Screen-time weight-loss intervention targeting children at home (SWITCH): a randomized controlled trial

BACKGROUND: Screen-based activities, such as watching television (TV), playing video games, and using computers, are common sedentary behaviors among young people and have been linked with increased energy intake and overweight. Previous home-based sedentary behaviour interventions have been limited by focusing primarily on the child, small sample sizes, and short follow-up periods. The SWITCH (Screen-Time Weight-loss Intervention Targeting Children at Home) study aimed to determine the effect of a home-based, family-delivered intervention to reduce screen-based sedentary behaviour on body composition, sedentary behaviour, physical activity, and diet over 24 weeks in overweight and obese children.

METHODS: A two-arm, parallel, randomized controlled trial was conducted. Children and their primary caregiver living in Auckland, New Zealand were recruited via schools, community centres, and word of mouth. The intervention, delivered over 20 weeks, consisted of a face-to-face meeting with the parent/caregiver and the child to deliver intervention content, which focused on training and educating them to use a wide range of strategies designed to reduce their child's screen time. Families were given Time Machine TV monitoring devices to assist with allocating screen time, activity packages to promote alternative activities, online support via a website, and monthly newsletters. Control participants were given the intervention material on completion of follow-up. The primary outcome was change in children's BMI z-score from baseline to 24 weeks.

RESULTS: Children (n = 251) aged 9-12 years and their primary caregiver were randomized to receive the SWITCH intervention (n = 127) or no intervention (controls; n = 124). There was no significant difference in change of zBMI between the intervention and control groups, although a favorable trend was observed (-0.016; 95% CI: -0.084, 0.051; p = 0.64). There were also no significant differences on secondary outcomes, except for a trend towards increased children's moderate intensity physical activity in the intervention group (24.3 min/d; 95% CI: -0.94, 49.51; p = 0.06).

CONCLUSIONS: A home-based, family-delivered intervention to reduce all leisure-time screen use had no significant effect on screen-time or on BMI at 24 weeks in overweight and obese children aged 9-12 years.

The non-advertising effects of screen-based sedentary activities on acute eating behaviours in children, adolescents, and young adults. A systematic review.

Sedentary screen time may be an important determinant of childhood obesity. A number of potential mechanisms to explain the link between screen time and increased bodyweight have been proposed; however, the relationship appears to be best explained by the effects on dietary intake, which is attributed to either food advertising or effects independent of food advertising. Technological advances have allowed for greater accessibility and exposure to advertisement-free screen-based media. This review was conducted to systematically synthesise the evidence from laboratory based studies which have investigated the non-advertising effects of screen time (TV viewing, sedentary video games, and computer use) on dietary intake in children, adolescents, and young adults. MEDLINE, PubMed, PsychInfo, CINAHL, and Embase were searched from inception through 5 July 2013. Ten trials met the inclusion criteria and were included in the review. Risk of study bias was judged to range from low to high. Screen time in the absence of food advertising was consistently found to be associated with increased dietary intake compared with non-screen behaviours. Suggested explanations for this relationship included: distraction, interruption of physiologic food regulation, screen time as a conditioned cue to eat, disruption of memory formation, and the effects of the stress-induced reward system. Due to the limited number of high-quality studies available for this review, our findings are preliminary. More work is required to better establish the link between dietary intake and advertisement-free screen time and assess whether differences exist between the different screen-based activities.

Screen-time weight-loss intervention targeting children at home (SWITCH): a randomized controlled trial study protocol

BACKGROUND: Approximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33%) do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet.

METHODS/DESIGN: The study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention) or control (no change). At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI) and standardized body mass index (zBMI). Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity.

DISCUSSION: This study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous), Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight management programs..

A syntenic cross species aneuploidy genetic screen links RCAN1 expression to β-cell mitochondrial dysfunction in Type 2 diabetes

Type 2 diabetes (T2D) is a complex metabolic disease associated with obesity, insulin resistance and hypoinsulinemia due to pancreatic β-cell dysfunction. Reduced mitochondrial function is thought to be central to β-cell dysfunction. Mitochondrial dysfunction and reduced insulin secretion are also observed in β-cells of humans with the most common human genetic disorder, Down syndrome (DS, Trisomy 21). To identify regions of chromosome 21 that may be associated with perturbed glucose homeostasis we profiled the glycaemic status of different DS mouse models. The Ts65Dn and Dp16 DS mouse lines were hyperglycemic, while Tc1 and Ts1Rhr mice were not, providing us with a region of chromosome 21 containing genes that cause hyperglycemia. We then examined whether any of these genes were upregulated in a set of ~5,000 gene expression changes we had identified in a large gene expression analysis of human T2D β-cells. This approach produced a single gene, RCAN1, as a candidate gene linking hyperglycemia and functional changes in T2D β-cells. Further investigations demonstrated that RCAN1 methylation is reduced in human T2D islets at multiple sites, correlating with increased expression. RCAN1 protein expression was also increased in db/db mouse islets and in human and mouse islets exposed to high glucose. Mice overexpressing RCAN1 had reduced in vivo glucose-stimulated insulin secretion and their β-cells displayed mitochondrial dysfunction including hyperpolarised membrane potential, reduced oxidative phosphorylation and low ATP production. This lack of β-cell ATP had functional consequences by negatively affecting both glucose-stimulated membrane depolarisation and ATP-dependent insulin granule exocytosis. Thus, from amongst the myriad of gene expression changes occurring in T2D β-cells where we had little knowledge of which changes cause β-cell dysfunction, we applied a trisomy 21 screening approach which linked RCAN1 to β-cell mitochondrial dysfunction in T2D.

Modern screen-use behaviors: the effects of single- and multi-screen use on energy intake

PURPOSE: The effects of using multiple screens at once on energy intake (EI) are unknown. This study compared EI of participants with access to multiple screens (television + iPad + smartphone) versus a single screen (television). METHODS: A laboratory-based, randomized, two-arm parallel (multi-screen vs. single-screen) trial was conducted in 78 adolescents (ages, 13-18 years). Food and drink were available during a 1-hour exposure period. Total EI was the primary outcome. Linear regression analyses were conducted to test the treatment difference, adjusting for age, sex, body mass index, and appetite at baseline. RESULTS: Total EI did not differ significantly between the two groups (multi-screen, 758 kcal [standard error = 75] vs. single-screen, 681 kcal [standard error = 75]; difference, +77 kcal; 95% confidence interval, -166 to +320). CONCLUSIONS: EI did not differ between adolescents with access to multiple screens and those with access to a single screen; however, limitations in the study design may have decreased the power of the study.

Women and the silent screen VII

In 2013 I was convenor (with Jeanette Hoorn) of a now well-established academic event, the Viith International Women and the Silent Screen conference. This provided a forum where researchers explored the significance of gender and early cinema in all its facets. Rather than a specialist forum within a broader disciplinary field, the conference offered an opportunity to present research that reframed the significance of gender in early cinema. I also programmed the film screenings, introduced these to audiences, and provided the opening and closing remarks on the conference.

Try walking in my shoes: empathy and portrayals of mental illness on screen

How is mental illness represented in film and television? What emotions are elicited from the viewer? How have these portrayals changed over time? And what are the implications of these portrayals for mental health awareness in the community?This interdisciplinary symposium brings together academics, filmmakers, mental health practitioners and consumers to explore these and other questions concerning the portrayal of mental illness on screen. Across two days of screenings, lectures, panels and workshops, we will discuss a range of representations of mental illness, from early cinema to Hollywood studio films, from ethnographic documentaries to television programs. The symposium has a particular focus on women’s mental health and the portrayal of mental illness in Australian films.A key theme of the symposium is the emotion of empathy. If sympathy suggests feeling for someone (that is, feeling sorry for them), empathy is distinguished by feeling with them. This sharing of emotion gives us valuable insight into how things are with another person. This insight can lead to a greater understanding that reduces stigma and discrimination, and helps us to see ‘the other’ as an equal human being. That is why empathy is such an important concept in philosophy, politics, psychology and human rights education.Cinema and television are powerful media that can take the audience on an imaginative journey and tap into our potential to empathise with another human being. Our speakers will examine the ways in which the viewer’s empathy is elicited (or not) by these screen portrayals of mental illness, as well as the benefits and limitations of an empathetic relationship between viewer and character. In this way, the symposium contributes to the broader discussion initiated by the ARC Centre of Excellence for the History of Emotions about the ways in which emotions shape individual, community and national identities.We welcome discussion of these issues from all participants – both speakers and audience members – and we look forward to a dialogue that is open-minded and sensitive to all involved. We hope this will be the start of many more conversations on this important issue that affects us all.

Screen Time Weight-loss Intervention Targeting Children at Home (SWITCH): process evaluation of a randomised controlled trial intervention.

BACKGROUND: The Screen Time Weight-loss Intervention Targeting Children at Home (SWITCH) trial tested a family intervention to reduce screen-based sedentary behaviour in overweight children. The trial found no significant effect of the intervention on children's screen-based sedentary behaviour. To explore these null findings, we conducted a pre-planned process evaluation, focussing on intervention delivery and uptake. METHODS: SWITCH was a randomised controlled trial of a 6-month family intervention to reduce screen time in overweight children aged 9-12 years (n = 251). Community workers met with each child's primary caregiver to deliver the intervention content. Community workers underwent standard training and were monitored once by a member of the research team to assess intervention delivery. The primary caregiver implemented the intervention with their child, and self-reported intervention use at 3 and 6 months. An exploratory analysis determined whether child outcomes at 6 months varied by primary caregiver use of the intervention. RESULTS: Monitoring indicated that community workers delivered all core intervention components to primary caregivers. However, two thirds of primary caregivers reported using any intervention component "sometimes" or less frequently at both time points, suggesting that intervention uptake was poor. Additionally, analyses indicated no effect of primary caregiver intervention use on child outcomes at 6 months, suggesting the intervention itself lacked efficacy. CONCLUSIONS: Poor uptake, and the efficacy of the intervention itself, may have played a role in the null findings of the SWITCH trial on health behaviour and body composition. TRIAL REGISTRATION: The trial was registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12611000164998 ); registration date: 10/02/2011.

New insights into the mechanism of low-temperature active-screen plasma nitriding of austenitic stainless steel

Low-temperature active-screen plasma nitriding is an effective surface engineering technology to improve the wear and corrosion resistance of austenitic stainless steel through the formation of expanded austenite. The material sputtered from the active screen and redeposited on the specimens has been suggested to play an important role in the nitriding mechanism involved. This paper reports a patterned deposition layer, which is in correlation with the grain orientation of polycrystalline specimens. This has provided new insights into the nitriding mechanism. © 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Dry sliding wear of active screen plasma carburised austenitic stainless steel

Low temperature diffusion treatments with nitrogen and carbon have been widely used to increase the tribological performance of austenitic stainless steels. These processes produce a layer of supersaturated austenite, usually called expanded austenite or S-phase, which exhibits good corrosion and wear resistance. The novel active screen technology is said to provide benefits over the conventional DC plasma technology. The improvements result from the reduction in the electric potential applied to the treated components, and the elimination of such defects and processing instabilities as edge effects, hollow cathode effects and arcing. In this study, AISI 316 coupon samples were plasma carburised in DC and active screen plasma furnaces. The respective layers of carbon expanded austenite were characterised and their tribological performance was studied and compared. Detailed post-test examinations included SEM observations of the wear tracks and of the wear debris, EDX mapping of the wear track, EBSD crystal orientation mapping of the cross sections of the wear tracks, and cross-sectional TEM. Based on the results of wear tests and post-test examinations, the wear mechanisms involved are discussed.

Corrosion behaviour of direct current and active screen plasma carburised AISI 316 stainless steel in boiling sulphuric acid solutions

Active screen plasma is a recently developed plasma surface alloying technique, which has shown potential for addressing some drawbacks associated with conventional direct current plasma processes. In this study, the corrosion performance of untreated, direct current and active screen plasma carburised AISI 316 was investigated by immersion in a boiling solution of sulphuric acid. The experimental results show that the corrosion behaviour of expanded austenite produced by low temperature plasma carburising is controlled by the type and density of surface defects; the corrosion properties of the active screen plasma carburised material are superior to that produced by direct current plasma because of the significantly reduced edge effect and surface defects; and the bias level used in the active screen carburising treatment has a profound effect on the corrosion performance of the material. Based on the experimental results, the corrosion mechanisms involved are discussed.

On the fundamental mechanisms of active screen plasma nitriding

The nitriding mechanisms of conventional DC plasma treatments have been extensively studied and discussed, but no general agreement has been reached thus far. The sputtering and redeposition theory is among the most accepted ones but, even though this mechanism is feasible, its contribution to the nitriding effect is under question. Furthermore, the novel active screen plasma nitriding technique has been successful in treating samples left at floating potential, where sputtering can not be considered to play a major role. Therefore, it has been proposed that the material sputtered from the cathodic mesh of the active screen furnace (auxiliary cathode) and deposited onto the treated specimens is involved in the mass transfer of nitrogen. The contribution made by this transferred material is the focus of attention of the present study. The hardening effect on the treated specimens showed considerable correlation with the deposition layer, and the XRD analysis of this deposited material yielded possible FeN and FexN peaks. This finding supports the deposition of iron nitrides and their subsequent decomposition on the treated substrate as a mechanism of significance to the plasma nitriding treatments conducted in active screen experimental settings.

Study of active screen plasma processing conditions for carburising and nitriding austenitic stainless steel

Active screen (AS) is an advanced technology for plasma surface engineering, which offers some advantages over conventional direct current (DC) plasma treatments. Such surface defects and process instabilities as arcing, edge and hollow cathode effects can be minimised or completely eliminated by the AS technique, with consequent improvements in surface quality and material properties. However, the lack of information and thorough understanding of the process mechanisms generate scepticism in industrial practitioners. In this project, AISI 316 specimens were plasma carburised and plasma nitrided at low temperature in AS and DC furnaces, and the treated samples were comparatively analysed. Two diagnostic techniques were used to study the plasma: optical fibre assisted optical emission spectroscopy, and a planar electrostatic probe. Optimum windows of treatment conditions for AS plasma nitriding and AS plasma carburising of austenitic stainless steel were identified and some evidence was obtained on the working principles of AS furnaces. These include the sputtering of material from the cathodic mesh and its deposition on the worktable, the generation of additional active species, and the electrostatic confinement of the plasma within the operative volume of the furnace.