Promoting Physical Activity Among Children and Adolescents With Disabilities: The Translation of Policy to Practice Internationally.

BACKGROUND: Physical inactivity among children and adolescents with disabilities (CAWD) is a global public health issue. Policy efforts to promote physical activity (PA) among CAWD have increased. This study summarizes the international policy trend for promoting PA among CAWD, with behavioral and policy insights specific to CAWD from country/regional indicators from the Active Healthy Kids Global Alliance Matrix on Physical Activity for Children and Adolescents to determine policy translation into practice. METHODS: International and national PA policy documents on CAWD were assessed. Data from the Global Matrix Para Report Cards on the behavioral and government indicators from 14 countries or regions (grouped by human development index) were reviewed and compared. RESULTS: Policy instruments began promoting PA for CAWD in 1989 via the Convention on the Rights of the Child. International policy has been advocating PA specifically for CAWD recently. In 2020, the World Health Organization published specific PA guidelines for CAWD. Data from the 14 Para Report Car found 14 grades on the average behavioral indicator and 12 on the government indicator. A gap between the average behavioral indicator (D-) and the government indicator (C+) was found in the Para Report Card data. CONCLUSIONS: Although international policies are consistent in their attention to the needs of CAWD, national/regional policies vary. Coverage ranges from nonexistent to embedded in broader inclusion concepts. A gap in policies to promote PA of CAWD is prevalent and is more prominent in countries or regions with a lower human development index ranking.

The First Global Physical Activity and Sedentary Behavior Guidelines for People Living With Disability.

BACKGROUND: The World Health Organization has released the first global public health guidelines on physical activity and sedentary behavior for people living with disability. This paper presents the guidelines, related processes, and evidence, and elaborates upon how the guidelines can support inclusive policy, practice, and research. METHODS: Methods were consistent with the World Health Organization protocols for developing guidelines. Systematic reviews of the evidence on physical activity for health for people living with disability were appraised, along with a consideration of the evidence used to inform the general 2020 World Health Organization guidelines. RESULTS: Evidence supported the development of recommendations for people living with disability, stressing that there are no major risks to engaging in physical activity appropriate to an individual's current activity level, health status, and physical function, and that the health benefits accrued generally outweigh the risks. They also emphasize the benefits of limiting sedentary behavior. CONCLUSIONS: The guidelines mark a positive step forward for disability inclusion, but considerable effort is needed to advance the agenda. This paper highlights key considerations for the implementation of the new recommendations for people living with disability, in line with the human rights agenda underpinning the Global Action Plan on Physical Activity 2018-2030 and allied policies.

Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group.

BACKGROUND: In July, 2019, the World Health Organization (WHO) commenced work to update the 2010 Global Recommendations on Physical Activity for Health and established a Guideline Development Group (GDG) comprising expert public health scientists and practitioners to inform the drafting of the 2020 Guidelines on Physical Activity and Sedentary Behavior. The overall task of the GDG was to review the scientific evidence and provide expert advice to the WHO on the amount of physical activity and sedentary behavior associated with optimal health in children and adolescents, adults, older adults (> 64 years), and also specifically in pregnant and postpartum women and people living with chronic conditions or disabilities. METHODS: The GDG reviewed the available evidence specific to each sub-population using systematic protocols and in doing so, identified a number of gaps in the existing literature. These proposed research gaps were discussed and verified by expert consensus among the entire GDG. RESULTS: Evidence gaps across population sub-groups included a lack of information on: 1) the precise shape of the dose-response curve between physical activity and/or sedentary behavior and several of the health outcomes studied; 2) the health benefits of light-intensity physical activity and of breaking up sedentary time with light-intensity activity; 3) differences in the health effects of different types and domains of physical activity (leisure-time; occupational; transportation; household; education) and of sedentary behavior (occupational; screen time; television viewing); and 4) the joint association between physical activity and sedentary time with health outcomes across the life course. In addition, we acknowledge the need to conduct more population-based studies in low- and middle-income countries and in people living with disabilities and/or chronic disease, and to identify how various sociodemographic factors (age, sex, race/ethnicity, socioeconomic status) modify the health effects of physical activity, in order to address global health disparities. CONCLUSIONS: Although the 2020 WHO Guidelines for Physical Activity and Sedentary Behavior were informed by the most up-to-date research on the health effects of physical activity and sedentary time, there is still substantial work to be done in advancing the global physical activity agenda.

World Health Organization 2020 guidelines on physical activity and sedentary behaviour.

OBJECTIVES: To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. METHODS: The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. RESULTS: The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150-300 min of moderate-intensity, or 75-150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. CONCLUSION: These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 and to strengthen surveillance systems that track progress towards national and global targets.

Current antimicrobial use in farm animals in the Republic of Ireland.

Antimicrobial resistance has been recognised as one of the most difficult challenges facing human and animal health in recent decades. The surveillance of antimicrobial use in animal health plays a major role in dealing with the growing issue of resistance. This paper reviews current data available on antimicrobial use in farmed animals in the Republic of Ireland, including each of the major livestock production sectors; pigs, poultry, dairy, beef and sheep. A systematic literature search was conducted to identify relevant published literature, and ongoing research was identified through the network of authors and searches of each of the research databases of the main agriculture funding bodies in Ireland. The varying quantities and quality of data available across each livestock sector underlines the need for harmonisation of data collection methods. This review highlights the progress that has been made regarding data collection in the intensive production sectors such as pigs and poultry, however, it is clear there are significant knowledge gaps in less intensive industries such as dairy, beef and sheep. To comply with European regulations an antimicrobial data collection system is due to be developed for all food-producing animals in the future, however in the short-term surveillance studies have allowed us to build a picture of current use within the Republic of Ireland. Further studies will allow us to fill current knowledge gaps and build a more comprehensive overview of antimicrobial use in farm animals in Ireland.

Relative effect of milk constituents on fertility performance of milk-recorded, spring-calving dairy cows in Ireland.

Several studies have reported associations between milk composition data and fertility performance. However, no work to date has estimated the effect of milk constituents on fertility performance in cows with low milk constituent concentrations. The objective of this study was to assess the association between milk constituents, animal characteristics, and time from mating start date (MSD) to conception using survival analysis. Furthermore, we aimed to investigate the relative effect of each variable by predicting median times to conception for animals with different combinations of characteristics and milk compositions. The final data set consisted of 87,227 cow lactation records from 64,519 cows in 2,049 herds with calving dates from 2010 to 2013. Milk recording data from each lactation were used, including test day recordings at 0 to 30, 31 to 60, and 61 to 90 d in milk (DIM). The analysis was limited to spring-calving cows (i.e., animals calving from January to May inclusive). Mating start date was determined for each unique herd in each year. A cow-specific MSD (MSDcow) was defined taking into consideration the MSD for each herd and the calving date and a minimum calving to insemination interval of each herd year. The conception date for each cow was estimated using the subsequent calving date. Cows with no subsequent calving date were assumed not to have conceived. Time from MSDcow to approximate conception date was analyzed using survival analysis. Cox proportional hazard models were constructed for each of the 3 recording windows: 0 to 30, 31 to 60, and 61 to 90 DIM. A fourth model was used to assess the dynamics of milk composition over the 3 windows. To investigate the effect of these variables, model outputs were used to create parametric accelerated failure time models to predict median survival times for animals at the 10th and 90th percentiles of the variable of interest but otherwise identical across the rest of the variables. Results demonstrated that fertility breeding subindex had the largest effect on time from MSDcow to conception, with an additional 62 d open for those in the 10th percentile versus those in the 90th percentile. Of the milk constituents, milk lactose concentration had the greatest effect on MSD to conception, particularly when measured from 0 to 30 DIM. An additional 10 d open resulted from comparing those in the 10th and 90th percentiles. Milk protein concentration, although statistically significant, had a lower effect on fertility outcome when comparing cows in the 10th and 90th percentiles for this exposure variable. The greatest effect was found in the 61 to 90 DIM recording window, where cows in the 10th percentile had an additional 9 d open at the subsequent breeding season compared with those in the 90th percentile. Overall, our study shows that although the associations between milk constituents and fertility are statistically significant, their overall influence in determining MSD to conception in this study population is relatively modest, particularly compared with fertility breeding subindex, when comparing cows at the 10th and 90th percentiles. Of the milk constituents measured, milk lactose concentration measured at 0 to 30 DIM had the greatest effect in determining fertility outcome when comparing cows at the 10th and 90th percentiles. The predictive value of early-lactation test day milk composition data on hazard of pregnancy during the following breeding period, within a spring-calving context, appears to be relatively modest at the individual-cow level. Further work is required to test the usefulness of these associations at the herd level.

Inaugural HealthAccord Conference (SportAccord Convention, Bangkok, Thailand): The Power of Sport - The Power to Change.

SportAccord organized the inaugural HealthAccord conference on April 19, 2018, in Bangkok, Thailand. The goal of HealthAccord is for the International Sport Federations (IF) and sport industry leaders to address high-priority issues facing sport through a serious commitment to innovation to protect athlete health, to enhance athlete performance, and to stimulate action to improve global health through the promotion of physical activity. The first HeathAccord conference was organized by drawing on the knowledge and experience of experts from global health programs focused on athletes and global citizens, respectively. The first session, "The Power of Sport," addressed the application of "state of the art" sport science and sport medicine for the protection of athlete health and to enhance sport performance. "The Power of Sport" session concentrated on enabling athletes to perform spectacular feats that are "higher, stronger, faster" intended to engage and thrill global audiences without resorting to prohibited substances and methods, to enable athletes to remain active in sport for a longer career, and to increase the attraction of sport for sponsors. In the second session, "The Power to Change," sport was viewed as having an important role in promoting physical activity within their respective federations, community, and internationally. The Olympic movement, IF, and other sport stakeholders are urgently needed to become the social drivers to correct the mismatch between physical activity for health development and draw toward sedentary lifestyles of the modern world. Key outcomes of this first HealthAccord conference were the agreement among participants to develop an innovative and high-impact collaboration between IF and related stakeholders; to use sport as a social movement platform to measurably improve health, both for athletes and for global citizens.

The prevalence of obesity in children and young people with Down syndrome.

BACKGROUND: Overweight and obesity is a growing concern among individuals with intellectual disabilities; however, little is known about the prevalence among children and youth with Down syndrome (CYDS). The purpose of this study was to determine the prevalence of overweight/obesity among CYDS in South West Ireland. METHODS: This cross-sectional study measured height and weight of 61 CYDS aged 4-16 years. Body mass index (BMI) was calculated and percentage body fat (PBF) was measured using bio-electrical impendence analysis (BIA). RESULTS: Using the International Obesity Task Force BMI cut-offs, 51.6% of males and 40% of females were overweight/obese compared to 32% and 14.8%, respectively, using PBF. The mean PBF for males was 18.76 versus females 22.38 (p < .05). There is a higher prevalence of overweight/obesity, particularly in males, compared to the general population of children. CONCLUSIONS: The difference in estimation of overweight/obesity between BMI and BIA has implications for research and clinical practice.

Erratum to: The prevalence, temporal and spatial trends in bulk tank equivalent milk fat depression in Irish milk recorded herds.

[This corrects the article DOI: 10.1186/s13620-017-0092-y.].

The prevalence, temporal and spatial trends in bulk tank equivalent milk fat depression in Irish milk recorded herds.

BACKGROUND: Milk fat is important in terms of economic value and in its potential to provide information concerning cow diet and health. Under current milk payment schemes in Ireland farmer income is directly linked to milk fat production. METHODS: A descriptive analysis of milk fat depression (MFD) as calculated from test day milk recording data across all milk recording herds from 2004 to 2014 was undertaken. A dataset of 17 million test day records was used to calculate the prevalence of MFD in Irish milk recorded herds and to create a graphical description of the major descriptive epidemiological trends in milk fat depression in time and space in Ireland. The bulk tank equivalent (BTE) for test day milk fat was calculated for each herd and for cohorts of cows within herds using the formula; BTE milk fat = sum test day fat kg/sum test day milk kg. Milk fat depression was defined as BTE <3.3% milk fat and BTE > 3.2% milk protein. RESULTS: The annual prevalence of MFD decreased significantly over time in a linear manner until 2014. Across all years the highest prevalence of MFD occurred in April or May. The highest prevalence occurred most commonly in May, with 9.1% of herds experiencing MFD in 2014. The highest prevalence of MFD in autumn calved cohorts occurred at 181-210 days in milk whereas it occurred at days 61-90 in milk in spring calving cohorts. The stage of lactation for the most common occurrence of MFD in both the spring and autumn cohorts corresponded with the month of May. There were some notable spatial patterns regarding variations in prevalence of MFD across the country. Cohorts of cows with the highest genetic values for milk yield had the highest prevalence of MFD whereas cohorts of cows with the highest breeding values for milk fat percent had the lowest prevalence of MFD. CONCLUSIONS: A subpopulation of Irish herds experienced the condition of MFD. Descriptive analysis suggested spatial, temporal and animal level associations. This condition warrants further investigation.

Dermatosparaxis in two Limousin calves.

BACKGROUND: An unusual presentation of skin disease was identified in two related neonatal Pedigree Limousin calves presented to University Veterinary Hospital, University College Dublin, following detailed post mortem examination a diagnosis of dermatosparaxis was made. Dermatosparaxis in animals or Ehlers Danlos Syndrome, which is the analogous condition seen in humans, is a connective tissue disorder characterised by extreme skin fragility. To the authors' knowledge this is the first report of such a diagnosis in the Limousin breed and the features of this lethal phenotype were severe in comparison to previous reports of the condition. CASE PRESENTATION: Two calves, which were full siblings, a pedigree Limousin bull (Calf A) and pedigree Limousin heifer (Calf B) were examined clinically after presenting collapsed since birth, both had grossly abnormal skin with multiple skin fissures visible and both calves were subsequently euthanised. Both calves underwent gross post mortem examination, after which histological samples were reviewed and electron microscopical examination of selected skin samples was carried out. Histological features of dysplastic dermal collagen were identified. The diagnosis of dermatosparaxis in the Limousin breed was confirmed. Genetic testing was conducted to determine if the current cases had the same mutation as has previously been described in Belgian Blue cattle. Some common parentage was traced but genetic testing did not show a similar mutation to that previously described in cattle. The specific genetic cause in this case is unknown. CONCLUSIONS: This is the first report of dermatosparaxis in the Limousin and the presentation of the dermatosparaxis phenotype has some noteworthy features thus further genetic testing is required to pinpoint the causative mutation or other genetic defect. Given the popularity of the breed and the lethal nature of the phenotype in this case it is important to raise awareness of the condition.