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Background Inactive lifestyles are becoming the norm and creative approaches to encourage adolescents to be more physically active are needed. Little is known about how gamification techniques can be used in physical activity interventions for young people. Such approaches may stimulate interest and encourage physical activity behaviour. The study investigated the feasibility of implementing and evaluating a physical activity intervention for adolescents which included gamification techniques within schools. We tested recruitment and retention strategies for schools and participants, the use of proposed outcome measures, and explored intervention acceptability. Methods This school-based feasibility study of a randomised cluster trial recruited adolescents aged 12–14 years (n = 224) from five schools (three intervention; two control) in Belfast, Northern Ireland. The 22-week intervention (The StepSmart Challenge) informed by self-determination theory and incorporating gamification strategies involved a school-based pedometer competition. Outcomes, measured at baseline, and post-intervention (at 22 weeks post-baseline and 52 weeks post-baseline) included daily minutes of moderate to vigorous physical activity (MVPA) (measured using ActiGraph accelerometer), mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), social support for physical activity, time preference (for delayed and larger rewards or immediate and smaller rewards), pro-social behaviour (Strengths and Difficulties Questionnaire (SDQ)) and the influence of social networks. The intervention’s acceptability was explored in focus groups. Results We invited 14 schools to participate; eight showed interest in participating. We recruited the first five who responded; all five completed the trial. Of the 236 pupils invited, 224 participated (94.9%): 84.8% (190/224) provided valid MVPA (minutes/day) at baseline and 57.2% (123/215) at 52 weeks. All other outcomes were well completed apart from the SDQ (65% at baseline). Qualitative data highlighted that participants and teachers found The StepSmart Challenge to be an acceptable intervention. Conclusions The level of interest and high recruitment and retention rates provide support for the feasibility of this trial. The intervention, incorporating gamification strategies and the recruitment methods, using parental opt-out procedures, were acceptable to participants and teachers. Teachers also suggested that the implementation of The StepSmart Challenge could be embedded in a lifelong learning approach to health within the school curriculum. As young people’s lives become more intertwined with technology, the use of innovative gamified interventions could be one approach to engage and motivate health behavioural change in this population. Trial registration NCT02455986 (date of registration: 28 May 2015).

This study aimed to evaluate a set of guidelines for music use with people with dementia. A secondary aim was to identify challenges and barriers to implementation of music interventions by caregivers. Caregivers ( n = 16) were interviewed after implementing a music listening programme based on the guidelines with 29 people with dementia in home-care and aged care facilities. Caregivers found the guidelines informative, easy to understand and use. Positive effects on mood, reduced agitation and reduced challenges to care were reported. Difficulties with technology and finding time to implement the music programme were identified. Results highlight the need for more research around appropriate technology and the streamlining of processes and procedures for aged care staff. Further iterations of the guidelines will need to address these issues and consider the differing needs of home-based carers and aged care providers separately.

Background: Existing literature indicates that young people in state care have particular sexual health needs that include addressing their social and emotional well-being, yet little has been published as to how these components of sex education are actually delivered by service-providers. Objective: The aim of this study was to analyse the processes involved in delivering relationship and sexuality education to young people in state care from the perspectives of a sample of service-providers with a role in sexual health-care delivery. Design: Qualitative methodological strategy. Setting: Service-delivery sites at urban and rural locations in Ireland. Method: A total of 22 service-providers were interviewed in depth, and data were analysed using a qualitative analytical strategy resembling modified analytical induction. Findings: Participants proffered their perceptions and examples of their practices of sex education in relation to the following themes: (1) acknowledging the multi-dimensional nature of sexual health in the case of young people in care; (2) personal and emotional development education to address poor self-esteem, emotional disconnectedness and an inability to recognise and express emotions; (3) social skills’ education as part of a repertoire of competencies needed to negotiate relationships and safer sex; (4) the application of positive social skills embedded in everyday social situations; and (5) factual sexuality education. Conclusion: Insights into service-providers’ perceptions of the multi-dimensional nature of the sexual health needs of young people in state care, and the ways in which these service-providers justified their practice make visible the complex character of sex education and the degree of skill required to deliver it to those in state care.

This paper presents a research protocol for a randomised controlled efficacy trial of the ‘Dead Cool’ smoking prevention programme. Dead Cool is a three to four-hour programme designed to be used by teachers with Year 9 students in Northern Ireland. The main outcome of the programme is to prevent students from starting to smoke. The protocol reports a research design intended to test the efficacy of the programme in 20 post-primary school settings. Selected schools included those from secondary /grammar/integrated/single sex/coeducational, rural and urban schools from both the maintained and controlled state sector and independent sector schools. Outcome measures include self-reported behaviours, monitoring of carbon monoxide (CO) in exhaled breath and focus groups designed to assess implementation fidelity and opinions on efficacy in intervention schools and explore the ‘counterfactual’ potential treatments in control schools.

Music is frequently used in aged care, being easily accessible and cost-effective. Research indicates that certain types of musical engagement hold greater benefits than others. However, it is not clear how effectively music is utilized in aged care facilities and what the barriers are to its further use. This study used a mixed-methods paradigm, surveying 46 aged care workers and conducting in-depth interviews with 5, to explore how music is used in aged care facilities in Australia, staff perceptions of the impact of music on residents, and the barriers to more effective implementation of music in aged care settings.

This chapter makes a case for investing in early childhood development (ECD) programs and services as a key mechanism to achieving the Sustainable Development Goals and contributing to peacebuilding efforts in the global context. The links among early childhood development, sustainable development and peacebuilding are discussed from macroeconomic, biodevelopmental and social perspectives. We use the Global Peace Index (formulated by the Institute of Economics and Peace to measure progress towards peace across countries) to illustrate links between ECD program outcomes and peacebuilding-relevant indicators. Drawing from this analysis, we frame a theory of change that includes overarching inputs, activities, outputs and outcomes of the ‘peacebuilding through ECD’ agenda. The chapter outlines research gaps and priorities to bolster the evidence-base of peacebuilding through ECD in multiple contexts. We put forth a call to action for interdisciplinary research and multi-sectoral partnerships to effectively leverage peacebuilding through ECD as a strategy for sustainable development.

Existing literature tells us that one of the factors important to the sexual health and intimate relationships of adolescents is the extent to which teenagers feel emotionally connected and supported by their families. In this article, we analyse the experiences of disconnectedness from their families and transience during childhood reported by a sample of young adults formerly in care, and the influence they believed this had on their sense of security and later intimate relationships. The sample comprised 19 young adults aged 18–22 years who were interviewed about experiences associated both directly and indirectly with sexual health, during which childhood experiences of transience emerged as an issue. Findings indicated that disconnectedness and transience were experienced as distressing for participants, generating feelings of rejection and compromising their sense of trust in others. Feelings of insecurity and mistrust were reported by some to influence their adult relationships. We conclude that while not always possible, social care professionals should endeavour to support enduring relationships with trusted adults and continuity of carer among young people in care.

This article presents the results from an analysis of data from service providers and young adults who were formerly in state care about how information about the sexual health of young people in state care is managed. In particular, the analysis focuses on the perceived impact of information sharing between professionals on young people. Twenty-two service providers from a range of professions including social work, nursing and psychology, and 19 young people aged 18-22 years who were formerly in state care participated in the study. A qualitative approach was employed in which participants were interviewed in depth and data were analysed using modified analytical induction (Bogdan & Biklen, 2007). Findings suggest that within the care system in which service provider participants worked it was standard practice that sensitive information about a young person's sexual health would be shared across team members, even where there appeared to be no child protection issues. However, the accounts of the young people indicated that they experienced the sharing of information in this way as an invasion of their privacy. An unintended outcome of a high level of information sharing within teams is that the privacy of the young person in care is compromised in a way that is not likely to arise in the case of young people who are not in care. This may deter young people from availing themselves of the sexual health services.

BackgroundNarcolepsy is a chronic primary sleep disorder, characterized by excessive daytime sleepiness and sleep dysfunction with or without cataplexy. Narcolepsy is uncommon, with a low prevalence rate which makes it difficult to diagnose definitively without a complex series of tests and a detailed history. The aim of this study was to review patients referred to a tertiary sleep centre who had been labelled with a diagnosis of narcolepsy prior to referral in order to assess if the diagnosis was accurate, and if not, to determine the cause of diagnostic misattribution.MethodsAll patients seen at a sleep centre from 2007–2013 (n = 551) who underwent detailed objective testing including an MSLT PSG, as well as wearing an actigraphy watch and completing a sleep diary for 2 weeks, were assessed for a pre-referral and final diagnosis of narcolepsy.ResultsOf the 41 directly referred patients with a diagnostic label of narcolepsy, 19 (46 %) were subsequently confirmed to have narcolepsy on objective testing and assessment by a sleep physician using ICSD-2 criteria.ConclusionsThe diagnosis of narcolepsy was incorrectly attributed to almost 50 % of patients labelled with a diagnosis of narcolepsy who were referred for further opinion by a variety of specialists and generalists. Accurate diagnosis of narcolepsy is critical for many reasons, such as the impact it has on quality of life, driving, employment, insurance and pregnancy in women as well as medication management.

Aim: To analyse the role of sex-focused knowledge in the contraceptive behaviour of sexually active young people in state care.Methods: The sample consisted of 19 care leavers (young people previously in state care) aged 18-22 years, 16 females and 3 males. In-depth interviewing was the method of data collection, and a qualitative strategy resembling modified analytical induction was used to analyse data.Findings: Findings indicated that a lack of information was not the sole, or even the primary reason for engaging in unsafe sexual practices. Other factors such as ambivalence to becoming pregnant also featured in participants’ accounts. Several participants conveyed a relatively weak sense of agency about consistently using contraception. A small number of participants expressed a strong determination to avoid pregnancy, and these appeared to have a level of anxiety about becoming pregnant that motivated them to engage with knowledge about contraception and its use.Conclusion: Lack of sex-focused information is just one aspect of a myriad of complex factors, including socioeconomic disadvantage and/or emotional deprivation, that influences contraceptive behaviour.

Research on the effects of breastfeeding on child cognitive development has produced conflicting results, and many studies do not account for infant stimulation in the home. The aim of this study is to determine whether breastfeeding predicts enhanced cognitive development in one-year-old infants after controlling for the main socio-economic and environmental factors, including stimulation in the home. This cross-sectional observational study involved 137 infants and their mothers. Information on maternal socio-demographic factors and breastfeeding practices was obtained through semi-structured interview. Stimulation in the home was measured using the HOME Inventory. Cognitive development was assessed using the Bayley Scales of Infant Development. Mean cognitive scores were significantly higher in breast-fed infants (110) compared with formula-fed infants (105). Breastfeeding duration had a positive linear association with cognitive scores at one year. In linear regression, the adjusted standardised beta ...

The Growth, Learning and Development (GLAD) study aimed to examine how a broad range of factors influence child weight during the first year of life. Assessments were undertaken within a multidisciplinary team framework. The sample was drawn from the community and data collection was undertaken in the four Greater Belfast Trusts. Twohundred and thirty-four families took part, each receiving a total of five home visits during which physical growth, oral-motor skills and development were assessed. Psychosocial evaluation examined parent-child interaction, feeding and other parental and child characteristics using quantitative and observational techniques. This paper outlines the main findings and recommendations from the GLAD study.

This study reports on the first phase of a large-scale, longitudinal, multidisciplinary community study examining the growth, learning and development of young children with a particular focus on failure to thrive without organic cause. However, the group identified in this study may be better described as weight faltering. This paper examines the psychological data collected using the Parenting Stress Index, Rosenberg Self-Esteem and the General Health Questionnaire in relation to child growth. There were no significant differences between the mothers of the weight faltering and control children in terms of parenting stress, maternal depression, maternal perceptions of their parenting competence or maternal self-esteem. Maternal sensitivity to comments about child size, regardless of direction, had a negative impact on mood. Copyright © 2007 John Wiley & Sons, Ltd.

The paper presents a protocol for ‘A randomized controlled trial of functional family therapy (FFT): an Early Intervention Foundation (EIF) partnership between Croydon Council and Queen's University Belfast’. The protocol describes a trial that uses FFT as an alternative intervention to current use of the youth justice system and local authority care with the aim of reducing crime/recidivism in young people referred to Croydon Council. The trial will take place over a period of 36 months and will involve up to 154 families. Croydon Council will employ a team of five Functional Family Therapists who will work with families to promote effective outcomes. The Centre for Effective Education at Queen's University Belfast will act as independent evaluators of outcomes for families and young people. The work is supported from the United Kingdom Economic & Social Research Council/Early Intervention Foundation Grant Number ES/M006921/1

Human activities have fundamental impacts on the distribution of species through altered land use, but also directly by dispersal of propagules. Rare long-distance dispersal events have a disproportionate importance for the spread of species including invasions. While it is widely accepted that humans may act as vectors of long-distance dispersal, there are few studies that quantify this process. We studied in detail a mechanism of human-mediated dispersal (HMD). For two plant species we measured, over a wide range of distances, how many seeds are carried by humans on shoes. While over half of the seeds fell off within 5 m, seeds were regularly still attached to shoes after 5 km. Semi-mechanistic models were fitted, and these suggested that long-distance dispersal on shoes is facilitated by decreasing seed detachment probability with distance. Mechanistic modelling showed that the primary vector, wind, was less important as an agent of long-distance dispersal, dispersing seeds less than 250 m. Full dispersal kernels were derived by combining the models for primary dispersal by wind and secondary dispersal by humans. These suggest that walking humans can disperse seeds to very long distances, up to at least 10 km, and provide some of the first quantified dispersal kernels for HMD.

Electronic data collection for randomised trials is attractive as it can, in theory, provide great financial advantages by reducing fieldwork costs and data inputting time, as well as increasing the accuracy of responses over and above paper based methods. For trials involving young people, electronic methods provide other advantages such as the ability to adapt questions to meet the needs of young people of differing ages and abilities. Researchers have also suggested that young people prefer electronic methods over traditional ones and have found equal validity across both methods. This presentation will discuss issues relating to the collection of sensitive information from young people in Northern Ireland, using electronic and paper formats. We will draw on experience gained across several research studies that have collected data on sexual risks and behaviours, particularly in school-based research; including a recent trial on adolescent pregnancy. We will examine the feasibility, reliability and validity of data collected along with an evaluation of the cost implications and ease of using both methods (including the merging of the resulting datasets if both methods are offered). The views of the researchers and participants will also be reflected upon.

It has been hypothesized that ribose supplementation rapidly replenishes adenosine triphosphate stores and thereby improves exercise performance. We compared the effects of ribose versus dextrose on rowing performance.Double-blind randomized trial.Rowing team training area of large midwestern university.Thirty-one women collegiate rowers.We studied the effects of ribose versus dextrose supplementation (10 g each in 8 oz water) for 8 weeks before and after practice and 2000-m time trials. OUTCOME MEASUREMENTS AND RESULTS: In the time trials, the dextrose group showed significantly more improvement at 8 weeks than the ribose group (median, 15.2 vs. 5.2 s; P = 0.031).We doubt ribose impaired, and hypothesize dextrose enhanced, rowing performance. Further research is needed to define what role, if any, dextrose and ribose play as athletic supplements.

Harmful social behaviour is behaviour that is directed at pen mates which, if persistent, causes injury. It includes tail, ear and flank biting. The aim of this work was to determine if pigs that are predisposed to harmful social behaviour can be identified early in life using a test. In this experiment a test that measured the chewing behaviour of pigs on an artificial tail was developed from Fraser (1987), as one of a wider battery of tests under investigation in the overall project. The validity of the test was evaluated by correlating the rope directed behaviour in the test with harmful social behaviour in the home pen.

This study explored the patterning of young people's sexual health competence, and how this relates to sexual health outcomes. A survey of 381 young people attending two sexual health clinics in Northern Ireland was carried out between 2009 and 2010. Latent profile analysis of self-rated decision making, self-rated sexual health knowledge, and knowledge of sexually transmitted disease questionnaire scores was used to determine typologies of sexual health competence. Analysis revealed three categories of sexual health competence and explored their association with other behaviours and social characteristics. Young people's subjective opinion of their sexual health competency, when not matched with a corresponding knowledge of sexual health, could place people at an increased risk of poor sexual health outcomes. Greater levels of peer pressure to have sex and early sexual debut were associated with poorer sexual health knowledge. This finding warrants further investigation, as the importance of self-perceived competence for sexual health screening and education programmes are considerable.