intensity activities' (3 to 6 METs), but supermarket shopping did not reach this criterion. The MET values for these activities were similar to those reported in the Compendium of Physical Activities (Ainsworth et al., 2000). However, the energy expenditures of walking, both with and without a stroller, were higher than those reported in the Compendium. The findings suggest that some of the tasks associated with domestic caring duties are conducted at an intensity which is sufficient to confer some health benefit. Such benefits will only accrue however if the daily duration of these activities is sufficient to meet current guidelines.

Exercise—promoting healthy lifestyles in children and adolescents

Regular physical activity is an important component of a healthy lifestyle in children and adolescents. However, despite the noted short- and long-term health benefits associated with physical activity, monitoring and surveillance studies show that a significant percentage of children and adolescents fail to meet the recommended guideline of 60 minutes or more of moderate-to-vigorous physical activity daily. This review examines key evidence from the public health and health promotion literature on promotion of health-enhancing physical activity in children and adolescents. We describe best practice in three key behavior settings—schools, homes, and health care settings. In school-based settings, it has been shown that physical education programs can be modified to increase the percentage of class time engaged in moderate-to-vigorous physical activity. In the home setting, there is evidence that teaching parents to establish and monitor physical activity goals and provide appropriate rewards for meeting these goals results in gains in physical activity and/or physical fitness. In health care settings, evidence from two studies suggests that physician-based counseling coupled with stage appropriate written materials can be effective among adolescent youth.

Why we should not cut P.E.

Thinking of cutting physical education? Think again. Even as we bemoan children's sedentary lifestyles, we often sacrifice school-based physical education in the name of providing more time for academics. In 2006, only 3.8 percent of elementary schools, 7.9 percent of middle schools, and 2.1 percent of high schools offered students daily physical education or its equivalent for the entire school year (Lee, Burgeson, Fulton, & Spain, 2007). We believe this marked reduction in school-based physical activity risks students' health and can't be justified on educational or ethical grounds. We'll get to the educational grounds in a moment. As to ethical reasons for keeping physical activity part of our young people's school days, consider the fact that childhood obesity is now one of the most serious health issues facing U.S. children (Ogden et al., 2006). School-based physical education programs engage students in regular physical activity and help them acquire skills and habits necessary to pursue an active lifestyle. Such programs are directly relevant to preventing obesity. Yet they are increasingly on the chopping block.

10,000 steps Rockhampton: a whole community approach to increasing levels of physical activity

10,000 Steps Rockhampton is a multi-strategy health promotion program which aims to develop sustainable community-based strategies to increase physical activity.The central coordinating focus of the project is the use of pedometers to raise awareness of and provide motivation for physical activity, around the theme of '10,000 steps/day - Every step counts.' To date, five key strategies have been implemented: (1) a media-based awareness raising campaign; (2) promotion of physical activity by health professionals; (3) improving social support for physical activity through group-based programs; (4) working with local council to improve environmental support for physical activity, and; (5) establishment of a ‘micro-grants’ fund to which community groups could apply for assistance with small, innovative physical activity enhancing projects. Strategies were introduced on a rolling basis beginning in February 2002 with 'layering' of interventions designed to address the multi-level individual social and environmental determinants of physical activity. The project was quasi-experimental in design, involving collection of baseline and two year follow-up data from community based surveys in Rockhampton and in a matched regional Queensland town. In August 2001,the baseline CATI survey (N=1281)found that 47.9% of men and 33.0% of women were meeting the national guidelines for physical activity. In August 2002, a smaller survey (N=400) found an increase in activity levels among women (39.7% active) but not in men (48.5%). Data from the two year follow up survey, to be conducted in August 2003, will be presented, with discussion of the major successes and challenges of this landmark physical activity intervention. Acknowledgement: This project is supported by a grant from Health Promotion Queensland

Estimating local stream fish assemblage attributes: Sampling effort and efficiency at two spatial scales

As part of a wider study to develop an ecosystem-health monitoring program for wadeable streams of south-eastern Queensland, Australia, comparisons were made regarding the accuracy, precision and relative efficiency of single-pass backpack electrofishing and multiple-pass electrofishing plus supplementary seine netting to quantify fish assemblage attributes at two spatial scales (within discrete mesohabitat units and within stream reaches consisting of multiple mesohabitat units). The results demonstrate that multiple-pass electrofishing plus seine netting provide more accurate and precise estimates of fish species richness, assemblage composition and species relative abundances in comparison to single-pass electrofishing alone, and that intensive sampling of three mesohabitat units (equivalent to a riffle-run-pool sequence) is a more efficient sampling strategy to estimate reach-scale assemblage attributes than less intensive sampling over larger spatial scales. This intensive sampling protocol was sufficiently sensitive that relatively small differences in assemblage attributes (<20%) could be detected with a high statistical power (1-β > 0.95) and that relatively few stream reaches (<4) need be sampled to accurately estimate assemblage attributes close to the true population means. The merits and potential drawbacks of the intensive sampling strategy are discussed, and it is deemed to be suitable for a range of monitoring and bioassessment objectives.

Spatial prediction on a river network

This article develops methods for spatially predicting daily change of dissolved oxygen (Dochange) at both sampled locations (134 freshwater sites in 2002 and 2003) and other locations of interest throughout a river network in South East Queensland, Australia. In order to deal with the relative sparseness of the monitoring locations in comparison to the number of locations where one might want to make predictions, we make a classification of the river and stream locations. We then implement optimal spatial prediction (ordinary and constrained kriging) from geostatistics. Because of their directed-tree structure, rivers and streams offer special challenges. A complete approach to spatial prediction on a river network is given, with special attention paid to environmental exceedances. The methodology is used to produce a map of Dochange predictions for 2003. Dochange is one of the variables measured as part of the Ecosystem Health Monitoring Program conducted within the Moreton Bay Waterways and Catchments Partnership.

The cost-effectiveness of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer

Objective To summarise how costs and health benefits will change with the adoption of total laparoscopic hysterectomy compared to total abdominal hysterectomy for the treatment of early stage endometrial cancer. Design Cost-effectiveness modelling using the information from a randomised controlled trial. Participants Two hypothetical modelled cohorts of 1000 individuals undergoing total laparoscopic hysterectomy and total abdominal hysterectomy. Outcome measures Surgery costs; hospital bed days used; total healthcare costs; quality-adjusted life years; and net monetary benefits. Results For 1000 individuals receiving total laparoscopic hysterectomy surgery, the costs were $509 575 higher, 3548 hospital fewer bed days were used and total health services costs were reduced by $3 746 221. There were 39.13 more quality-adjusted life years for a 5 year period following surgery. Conclusions The adoption of total laparoscopic hysterectomy is almost certainly a good decision for health services policy makers. There is 100% probability that it will be cost saving to health services, a 86.8% probability that it will increase health benefits and a 99.5% chance that it returns net monetary benefits greater than zero.

In Response: "Oral versus IV treatment for catheter-related bloodstream infections - by Burke A. Cunha"

In his letter Cunha suggests that oral antibiotic therapy is safer and less expensive than intravenous therapy via central venous catheters (CVCs) (1). The implication is that costs will fall and increased health benefits will be enjoyed resulting in a gain in efficiency within the healthcare system. CVCs are often used in critically ill patients to deliver antimicrobial therapy, but expose patients to a risk of catheter-related bloodstream infection (CRBSI). Our current knowledge about the efficiency (i.e. costeffectiveness) of allocating resources toward interventions that prevent CRBSI in patients requiring a CVC has already been reviewed (2). If for some patient groups antimicrobial therapy can be delivered orally, instead of through a CVC, then the costs and benefits of this alternate strategy should be evaluated...