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Background: The ActiPASS software was developed from the open-source Acti4 activity classification algorithm for thigh-worn accelerometry. However, the original algorithm has not been validated in children or compared with a child-specific set of algorithm thresholds. This study aims to evaluate the accuracy of ActiPASS in classifying activity types in children using 2 published sets of Acti4 thresholds. Methods: Laboratory and free-living data from 2 previous studies were used. The laboratory condition included 41 school-aged children (11.0 [4.8] y; 46.5% male), and the free-living condition included 15 children (10.0 [2.6] y; 66.6% male). Participants wore a single accelerometer on the dominant thigh, and annotated video recordings were used as a reference. Postures and activity types were classified with ActiPASS using the original adult thresholds and a child-specific set of thresholds. Results: Using the original adult thresholds, the mean balanced accuracy (95% CI) for the laboratory condition ranged from 0.62 (0.56–0.67) for lying to 0.97 (0.94–0.99) for running. For the free-living condition, accuracy ranged from 0.61 (0.48–0.75) for lying to 0.96 (0.92–0.99) for cycling. Mean balanced accuracy for overall sedentary behavior (sitting and lying) was ≥0.97 (0.95–0.99) across all thresholds and conditions. No meaningful differences were found between the 2 sets of thresholds, except for superior balanced accuracy of the adult thresholds for walking under laboratory conditions. Conclusions: The results indicate that ActiPASS can accurately classify different basic types of physical activity and sedentary behavior in children using thigh-worn accelerometer data. [ABSTRACT FROM AUTHOR]

To understand the environmental determinants of physical activity (PA), precise spatial localization is crucial. This cross-sectional study focuses on the spatiotemporal distribution of PA among Czech adolescents (n = 171) using Global Positioning System loggers and accelerometers. The results showed that adolescents spent most of their time in sedentary behavior, with 57.2% and 58.5% of monitored time at home and school, respectively. The park and playground had the lowest proportion of sedentary behavior but also the lowest amount of moderate to vigorous PA (MVPA). However, when considering the time spent in each domain, the highest proportion of MVPA was seen in publicly accessible playgrounds (13.3% of the time). Chi-square analysis showed that the relative distribution of different PA intensities did not differ across spatial domains. Based on these results, the authors propose 2 key strategies for increasing MVPA in adolescents: Increase the time spent in activity-supportive environments, such as parks and playgrounds, and design techniques to increase MVPA at home and school settings. [ABSTRACT FROM AUTHOR]

Purpose: To describe program characteristics and outcomes of a residential substance use recovery program serving pregnant and parenting women in a rural and urban location. Description: This assessment of administrative records from April 1, 2020 through March 31, 2022, included women in a rural (n = 140) and urban (n = 321) county in Kentucky. Assessment: This retrospective case study used descriptive and non-parametric analyses to assess the population and examine differences between locations, race, and ethnicity for women served. Logistic regression tested predictors of goal achievement by community. Of 461 women served, 65 (14.1%) delivered a baby while in treatment; 62 of which were considered healthy. 13% of the women were Black, 83.1% non-Hispanic (NH) white, and 3.7% were other races/biracial; 1.3% were Hispanic. The mean age was 30.92 years (SD 6.23) and treatment duration was 90.11 days (SD 67.70). Program goals were achieved by 312 (67.7%). There were no differences in rates of goal achievement or treatment duration by race, ethnicity, or age and no difference in the rate of achievement by location in univariate analyses. However, treatment duration was positively associated with program success in both communities. In the urban community, Black women were 8% more likely to successfully complete the program compared to NH white women (OR = 9.77 [95% CI 1.21,79.18; p = 0.033]) after controlling for confounders. Insufficient sample size for non-white women in the rural community prohibited evaluation. Conclusions: Duration of time in the program best predicted successful completion for women in recovery. These findings have policy implications. Significance: Women having difficulties with substance use are typically of childbearing age. Integrated programs are needed to address the multi-factorial needs of these women. Models suggest that optimal care involves services that are co-located or closely aligned. The current evaluation contributes to the literature by examining outcomes for women in recovery. This case study examines client outcomes at a community-based residential treatment program and found evidence that the length of stay was associated with achievement of program goals. Lastly, contrary to previous reports, Black women in an urban community had an 8% greater probability of successful completion compared to white women. [ABSTRACT FROM AUTHOR]

The transition to secondary school can be a challenging period for adolescents. Although several questionnaires exist to measure transition‐related concerns, there is a need to develop a comprehensive survey for assessing the knowledge and skills that adolescents require to adapt effectively to a new school. Thus, the purpose of this study was to develop and investigate the psychometric properties of a preliminary self‐report tool (PSTRS) for identifying the presence or absence of factors that facilitate transition to secondary school and are important for adolescent understanding of well‐being. The PSTRS was developed in a series of stages that involved a systematic review of the school transition literature, a review of psychometric scales, empirical data of adolescents' well‐being conceptualizations, expert reviews, and a pilot study. Seventy‐one items were compiled to collect information on 20 school, social, physical, psychological, and spiritual components. Cronbach's alpha for the survey was 0.943 in a sample of Year 8 NZ intermediate school students (N = 471). Test–retest reliability was 0.866 in a subsample of 121 participants. Single‐measures ICCs of subscales ranged from 0.501 to 0.943. The PC analysis resulted in a three‐component factor structure. The PSTRS and its subscales positively correlated with well‐being and negatively correlated with anxiety. Overall, PSTRS appears to be a reliable and valid tool for determining adolescent readiness to transition to secondary school. PSTRS data may be useful for researchers, school professionals, psychologists, and policymakers to better understand positive school transitions. Implications for future research and practice are discussed. Practitioner points: Data provides preliminary support for the integrity of the new Positive School Transition Readiness Survey, which is a self‐report measure that can be useful for researchers and school professionals to determine adolescent readiness to transition to secondary school.The preliminary self‐report tool (PSTRS) is comprised of several short psychometrically sound subscales that present a quick and convenient way to identify the presence or absence of factors that facilitate transition to secondary school and are important for adolescent understanding of well‐being.The preliminary validation demonstrated good test−retest reliability and construct validity of the PSTRS. [ABSTRACT FROM AUTHOR]

The article focuses on clinical documentation improvement programs discussed at the SONPM Coding Committee's recent workshop and deep dive session at the 2024 Perinatal Practice Strategies meeting. It highlights the importance of accurate documentation in impacting patient care, quality metrics, and revenue cycles, emphasizing strategies such as educational interventions, template utilization, and emerging technologies like artificial intelligence to enhance clinical documentation.

Objective: To describe network structure and alignment across organizations in healthcare, public health, and social services sectors that serve pregnant and parenting women with substance use disorder (SUD) in an urban and a rural community. Data Sources and Study Settings: Two community networks, one urban and one rural with each including a residential substance use treatment program, in Kentucky during 2021. Study Design: Social network analysis measured system collaboration and cross‐sector alignment between healthcare, public health, and social services organizations, applying the Framework for Aligning Sectors. To understand the alignment and structure of each network, we measured network density overall and between sectors, network centralization, and each organization's degree centrality and effective size. Data Collection/Extraction Methods: Computer‐assisted telephone interviews were conducted to document alignment around shared purpose, data, financing, and governance. Principal Findings: On average, overall and cross‐sector network densities in both communities were similar. However, alignment was highest for data sharing and financing in the urban community and for shared purpose and governance in the rural community. Cross‐sector partnerships involving healthcare organizations were more prevalent in the rural county (44% vs. 38% for healthcare/public health, 44% vs. 29% for healthcare/social services), but more prevalent for those involving public health/social services organizations in the urban county (42% vs. 24%). A single healthcare organization had the highest degree centrality (Mdn [IQR] = 26 [26–9.5]) and effective size (Mdn [IQR] = 15.9 [20.6–8.7]) within the rural county. Social services organizations held more central positions in the urban county (degree centrality Mdn [IQR] = 13 [14.8–9.5]; effective size Mdn [IQR] = 10.4 [11.4–7.9]). Conclusions: Cross‐sector alignment may strengthen local capacity for comprehensive SUD care for pregnant and parenting women. Healthcare organizations are key players in cross‐sector partnerships in the rural community, where one healthcare facility holds the central brokerage role. In contrast, public health agencies are key to cross‐sector collaboration with social services in the urban community. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges and importance of medical coding in neonatology. Topics include the role of Common Proficiency Test (CPT) and International Classification of Diseases (ICD)-10 codes in neonatal care, resources available for proper coding and documentation, and upcoming articles aimed at improving coding practices in the field.

Background: Curriculum-integrated dance programs are a promising but relatively under-researched strategy for increasing children's physical activity (PA). The aim of this study was to determine the impact of a curriculum-integrated dance program on children's PA. Methods: A total of 134 primary children aged 7–9 years from 4 New Zealand schools were assigned to either a dance group (n = 78) or a control group (n = 56). The dance group participated in a 6-week curriculum-integrated dance program during school time. Although the dance program focused on curricular learning, fitness and coordination were embedded in the dance sessions. Intensity of PA varied according to the focus of each dance session. PA was measured at baseline and postintervention using a waist-mounted ActiGraph GT3X+ accelerometer for 8 consecutive days. Results: There were no significant intervention effects on PA levels between the dance and control groups postintervention. Conclusion: Dance-embedded learning did not increase overall levels of PA in this study. Future studies may consider assessing longer term effects of a dance-based intervention, or programs that place more focus on PA promotion. [ABSTRACT FROM AUTHOR]

Background: Application of machine learning for classifying human behavior is increasingly common as access to raw accelerometer data improves. The aims of this scoping review are (1) to examine if machine-learning techniques can accurately identify human activity behaviors from raw accelerometer data and (2) to summarize the practical implications of these machinelearning techniques for future work. Methods: Keyword searches were performed in Scopus, Web of Science, and EBSCO databases in 2018. Studies that applied supervised machine-learning techniques to raw accelerometer data and estimated components of physical activity were included. Information on study characteristics, machine-learning techniques, and key study findings were extracted from included studies. Results: Of the 53 studies included in the review, 75% were published in the last 5 years. Most studies predicted postures and activity type, rather than intensity, and were conducted in controlled environments using 1 or 2 devices. The most common models were support vector machine, random forest, and artificial neural network. Overall, classification accuracy ranged from 62% to 99.8%, although nearly 80% of studies achieved an overall accuracy above 85%. Conclusions: Machine-learning algorithms demonstrate good accuracy when predicting physical activity components; however, their application to free-living settings is currently uncertain. [ABSTRACT FROM AUTHOR]

The article offers information on the importance of clinical documentation in successful coding and billing, focusing on its impact on revenue for clinicians and facilities. Topics include the role of documentation in supporting proper ICD-10 diagnosis coding and subsequent CPT coding, as well as its importance in facility billing, particularly in DRG billing.

The article focuses on the challenges neonatologists and healthcare providers face in correctly coding with the International Classification of Diseases, 10 Revision (ICD-10), emphasizing the importance of accurate coding for billing and reimbursement. It addresses common coding errors related to prenatal consultations, attendance at delivery, and NICU admissions.

The auxetic sandwich panels for structures have been designed to provide impact protection. The aim of this work is to modify an auxetic (re-entrant) honeycomb cell to reduce the stress concentrations within the cell structure, and further enhancement of this design. The auxetic structure was filled to achieve a greater energy absorbance and enhance safety applications. Analytical and elastic three-dimensional finite element approaches were used to investigate the structural strength performance. The basic model (i.e. modified re-entrant strut cell design) consisted of the honeycomb auxetic polypropylene (PP) structure sandwiched between two steel plates (known as safety panels) which were placed under static compression loading. The cell geometry and size were then modified to reduce the stress concentration zones. The structure cells were filled with silly putty and polyvinyl chloride (PVC) foam. The effect of the filling the cells on the stress concentration and energy absorbance were analysed using elastic stress and deformation analysis methods. During the stress path analysis, it was found that an increase in Young's modulus of the filling was directly proportional to a decrease in internal stresses. It was concluded that while filling the basic model with soft materials reduced the stress concentration, but it led to a reduction in the energy absorbance capability. Further on, the lower stress produced by the enhanced could be useful to prevent significant penetration of the protective panel. Compared to similar structures of steel, auxetic foam panels have the advantage of having only a fraction of the weight and being corrosion resistant at the same time as keeping impact strength. Graphical abstract [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to examine socio-demographic differences in physical activity (aerobic and muscle-strengthening) among young adults (18–24 years). Methods: Data collected between 2017–2019 as a part of Sport New Zealand's Active NZ survey were examined using logistic regression analyses to determine the odds of participants meeting aerobic, muscle-strengthening and combined physical activity recommendations. Gender, ethnicity, employment/student status, disability status, and socio-economic deprivation were included as explanatory variables in analyses. Results: The proportion of young adults meeting recommendations varied according to physical activity type (aerobic:63.2%; strength:40.1%; combined:37.2%). Young adults not employed/studying had lower odds of meeting recommendations than those full-time employed (OR = 0.43 [0.34–0.54]). Physical activity levels differ according to gender and this intersects with ethnicity, employment/student status, and social deprivation. For example, the odds of Pasifika young adults meeting combined physical activity recommendations compared to Europeans were not different (OR = 0.95 [0.76–1.19]), but when stratified by gender the odds were significantly higher for men (OR = 1.55 [1.11–2.16]) and significantly lower for women (OR = 0.64 [0.47–0.89]. Similarly, young adults in high deprivation areas had lower odds of meeting combined physical activity recommendations than those in low deprivation areas (OR = 0.81 [0.68–0.95]), but this was mainly due to the difference among women (OR = 0.68 [0.54–0.85]) as there was no difference among men (OR = 0.97 [0.76–1.25]). Conclusions: Intersections between socio-demographic characteristics should be considered when promoting physical activity among young adults in Aotearoa New Zealand, particularly young adults not employed/studying, and young women who live in deprived areas or identify as Asian or Pasifika. Tailored approaches according to activity type for each of these groups are required. [ABSTRACT FROM AUTHOR]

This study evaluated the changes in literacy and numeracy levels on schoolchildren across four New Zealand primary schools. A total of 187 schoolchildren aged 8–9 years were assigned to either a dance group (n = 101) or control group (n = 86). The dance group (DG) from each school participated in a six-week, curriculum-integrated dance program with their teacher during school time. Mathematics and reading aptitude were evaluated at baseline and post-intervention timepoints using standardized questionnaires. DG participants shared their perceptions of the dance program through journal reflections and focus group interviews. Intervention effects were assessed using generalized linear models, and children's perceptions of the program were thematically analyzed. The intervention had positive effects on reading for children with special needs and those of Asian descent. Children's reflections suggest that the dance program may have deepened their understanding of mathematics and enhanced their English vocabulary and comprehension. [ABSTRACT FROM AUTHOR]

Early childhood education and care (ECE) type (e.g., center-based care, home-based care, informal care) and quantity (i.e., time spent in ECE) have been linked to observed behavioral challenges in children. However, there is a dearth of research on this association in New Zealand. Using data from 6,536 children from the Growing Up in New Zealand longitudinal birth cohort, the current study investigated whether the type of ECE and weekly hours of attendance at 24 months of age was associated with behavioral outcomes at 54 months. Behavioral outcomes were measured using the Strengths and Difficulties Questionnaire. Research Findings: Compared to children who did not attend ECE, adjusted analyses showed that children in center-based care and children who spent 20 to <30 hours a week in ECE had a lower odds of mother-rated peer challenges at 54 months. Spending 20 to <30 hours a week in ECE was also protective against the development of later mother-rated emotional challenges. Practice or Policy: Future research should investigate whether structural and process quality contributes to the beneficial impact of ECE in New Zealand, particularly center-based care. [ABSTRACT FROM AUTHOR]

Background: The time that children spend in physical activity, sedentary behaviour, and sleep each day (i.e., 24-h time-use behaviours), is related to physical and mental health outcomes. Currently, there is no comprehensive evidence on New Zealand school-aged children's 24-h time-use behaviours, adherence to the New Zealand 24-h Movement Guidelines, and how these vary among different sociodemographic groups. Methods: This study utilises data from the 8-year wave of the Growing Up in New Zealand longitudinal study. Using two Axivity AX3 accelerometers, children's 24-h time-use behaviours were described from two perspectives: activity intensity and activity type. Compositional data analysis techniques were used to explore the differences in 24-h time-use compositions across various sociodemographic groups. Results: Children spent on average, 31.1%, 22.3%, 6.8%, and 39.8% of their time in sedentary, light physical activity, moderate-to-vigorous physical activity, and sleep, respectively. However, the daily distribution of time in different activity types was 33.2% sitting, 10.8% standing, 7.3% walking, 0.4% running, and 48.2% lying. Both the activity intensity and activity type compositions varied across groups of child ethnicity, gender, and household income or deprivation. The proportion of children meeting each of the guidelines was 90% for physical activity, 62.5% for sleep, 16% for screen time, and 10.6% for the combined guidelines. Both gender and residence location (i.e., urban vs. rural) were associated with meeting the physical activity guideline, whereas child ethnicity, mother's education and residence location were associated with meeting the screen time guideline. Child ethnicity and mother's education were also significantly associated with the adherence to the combined 24-h Movement Guidelines. Conclusions: This study provided comprehensive evidence on how New Zealand children engage in 24-h time-use behaviours, adherence to the New Zealand 24-h Movement Guidelines, and how these behaviours differ across key sociodemographic groups. These findings should be considered in designing future interventions for promoting healthy time-use patterns in New Zealand children. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges and complexities of supervising trainees and billing practices in the context of the evolving healthcare environment, where advanced practice providers (APPs) are increasingly involved in patient care. It discusses scenarios involving attending physicians, trainees, and APPs, emphasizing the importance of understanding the correct billing procedures and documentation based on guidelines such as the Physician at Teaching Hospitals (PATH) guidelines.

The article focuses on the use of add-on codes in neonatology for procedures and services that require additional work beyond what is included in the global intensive care and critical care codes. It highlights common procedures in neonatology that are not bundled into the global codes, such as thoracentesis, thoracostomy and circumcision. It also emphasizes the need for neonatologists to use add-on codes in specific situations where the work involved exceeds the standard critical care codes.

Background: In this article, we report the grades for the second New Zealand Report Card on Physical Activity for Children and Youth, which represents a synthesis of available New Zealand evidence across 9 core indicators. Methods: An expert panel of physical activity (PA) researchers collated and reviewed available nationally representative survey data between March and May 2016. In the absence of new data, (2014-2016) regional level data were used to inform the direction of existing grades. Grades were assigned based on the percentage of children and youth meeting each indicator: A is 81% to 100%; B is 61% to 80%; C is 41% to 60%, D is 21% to 40%; F is 0% to 20%; INC is Incomplete data. Results: Overall PA, Active Play, and Government Initiatives were graded B-; Community Environments was graded B; Sport Participation and School Environment received a C+; Sedentary Behaviors and Family/Peer Support were graded C; and Active Travel was graded C-. Conclusions: Overall PA participation was satisfactory for young children but not for youth. The grade for PA decreased slightly from the 2014 report card; however, there was an improvement in grades for built and school environments, which may support regional and national-level initiatives for promoting PA. [ABSTRACT FROM AUTHOR]

Background: Physical activity level is an important tool to identify individuals predisposed to developing chronic diseases, which represent a major concern worldwide. Objective: To identify correlates of daily step counts measured using pedometers, as well as analyze the associations between health outcomes and 3 different amounts of daily physical activity. Methods: The sample comprised 278 participants (126 men and 153 women) with a mean age of 46.51 ± 9.02 years. Physical activity was assessed using pedometers for 7 consecutive days, and 3 amounts of daily physical activity were considered: ≥10,000 steps/day, ≥7500 steps/day, and <5000 steps/day. Sleep quality was assessed through a questionnaire, and dual-energy x-ray absorptiometry was used to measure body fat. Sociodemographic and anthropometric data were also collected. Results: The percentages of adults achieving at least 10,000 and 7500 steps/day on a minimum of 5 days of the evaluated week were 12.9% and 30.9%, respectively. Adults who reached ≥7500 steps/day had a lower likelihood of being obese (odds ratio [OR] = 0.38, 95% confidence interval [CI], 0.17-0.85) and reporting worse sleep quality (OR = 0.58, 95% CI, 0.34-0.99). Adults who reached <5000 steps/day had a higher likelihood of reporting worse sleep quality (OR = 2.11, 95% CI, 1.17-3.82). Conclusion: Physical activity in adulthood, as measured by pedometer, constituted a behavior related to lower adiposity and better sleep quality. [ABSTRACT FROM AUTHOR]

Background: The distance between home and school is the most consistent predictor of active transport in youth: the closer an individual lives to school, the more likely they are to use active transport. While this suggests that it is preferable to live as close to school as possible, the limited physical activity accumulated during short trips may not offer substantial benefits to active transporters. Methods: The current study investigated the predicted physical activity benefits associated with a range of home-school distances in 595 young people aged 5 to 16 years (Years 1 to 11). Physical activity was measured using sealed pedometers over 7 days. Participants' home addresses and usual transport mode to and from school were collected via a questionnaire completed by parents (Years 1 to 6) and participants (Years 7 to 11). Results: A nonlinear relationship between predicted weekday activity and distance was detected, such that the high probability of active transport at short distances was offset by the low physical activity associated with walking short distances. Conclusions: A distance of approximately 2 km was associated with the best physical activity outcomes related to active transport (9% to 15% increase on weekdays). These findings have potential implications for future interventions and for planning residential developments or facilities. [ABSTRACT FROM AUTHOR]

The article reports that the Current Procedural Terminology codes are updated annually as providers must be knowledgeable about changes that affect their billing practices. Topics include considered the American Medical Association updated guidelines for CPT® Evaluation and Management codes effective January 1, 2023 for both inpatient and outpatient consultation to decrease documentation burden irrelevant to patient care and reduce provider burn out.

The article presents results from New Zealand's 2018 Report Card on Physical Activity for Children and Youth. It mentions indicators on the basis of which grades are assigned including organized sport participation, active transportation, and sedentary behavior. The report card suggests that future initiatives should consider opportunities to build on the existing support systems and develop effective interventions to encourage PA, active transportation, and active play.

Face coverings are a key component of preventive health measure strategies to mitigate the spread of respiratory illnesses. In this study five groups of masks were investigated that are of particular relevance to the SARS-CoV-2 pandemic: re-usable, fabric two-layer and multi-layer masks, disposable procedure/surgical masks, KN95 and N95 filtering facepiece respirators. Experimental work focussed on the particle penetration through mask materials as a function of particle diameter, and the total inward leakage protection performance of the mask system. Geometric mean fabric protection factors varied from 1.78 to 144.5 for the fabric two-layer and KN95 materials, corresponding to overall filtration efficiencies of 43.8% and 99.3% using a flow rate of 17 L/min, equivalent to a breathing expiration rate for a person in a sedentary or standing position conversing with another individual. Geometric mean total inward leakage protection factors for the 2-layer, multi-layer and procedure masks were <2.3, while 6.2 was achieved for the KN95 masks. The highest values were measured for the N95 group at 165.7. Mask performance is dominated by face seal leakage. Despite the additional filtering layers added to cloth masks, and the higher filtration efficiency of the materials used in disposable procedure and KN95 masks, the total inward leakage protection factor was only marginally improved. N95 FFRs were the only mask group investigated that provided not only high filtration efficiency but high total inward leakage protection, and remain the best option to protect individuals from exposure to aerosol in high risk settings. The Mask Quality Factor and total inward leakage performance are very useful to determine the best options for masking. However, it is highly recommended that testing is undertaken on prospective products, or guidance is sought from impartial authorities, to confirm they meet any implied standards. [ABSTRACT FROM AUTHOR]

The article discusses how regulating donor milk will protect infant health, and shares insights on severe gaps in child food and nutrition. Topics include neonatologist and advanced practice provider (APP) should be aware of known maternal-fetal conditions impacting the delivery; and care provider should perform a focused physical examination of the infant prior to disposition and admission to the newborn nursery or Neonatal Intensive Care Unit (NICU).

The article discusses the parallels between football strategies and healthcare management, emphasizing the importance of collaborative planning for optimal patient care. Topics include establishing care plans for complex patients through interdisciplinary team conferences, highlighting the significance of effective communication and coordination among healthcare providers.

The article discusses the common structure for songwriters and relate it to Current Procedure Terminology. Topics include the three-code structure for reporting services or procedures and devices and drugs required for services or procedures; temporary codes for emerging technology, services, or procedures, and physician payment system or resource based relative value scale (RBRVS) is structured on the principle that physician payments should vary with the costs of resources.

Introduction: Accelerometers are commonly used to assess time-use behaviors related to physical activity, sedentary behavior, and sleep; however, as new accelerometer technologies emerge, it is important to ensure consistency with previous devices. This study aimed to evaluate the concurrent validity of the commonly used accelerometer, ActiGraph GT3X+, and the relatively new Axivity AX3 (fastened to the lower back) for detecting physical activity intensity and body postures when using direct observation as the criterion measure. Methods: A total of 41 children (aged 6-16 years) and 33 adults (aged 28-59 years) wore both monitors concurrently while performing 10 prescribed activities under laboratory conditions. The GT3X+ data were categorized into different physical activity intensity and posture categories using intensity-based cut points and ActiGraph proprietary inclinometer algorithms, respectively. The AX3 data were first converted to ActiGraph counts before being categorized into different physical activity intensity categories, while activity recognition models were used to detect the target postures. Sensitivity, specificity, and the balanced accuracy for intensity and posture category classification were calculated for each accelerometer. Differences in balanced accuracy between the devices and between children and adults were also calculated. Results: Both accelerometers obtained 74-96% balanced accuracy, with the AX3 performing slightly better (~4% higher, p < .01) for detecting postures and physical activity intensity. Error in both devices was greatest when contrasting sitting/standing, sedentary/light intensity, and moderate/light intensity. Conclusion: In comparison with the GT3X+ accelerometer, AX3 was able to detect various postures and activity intensities with slightly higher balanced accuracy in children and adults. [ABSTRACT FROM AUTHOR]

Aim: This systematic review evaluates the current evidence for the use of probiotics in the prevention of acute otitis media (AOM) in children. Methods: This study is registered with PROSPERO prior to commencement. PubMed, MEDLINE, EMBASE and Cochrane database were searched using relating keywords. All literature was screened to determine relatability to the topic. Review articles were also screened for additional literature. Results: Thirteen studies were found on probiotics and their role in preventing AOM in children. They ranged in quality from poor to moderate. Half (2/4) of the studies that used nasal probiotic formulations showed a significant difference in reducing otitis media, while only a third (3/9) of the studies using oral formulations suggest benefit in reducing AOM. None of the studies demonstrated significant adverse effects from probiotics. Conclusion: The evidence for any effect of probiotics on the prevention of AOM is limited, and the overall low quality of studies makes it difficult to draw definitive conclusions. No serious adverse events were noted, and there is some evidence to suggest possible benefit with nasal probiotic administration. [ABSTRACT FROM AUTHOR]

Most respirators employed in health care settings, and often in first responder and industrial settings, are intended for single-use: the user dons the respirator, performs a work activity, and then doffs and discards the respirator. However, in the current COVID-19 pandemic, in the presence of persistent shortages of personal protective equipment, extended use and reuse of filtering facepiece respirators are routinely contemplated by many health care organizations. Further, there is considerable current effort to understand the effect of sterilization on the possibility of reuse, and some investigations of performance have been conducted. While the ability of such a respirator to continue to provide effective protection after repeated sanitization cycles is a critical component of implementing its reuse, of equal importance is an understanding of the impact that reusing the respirator multiple times in a day while performing work tasks, and even extending its wear over multiple days, has on the workplace protective performance. In this study, we subjected a stockpiled quantitatively fitted surgical style N95 filtering facepiece respirator device to extreme reuse and extended wear conditions (up to 19 uses over a duration of 5 days) and measured its protective performance at regular intervals, including simulated workplace protection factor measurements using total inward leakage. With this respirator, it was shown to be possible to maintain protection corresponding to an assigned protection factor greater than 10 under extreme usage conditions provided an individual is properly trained in the use of, and expertly fitted in, the respirator. Other factors such as hygiene and strap breakage are likely to place limits on reuse. [ABSTRACT FROM AUTHOR]

This paper explains the design, development and delivery of a curriculum-integrated dance programme across four primary schools in Auckland, New Zealand. Four teachers and their respective classes (101 children in total) were part of the programme. Each class participated in 18 dance sessions at their schools during school hours. The dance educator delivered the dance programme and collaborated with each class teacher for planning and implementation. Various topics related to science, mathematics, English and Māori culture were covered in accordance with the term focus of each class teacher. The core values from the New Zealand primary school curriculum and New Zealand arts curriculum were embedded in the dance programme. The applicability, transferability (to other participant groups), challenges (such as time and venue) and evaluation design associated with the dance programme are discussed. Teachers' reflections are embedded with researcher observations as they describe the significance of the dance programme. [ABSTRACT FROM AUTHOR]

Background: Aims were to investigate sex, ethnicity, and age differences in achieving daily step count and television (TV) watching recommendations in schoolchildren. Methods: Participants were 615 children (n = 325) and adolescents (n = 290) aged 5 to 16 years. Activity was assessed over 5 days using pedometers; TV time was collected via parental proxy-report and self-report. Ethnic, sex, and age differences in step counts, TV time, and odds of meeting TV and step count recommendations were examined for weekdays, weekend days, and overall using generalized estimation equation modeling. Results: Overall, girls were more active than boys (P < .001). Adolescents were more active than children (P = .044), watched more TV (P = .005), and were less likely to meet TV watching recommendations (P = .004). Non-European children watched significantly more TV (P = .008), and were significantly less likely to meet TV recommendations than non-European children (P - .001). Participants watched more TV and accumulated less steps on weekend days than weekdays. Conclusions: Multifaceted interventions focusing on both increasing activity and decreasing TV time are needed, especially on weekends. Children and girls may benefit more from activity interventions, while ethnic-specific interventions focusing on TV habits may be most efficacious for adolescents. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the convergent validity of a new piezoelectric pedometer and an omnidirectional accelerometer for assessing children's time spent in moderate to vigorous physical activity (MVPA). A total of 114 children (51 boys, 63 girls) aged 5-11 years wore a sealed NL-1000 piezoelectric pedometer (New Lifestyles Inc, Lee's Summit, MO) and an Actical accelerometer (Mini Mitter, Bend, OR) over one school day. The NL-1000 pedometers were randomized to one of two manual intensity thresholds used to define MVPA (1): Level 3 = 2.9 metabolic equivalent test (MET) and (2) Level 4 = 3.6 MET. Compared with the Actical, the NL-1000 underestimated the time spent in MVPA by 37% and 45% at intensity levels 3 and 4, respectively. In addition, the 95% limits of agreement were wide at both intensity levels (level 3 = -144%, 70%; level 4 = -135%, 45%), indicating a low level of precision. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the convergent validity of a new piezoelectric pedometer and an omnidirectional accelerometer for assessing children's time spent in moderate to vigorous physical activity (MVPA). A total of 114 children (51 boys, 63 girls) aged 5-11 years wore a sealed NL-1000 piezoelectric pedometer (New Lifestyles Inc, Lee's Summit, MO) and an Actical accelerometer (Mini Mitter, Bend, OR) over one school day. The NL-1000 pedometers were randomized to one of two manual intensity thresholds used to define MVPA (1): Level 3 = 2.9 metabolic equivalent test (MET) and (2) Level 4 = 3.6 MET. Compared with the Actical, the NL-1000 underestimated the time spent in MVPA by 37% and 45% at intensity levels 3 and 4, respectively. In addition, the 95% limits of agreement were wide at both intensity levels (level 3 = -144%, 70%; level 4 = -135%, 45%), indicating a low level of precision. [ABSTRACT FROM AUTHOR]

Background: Global positioning systems (GPS), geographic information systems (GIS), and accelerometers are powerful tools to explain activity within a built environment, yet little integration of these tools has taken place. This study aimed to assess the feasibility of combining GPS, GIS, and accelerometry to understand transport-related physical activity (TPA) in adults. Methods: Forty adults wore an accelerometer and portable GPS unit over 7 consecutive days and completed a demographics questionnaire and 7-day travel log. Accelerometer and GPS data were extracted for commutes to/from workplace and integrated into a GIS database. GIS maps were generated to visually explore physical activity intensity, GPS speeds and routes traveled. Results: GPS, accelerometer, and survey data were collected for 37 participants. Loss of GPS data was substantial due to a range of methodological issues, such as low battery life, signal drop out, and participant noncompliance. Nonetheless, greater travel distances and significantly higher speeds were observed for motorized trips when compared with TPA. Conclusions: Pragmatic issues of using GPS monitoring to understand TPA behaviors and methodological recommendations for future research were identified. Although methodologically challenging, the combination of GPS monitoring, accelerometry and GIS technologies holds promise for understanding TPA within the built environment. [ABSTRACT FROM AUTHOR]

Glassbrook, DJ, Brown, SR, Helms, ER, Duncan, S, and Storey, AG. The high-bar and low-bar back-squats: a biomechanical analysis. J Strength Cond Res 33(7S): S1-S18, 2019-No previous study has compared the joint angle and ground reaction force (vertical force [ Fv ]) differences between the high-bar back-squat (HBBS) and low-bar back-squat (LBBS) above 90% 1 repetition maximum (1RM). Six male powerlifters (POW) (height: 179.2 +/- 7.8 cm; mass: 87.1 +/- 8.0 kg; age: 21-33 years) of international level, 6 male Olympic weightlifters (OLY) (height: 176.7 +/- 7.7 cm; mass: 83.1 +/- 13 kg; age: 22-30 years) of national level, and 6 recreationally trained male athletes (height: 181.9 +/- 8.7 cm; mass: 87.9 +/- 15.3 kg; age: 23-33 years) performed the LBBS, HBBS, and both LBBS and HBBS (respectively) up to and including 100% 1RM. Small to moderate (d = 0.2-0.5) effect size differences were observed between the POW and OLY in joint angles and Fv , although none were statistically significant. However, significant joint angle results were observed between the experienced POW/OLY and the recreationally trained group. Our findings suggest that practitioners seeking to place emphasis on the stronger hip musculature should consider the LBBS. Also, when the goal is to lift the greatest load possible, the LBBS may be preferable. Conversely, the HBBS is more suited to replicate movements that exhibit a more upright torso position, such as the snatch and clean, or to place more emphasis on the associated musculature of the knee joint. [ABSTRACT FROM AUTHOR]

Background: Medicare reimbursement is known to exhibit geographic variation for inpatient orthopedic procedures. This study determined whether US geographic variations also exist for commonly performed hand surgeries. Methods: Using the Medicare Provider Utilization and Payment Data (2012-2013) from Centers for Medicare & Medicaid Services, we analyzed regional physician charges/payments for common outpatient hand surgeries. Results: The most commonly performed procedures in the United States were open carpal tunnel release (n = 21 944), trigger finger release (n = 15 345), endoscopic carpal tunnel release (n = 7106), and basal joint arthroplasty/ligament reconstruction and tendon interposition (n = 2408). A range of average Medicare physician reimbursements existed based on geographic region for basal joint arthroplasty ($669-$571), endoscopic carpal tunnel release ($400-$317), open carpal tunnel release ($325-$261), and trigger finger release ($215-$167). The latter three exhibited statistically significant variation across geographic regions with regard to both charges and physician reimbursement. However, the overall percentage physician reimbursement (70%-79%) to charges was similar across all geographic regions. Conclusions: In conclusion, further research is warranted to determine why regional or geographic variations in physician payments exist in the United States for commonly performed hand surgeries. [ABSTRACT FROM AUTHOR]

Proton pump inhibitors (PPIs) have been associated with a variety of adverse events, although the level of evidence for many of these is weak at best. Recently, one national regulatory authority has mandated a change to the labeling of one PPI based on reports of possible associated rhabdomyolysis. Thus, in this review we summarize the available evidence linking PPI use with rhabdomyolysis. The level of evidence is insufficient to establish a causal relationship and is largely based on sporadic case reports. In general, patients with suspected PPI-associated rhabdomyolysis have not been re-challenged with a PPI after recovery. The mechanism whereby PPIs might have been associated with rhabdomyolysis is unclear but possibly related to interaction with concomitantly administered drugs such as HMG-CoA reductase inhibitors (statins). For patients with rhabdomyolysis, a careful search must be made for possible etiological factors. In patients who recover from an episode of possible PPI-related rhabdomyolysis but do not have a genuine requirement for PPI treatment, the PPI should not be re-introduced. For those with a definite indication for ongoing PPI treatment, the PPI can be re-introduced but should preferably not be administered with a statin. [ABSTRACT FROM AUTHOR]

The article report on International Classification of Diseases (I.C.D.) has evolved across decades, emerging from a death registry to a statistical classification system recognized within international healthcare systems in the U.S. It mentions that the I.C.D. system introduced prematurity as a cause of death as early as ICD-1, ICD-7 introduced specific conditions with and without mention of immaturity.3 ICD-9 introduced three general categories of related to fetal growth and gestation.

Popliteal artery injuries (PAIs) remain a challenging entity and carry the greatest risk of limb loss among traumatic lower extremity vascular injuries. Operative management of traumatic popliteal vascular injuries continues to evolve. Improved diagnostic imaging and the introduction of endovascular techniques offered alternative modalities to traditional surgical management. Despite major efforts in establishing protocols and guidelines in the management of vascular trauma, optimal strategies of traumatic PAIs are still under investigation. Herein, we discussed the role of multidisciplinary team, involving trauma and endovascular surgeons, emergency department personnel, and interventional radiologists in the management of complex PAIs. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to examine the convergent validity of two commonly-used accelerometers for estimating time spent in various physical activity intensities in adults. Methods: The sample comprised 37 adults (26 males) with a mean (SD) age of 37.6 (12.2) years from San Diego, USA. Participants wore ActiGraph GT3X+ and Actical accelerometers for three consecutive days. Percent agreement was used to compare time spent within four physical activity intensity categories under three counts per minute (CPM) threshold protocols: (1) using thresholds developed specifically for each accelerometer, (2) applying ActiGraph thresholds to regression-rectified Actical CPM data, and (3) developing new ‘optimal’ Actical thresholds. Results: Using Protocol 1, the Actical estimated significantly less time spent in light (-16.3%), moderate (-2.8%), and vigorous (-0.4%) activity than the ActiGraph, but greater time spent sedentary (+20.5%). Differences were slightly more pronounced when the low frequency extension filter on the ActiGraph was enabled. The two adjustment methods (Protocols 2 and 3) improved agreement in this sample. Conclusions: Our findings show that ActiGraph and Actical accelerometers provide significantly different estimates of time spent in various physical activity intensities. Regression and threshold adjustment were able to reduce these differences, although some level of non-agreement persisted. Researchers should be aware of the inherent limitations of count-based physical activity assessment when reporting and interpreting study findings. [ABSTRACT FROM AUTHOR]