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Individual and societal factors influencing the formation of long-term recreational exercise habits during the transition from adolescence to young adulthood are not well explored. Using data from the Longitudinal Survey of Australian Youth (LSAY), a population-representative cohort study of Young People followed from age 15 to 25, we aimed to (1) model longitudinal recreational exercise trajectories from age 16 to 24, (2) examine predictors at age 15 of entering these trajectories, and (3) explore the association between the trajectories and health, mental health and educational achievement outcomes measured at the final study wave (age 25). Self-reported recreational exercise frequency data from 9353 LSAY participants were analysed using group-based trajectory modelling. We modelled the evolution of two patterns of recreational exercise behaviour: daily exercise, as per public health guidelines (Model 1); and at least once weekly exercise (Model 2). Model 1 trajectories were guideline-adherent exercisers (17.9% of the sample), never guideline exercisers (27.5%), guideline drop-outs (15.2%) and towards guideline (39.4%); Model 2 trajectories were weekly exercise (69.5% of the sample), decreasing (17.4%), increasing (4.8%), and infrequent (8.3%). For both models, at age 15, trajectory membership was predicted by gender, self-efficacy, time spent participating in sport, time spent watching TV, parental socioeconomic status, and academic literacy. At age 25, people in the guideline-adherent exerciser trajectory (model 1) reported better general health relative to other trajectories, Those in the weekly exerciser trajectory (model 2) had better general health and reduced rates of psychological distress, were happier with life and were more optimistic for the future relative to participants in less than weekly trajectory groups. Exercise-promoting interventions for Young People should specifically address the needs of females, people with low self-efficacy, reluctant exercisers, higher academic achievers, and those experiencing socioeconomic disadvantage. [ABSTRACT FROM AUTHOR]

Gold Card SA is a four-session structured psychological intervention offered soon after an acute crisis presentation to people with symptoms characteristic of borderline personality disorder. This study describes individual and system-level outcomes from a large-scale health-care improvement initiative to implement Gold Card SA across South Australia. An uncontrolled pre-post study design was utilized examining service user (n = 332) patient-reported outcome measures and hospital service utilization records (6 months before and after Gold Card SA). Mixed-effects negative binomial regression analysis revealed a significant decrease in rates of service utilization across emergency department presentations (63%), mental health-related inpatient admissions (65%), and bed days (82%). Linear mixed-effect regression indicated large reductions in borderline symptoms and nonspecific psychological distress, and small to moderate improvements in psychosocial functioning. People presenting with or experiencing borderline personality disorder symptoms may benefit from a brief crisis intervention embedded within a stepped care model. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the role of free-play modes on gambling behaviour in computer-based roulette. Eighty participants were randomly allocated to one of four pre-exposure conditions: no exposure (control group), a loss condition, a break-even and a profit condition in which the return to player was greater than 100%. Behavioural persistence and betting behaviour was subsequently monitored in a period of regular roulette play. The results showed that players given opportunities for free-play sessions bet significantly more per spin and wagered more credits in total than the control group, although no significant group differences in behavioural persistence were observed. The results suggest that the role of free-play modes, as they commonly appear on some Internet gaming sites, may need to be investigated further because of their potential role in altering player perceptions of the activity and their influence on risk-taking behaviour.

Study Design.: Retrospective study. Objective.: The importance of attenuating the cardiovascular autoregulatory disturbances accompanying acute spinal cord injury (SCI) has long been recognized. This report assembles SCI emergency service data and correlates cardiovascular parameters to preserved functional neuroanatomy. Summary of Background Data.: The nascent nature of evidence-based reporting of prehospital cardiovascular autoregulatory disturbances in SCI indicates the need to assemble more information. Materials and Methods.: SCI data for <24 hours were extracted from ambulance and hospital records. The mean arterial pressure (MAP) was calculated. The International Standard for Neurological Classification of SCI (ISNCSCI) evaluates the primary outcome of motor incomplete injury (grades C/D) at acute presentation. Logistic regression was adjusted for multiple confounders that were expected to influence the odds of grade C/D. Results.: A cohort of 99 acute SCI cases was retained; mean (SD) age 40.7±20.5 years, 88 male, 84 tetraplegic, 65 grades A/B (motor complete injury), triage time 2±1.6 hours. The lowest recorded prehospital MAP [mean (SD): 77.9±19, range: 45–145 mm Hg] approached the nadir for adequate organ perfusion. Thirty-four (52%) grade A/B and 10 (30%) C/D cases had MAP readings <85 mm Hg. In data adjusted for age, injury level, and triage time a 5 mm Hg increase in the lowest MAP value was associated with a 34% increase in the odds of having motor incomplete injury at acute presentation (adjusted odds ratio=1.34; 95% CI: 1.11–1.61; P =0.002). Conclusion.: An important observation with implications for timely and selective cardiovascular resuscitation during SCI prehospital care involves significant negative associations between the depth of systemic hypotension and preserved functional neuroanatomy. Regardless of the mechanism, our confounder-adjusted logistic regression model extends in-hospital evidence and provides a conceptual bedside-bench framework for future investigations. [ABSTRACT FROM AUTHOR]

Background: Recombinant protein-based vaccines targeting serogroup B meningococci protect against invasive disease but impacts on carriage are uncertain. This study assessed carriage prevalence of disease-associated meningococci in 2018-2020 as the proportion of vaccinated adolescents increased following introduction of a school-based 4CMenB immunization program.Methods: Eligible participants who completed high school (aged 17-25) in South Australia in the previous year had an oropharyngeal swab taken and completed a risk factor questionnaire. Disease-associated meningococci (genogroups A, B, C, W, X, Y) were detected by meningococcal and genogroup-specific polymerase chain reaction.Results: The analysis included 4104 participants in 2018, 2690 in 2019, and 1338 in 2020. The proportion vaccinated with 4CMenB increased from 43% in 2018, to 78% in 2019, and 76% in 2020. Carriage prevalence of disease-associated meningococci in 2018 was 225/4104 (5.5%). There was little difference between carriage prevalence in 2019 (134/2690, 5.0%; adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], .64-1.05) and 2020 (68/1338, 5.1%; aOR, 0.82; 95% CI, .57-1.17) compared to 2018.Conclusions: Increased 4CMenB uptake in adolescents was not associated with decline in carriage of disease-associated meningococci. 4CMenB immunization programs should focus on direct (individual) protection for groups at greatest risk of disease.Clinical Trials Registration: NCT03419533. [ABSTRACT FROM AUTHOR]

Prolonged viewing of screen‐based media is associated with poor sleep in children. Previous systematic reviews have analysed the effectiveness of interventions that aim to limit children's screen use; however, none have evaluated its effect on sleep. The aim of this systematic review was to evaluate the effect of interventions that incorporate strategies to control children's screen use on screen use and sleep. The databases Pubmed, Embase, Eric, Scopus and PsycInfo were searched during October 2017 and updated in February 2019 for experimental studies with a control that assessed interventions to control screen use in children aged 2–14 years and reported both screen use and sleep outcomes. From 3,872 initial records, 11 studies (six randomized control [RCT], four cluster RCT and one cluster, quasi‐experimental) were eligible for inclusion. A total of 4,656 children aged 2–13 years were included in the studies. The mean reduction in screen time was 0.56 hr (33 min)/day (95% confidence interval [CI], 0.92, 0.20) and the mean sleep duration increased by 0.19 hr (11 min)/day (95% CI, 0.05, 0.33). Bedtime was advanced by 0.16 hr (10 min) on weekdays and by 1.0 hr at the weekend. Subgroup analyses indicated stronger intervention effects for interventions of shorter duration (<3 months), which specifically targeted screen use or sleep, and those with direct participant contact. In conclusion, small improvements in screen time and sleep duration can be achieved in children. It is not possible to determine if a reduction in screen time directly improves sleep, due to the limited number of studies, the presence of co‐interventions, issues with studies' methodological quality and heterogeneity. [ABSTRACT FROM AUTHOR]

Objectives: To determine the relationship between periodontal disease and glycemic control in children with type 1 diabetes and to characterize the diversity and composition of their oral microbiota. Methods: Cross‐sectional study including children with type 1 diabetes recruited from clinics at the Women's and Children's Hospital (Australia). Participants had a comprehensive dental assessment, periodontal examination, and buccal and gingival samples collected for 16S rRNA sequencing. Results: Seventy‐seven participants (age 13.3 ± 2.6 years, 38 males, BMI z‐score 0.81 ± 0.75) had a diabetes duration of 5.6 ± 3.9 years and median HbA1c of 8.5% (range 5.8–13.3), 69.4 mmol/mol (range 39.9–121.9). Thirty‐eight (49%) had early markers of periodontal disease. HbA1c was positively correlated with plaque index (Rho = 0.34, P = 0.002), gingival index (Rho = 0.30, P = 0.009), bleeding on probing (Rho = 0.44, P = 0.0001) and periodontal pocket depth >3 mm (Rho = 0.21, P = 0.06). A 1% increase in HbA1c was independently associated with an average increase in bleeding on probing of 25% (P = 0.002) and with an increase in the rate of sites with pocket depth >3 mm of 54% (P = 0.003). Higher HbA1c was independently related to increased phylogenetic alpha diversity (P = 0.008) and increased compositional variation (beta diversity P = 0.02) in gingival, but not buccal, microbiota. Brushing frequency, plaque index, and gingival index had a significant effect on microbiota composition, independent of HbA1c. Conclusions: Children with type 1 diabetes showed a continuous relationship between less favorable glycemic control and increased early markers of periodontal disease. Glycemic control was also related to the complexity and richness of the plaque microbiota, with diversity increasing as HbA1c levels increase. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease is a frequent complication of diabetes in adults, and both conditions are associated with systemic inflammatory states. This systematic review and meta‐analysis was conducted to establish the relative severity of periodontal disease risk markers in children and adolescents with type 1 diabetes (T1D). Methods: A systematic search strategy using PubMed and EMBASE databases was performed to identify relevant studies assessing periodontal risk markers in children and adolescents and T1D through to February 2019. Eligible studies were assessed for quality and heterogeneity, and a random effects model was used to estimate differences in selected periodontal risk markers in children with T1D relative to healthy controls. Results: The search identified 551 studies from which 23 were found to meet the inclusion criteria. Random effects meta‐analyses demonstrated that relative to healthy controls, children and adolescents with T1D had higher mean values for plaque index, gingival index, bleeding on probing, pocket depth and clinical attachment loss (all P <.001). Conclusions: Risk markers for periodontal disease were found to be more pronounced among children and adolescents with T1D compared to healthy controls. Early referral of these at risk individuals for dental examination is recommended to allow for early intervention. [ABSTRACT FROM AUTHOR]

Background Objectives Search Strategy Selection Criteria Data Collection and Analysis Main Results Conclusions Clinical and preclinical evidence indicate that in utero maternal asthma exposure increases progeny asthma risk. Whether maternal asthma also increases the risks of progeny allergy is unclear.To synthesise the available evidence on the relationship between in utero exposure to maternal asthma and postnatal asthma, wheezing and allergic diseases (Prospero: CRD42020201538).We systematically searched MEDLINE [PubMed], Embase [Ovid], Web of Science, Informit Health, the Cochrane Library, CINAHL [EBSCOhost], MedNar [Deep Web Technologies], ProQuest Theses and Dissertations, Scopus [Elsevier] and Trove, to the end of 2023.Studies reporting asthma, wheeze and/or allergic disease in progeny of women with and without asthma or with asthma classified by control, exacerbation or severity.Double screening, selection, data extraction and quality assessment were performed, using Joanna Briggs Institute (JBI) scoring.Of 134 non‐overlapping studies, 127 were included in ≥1 meta‐analysis. Maternal asthma ever was associated with greater risks of asthma (65 studies, risk ratio [95% confidence interval] 1.76 [1.57–1.96]), wheeze (35 studies, 1.59 [1.52–1.66]), food allergy (5 studies, 1.32 [1.23–1.40]), allergic rhinitis (7 studies, 1.18 [1.06–1.31]) and allergic dermatitis (14 studies, 1.17 [1.11–1.23]) ever in progeny. Asthma during the pregnancy, more severe, and uncontrolled maternal asthma were each associated with greater risks of progeny asthma.Children of mothers with asthma are at increased risk for the development of allergic diseases. Whether improved maternal asthma control reduces risks of child allergy as well as asthma requires further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Milk fat globule membrane (MFGM) is a complex lipid-protein structure in mammalian milk and human milk that is largely absent from breastmilk substitutes. The objective of this trial is to investigate whether providing infant formula enriched with MFGM versus standard infant formula improves cognitive development at 12 months of age in exclusively formula-fed full-term infants., Methods and Analysis: This is a randomised, controlled, clinician-blinded, researcher-blinded and participant-blinded trial of two parallel formula-fed groups and a breastfed reference group that were recruited in the suburban Adelaide (Australia) community by a single study centre (a medical research institute). Healthy, exclusively formula-fed, singleton, term-born infants under 8 weeks of age were randomised to either an MFGM-supplemented formula (intervention) or standard infant formula (control) from enrolment until 12 months of age. The reference group was not provided with formula. The primary outcome is the Cognitive Scale of the Bayley Scales of Infant Development, Fourth Edition (Bayley-IV) at 12 months. Secondary outcomes are the Bayley-IV Cognitive Scale at 24 months, other Bayley-IV domains (language, motor, emotional and behavioural development) at 12 and 24 months of age, infant attention at 4 and 9 months of age, parent-rated language at 12 and 24 months of age, parent-rated development at 6 and 18 months of age as well as growth, tolerance and safety of the study formula. To ensure at least 80% power to detect a 5-point difference in the mean Bayley-IV cognitive score, >200 infants were recruited in each group., Ethics and Dissemination: The Women's and Children Health Network Human Research Ethics Committee reviewed and approved the study (HREC/19/WCHN/140). Caregivers gave written informed consent prior to enrolling in the trial. Findings of this study will be disseminated through peer-reviewed publications and conference presentations., Trial Registration Number: ACTRN12620000552987; Australian and New Zealand Clinical Trial Registry: anzctr.org.au., Competing Interests: Competing interests: The project was funded by the sponsor, Fonterra Co-Operative Group Limited, Auckland, New Zealand, and funding was paid to the South Australian Health and Medical Research Institute. MM is supported by an Australian National Health and Medical Research Council Principal Research Fellowship ID: GNT 2016756. Study products were provided by Fonterra Co-Operative Group Limited. The Australian National Health and Medical Research Council has no role in the study design; collection, management, analysis and interpretation of data; writing of the report; and the decision to submit the report for publication and have no authority over any of these activities. Honoraria have been paid to Dr Gould’s institution to support conference travel by NuMega Ingredients. No other competing interests are declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)