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Growing concern about children and adolescent physical inactivity has made the promotion of physical activity a public health priority. International recommendations suggest children should accumulate at least 30 min of moderate-to-vigorous physical activity (MVPA) during school hours. This study assessed levels of objectively-measured MVPA in a large nationally representative sample of Scottish children aged 10-11. Risk factors for not meeting the school-hours MVPA recommendation were examined.Cross-sectional.Mean time spent in MVPA during school hours across five weekdays was measured using Actigraph accelerometry (May 2015-May 2016). Binary logistic regression, presented as odds ratio (O.R.) and confidence intervals (C.I.), explored associations between meeting/not meeting the recommendation by sex, socioeconomic status (SES), season, and urban/rural residence in 2022.Valid data were obtained from 773 children (53.9% girls, 46.1% boys) from 471 schools. Mean daily school-hours MVPA was 29 (SD 11) minutes; 42.7% of children reached the recommendation. The odds of girls (O.R. 0.43; C.I. 0.32, 0.57) meeting the recommendation was significantly lower (p 0.001) compared to boys. Children living in rural areas had higher odds (O.R. 1.49; C.I. 1.04, 2.15) of meeting the recommendation compared with those in urban areas (p = 0.032). No significant differences in meeting the recommendation by SES (p = 0.700). The overall trend for season was significant (p 0.001), with lower odds of meeting the recommendation in winter compared to summer.Most Scottish children aged 10-11 did not meet the 30 minute MVPA recommendation. Interventions to increase MVPA during school hours are essential to promote public health.

Adolescent health-related behaviours and outcomes are shaped by their peers through various social processes. Research using network data on friendship ties has uncovered evidence for processes such as peer influence and imitation. Much less is known about how the structure of small groups within a network, that represents its meso-level, affect individuals. The structure and composition of peer groups could play an important role in shaping health behaviour but knowledge of the effects of groups is limited. We used data from The Peers and Levels of Stress study, a cross-sectional study conducted in 2006 of 22 secondary schools in Glasgow, Scotland. Students from one year group (15-16 yrs., N= 3148; 50.8% women) provided information on socio-demographics, health behaviour and friendships via a questionnaire. Dependent variables were substance use and general mental wellbeing as composite scores on different measures. We used a series of multilevel models with students (level 1), network communities (peer groups) identified by the Walktrap algorithm (level 2), and schools (level 3). We found substantial and moderate clustering at the peer group level for substance use and mental wellbeing, respectively. Larger and more transitive groups were associated with less substance use, but worse mental wellbeing. Addressing the methodological gap regarding the influence of the choice of group detection method on findings, we repeated our analysis using nine additional methods. The choice of the method somewhat influenced peer group variance and greatly influenced association of peer group properties with health. This study makes two key contributions to school-health improvement research. Beyond describing the peer group clustering health outcomes, this is the first demonstration that structural and compositional characteristics of peer groups are associated with individual health, while highlighting the sensitivity of findings to group detection method used.

Outdoor and nature experiences including play have been shown to be beneficial for children's physical, cognitive, social and emotional development. Parents/carers play an important role in encouraging or impeding their child's access to the outdoor environment and participation in outdoor play. The COVID-19 pandemic and associated restrictions on free movement and social interactions placed an unprecedented pressure on families to manage the drastic change in their daily routines. This paper reports findings from two combined data sets generated in 2020 during the COVID-19 pandemic and provides a deeper understanding of the interconnected nature of how contextual factors influence parenting processes and outcomes relating to young children's outdoor and nature experiences and subsequent child health. Findings have the potential to inform the messaging of existing outdoor play policies and the content of new interventions aiming to promote the exposure of children to the natural outdoor environment.

Nature-based play benefits children's health and development. However, the delivery of this in early learning and childcare centres (ELC) is extremely diverse, and implementation is not well understood. We applied a systems science perspective to understand the factors crucial to implementing nature-based outdoor play in ELC settings. Through Group Model Building workshops with 20 participants in managerial and practitioner roles, crucial factors were appraised using Causal Loops Diagrams. Twelve thematic causal loops emerged. Network analysis was employed to analyse the diagram. Exponential Random graph models explained the diagram construction process. Centrality measures alongside conditional uniform tests identified six leverage factors: use of outdoor space, culture of being outdoors, ELC culture of outdoor play, perceived child safety and enjoyment, educator confidence and educator agency. This research brings novel and practically relevant evidence about the important factors, and interdependencies, involved in the implementation of outdoor play practice within ELC settings.

During the early years, children’s outdoor play is dependent on parental supervision. Parents’ perceptions are likely to influence what the child is permitted to do. To better understand the involved mechanisms in parents’ decision making in such contexts, an online photo-based questionnaire was administered. The tool investigates, in different situations, parents and their children’s experience, parents’ perceptions, and permission to play. A total of 417 parents of children aged from 1.5 and 6.0 completed the questionnaire. Results showed that parents, overall, have a positive attitude towards outdoor play. Main concerns were about risk of injury but in most cases, perceived benefits outweigh perceived dangers. “Sawing wood” was the only situation with a negative benefits/dangers balance. A linear regression analysis revealed that permission to play outdoors is based on parental assessment of benefits and dangers. Perceived benefits appeared to have more influence on parental decision than perceived dangers, while perceived competence had only a small influence. The results also showed that parents’ childhood experience of outdoor play was an important determinant for adults’ perceptions, perhaps demonstrating intergenerational concerns, as outdoor play is in decline. To overcome a negative intergenerational effect on children’s outdoor play, interventions and communication should focus on associated benefits.

Systematic reviews have demonstrated the scarcity of well-designed evaluations investigating outdoor nature-based play and learning provision for children in the early learning and childcare (ELC) sector among global Western countries. This study will examine the feasibility and acceptability of the programme and the evaluation design of outdoor nature-based play and learning provision across urban ELC settings in a Scottish metropolitan city. Six ELC settings with different outdoor nature-based play delivery models will be recruited. One trial design will be tested: a quasi-experimental comparison of children attending three different models of outdoor play and learning provision. Measures will be assessed at baseline and five weeks later. Key feasibility questions include: recruitment and retention of ELC settings and children; suitability of statistical matching based on propensity score; completeness of outcome measures. Process evaluation will assess the acceptability of trial design methods and provision of outdoor nature-based play among ELC educators. These questions will be assessed against pre-defined progression criteria. This feasibility study will inform a powered effectiveness evaluation and support policy making and service delivery in the Scottish ELC sector.

Insufficient physical activity (PA) among most children and adolescents is a global problem that is undermining the realisation of numerous developmental and health benefits. The aim of this study was to explore the potential impact of interventions on PA by using an agent-based model (ABM) simulating children's daily activities in an urban environment. Three domains for interventions were explored: outdoor play, school physical education and active travel. Simulated interventions increased children's average daily moderate-to-vigorous PA by 2–13 min and reduced the percentage of children not meeting PA guidelines, from 34% to 10%–29%, depending on the intervention. Promotion of active travel and outdoor play benefited more those in a higher socio-economic position. Agents' interactions suggested that: encouraging activity in diverse groups will reduce percentage of the least active in the population; and initiating outdoor events in neighbourhoods can generate an enhancing effect on children's engagement in PA. The ABM provided measurable outcomes for interventions that are difficult to estimate using reductionist methods. We suggest that ABMs should be used more commonly to explore the complexity of the social-environmental PA system., Highlights • We developed an agent-based model simulating children's daily physical activity. • Agents perform typical daily activities in a virtual urban model of Glasgow city. • Simulations explore impact of interventions on outdoor play, school, active travel. • Promotion of active travel had a differential impact across socio-economic position. • Outdoor play intervention produced a non-linear increase in physical activity.

This systematic review synthesised evidence on associations between nature-based early\ud childhood education (ECE) and children’s social, emotional, and cognitive development. A search\ud of nine databases was concluded in August 2020. Studies were eligible if: (a) children (2–7 years)\ud attended ECE, (b) ECE integrated nature, and (c) assessed child-level outcomes. Two reviewers\ud independently screened full-text articles and assessed study quality. Synthesis included effect\ud direction, thematic analysis, and results-based convergent synthesis. One thousand three hundred\ud and seventy full-text articles were screened, and 36 (26 quantitative; 9 qualitative; 1 mixed-methods)\ud studies were eligible. Quantitative outcomes were cognitive (n = 11), social and emotional (n = 13),\ud nature connectedness (n = 9), and play (n = 10). Studies included controlled (n = 6)/uncontrolled\ud (n = 6) before-after, and cross-sectional (n = 15) designs. Based on very low certainty of the evidence,\ud there were positive associations between nature-based ECE and self-regulation, social skills, social and\ud emotional development, nature relatedness, awareness of nature, and play interaction. Inconsistent\ud associations were found for attention, attachment, initiative, environmentally responsible behaviour,\ud and play disruption/disconnection. Qualitative studies (n = 10) noted that nature-based ECE afforded\ud opportunities for play, socialising, and creativity. Nature-based ECE may improve some childhood\ud development outcomes, however, high-quality experimental designs describing the dose and quality\ud of nature are needed to explore the hypothesised pathways connecting nature-based ECE to childhood\ud development (Systematic Review Registration: CRD42019152582).

Background Several systematic reviews have reviewed the evidence relating to nature on aspects of children and adolescent’s health and wellbeing; however, none have looked at the associations or effectiveness of attending nature-based early childhood education (ECE). The main objective is to systematically review and synthesise the evidence to determine if nature-based ECE enhances children’s health, wellbeing and development. Methods We will search the following electronic databases (from inception onwards): MEDLINE, Scopus, PsycINFO, ERIC, SportDiscus, Australian Education Index, British Education Index, Child Development and Adolescent studies, and Applied Social Sciences Index and Abstracts. Grey literature will be identified searching dissertations and reports (e.g. Open Grey, Dissertations Theses Database [ProQuest], and Google Scholar). All types of studies (quantitative and qualitative) conducted in children (aged 2–7 years old) attending ECE who had not started education at primary or elementary school will be included. The exposure of interest will be nature-based ECE settings that integrate nature into their philosophy and/or curriculum and environment. The outcomes of interest will be all aspects of the child’s physical, cognitive, social and emotional health wellbeing and development. Two reviewers will independently screen full-text articles. The study methodological quality (or bias) will be appraised using appropriate tools. If feasible, a meta-analysis will be conducted using a random-effect model for studies similar in exposure and outcome. Where studies cannot be included in a meta-analysis, findings will be summarised based on the effect directions and a thematic analysis will be conducted for qualitative studies. Discussion This systematic review will capture the state of the current literature on nature-based ECE for child health, wellbeing and development. The results of this study will be of interest to multiple audiences (including researchers and policy makers). Results will be published in a peer-reviewed journal. Gaps for future research will be identified and discussed. Systematic review registration PROSPERO CRD42019152582

The main goal of Physical Activity (PA) guidelines is to provide a structured and systematic set of evidence-based statements/recommendations that guide the public to improve their health through PA. A child is often referred to as physically inactive if they do not meet the PA guidelines. However, an active child can at the same time be a sedentary child; e.g., the child engages in 70 minutes of moderate to vigorous PA per day but spends the rest of the day seated behind his/her computer. Sedentary activities can include but are not limited to reading, sitting in a stroller/buggy, and watching a movie. The dose-response relationship can have different forms: for example, a dose-response relationship can be linear, which means that every added unit of something results in a consistent added health benefit. Sedentary behavior is defined as any waking behavior with an energy expenditure of less than 1.5 metabolic equivalents.

Background Living in urban or rural environments may influence children’s levels of physical activity and sedentary behaviours. We know little about variations in device-measured physical activity and sedentary levels of urban and rural children using nationally representative samples, or if these differences are moderated by socioeconomic factors or seasonal variation. Moreover, little is known about the influence of ‘walkability’ in the UK context. A greater understanding of these can better inform intervention strategies or policy initiatives at the population level. Methods Country-wide cross-sectional study in Scotland in which 774 children (427 girls, 357 boys), aged 10/11 years, wore an accelerometer on one occasion for at least four weekdays and one weekend day. Mean total physical activity, time spent in sedentary, light, and moderate-to-vigorous physical activity (MVPA), per day were extracted for weekdays, weekend days, and all days combined. Regression analyses explored associations between physical activity outcomes, urban/rural residence, and a modified walkability index (dwelling density and intersection density); with interactions fitted for household equivalised income and season of data collection. Sensitivity analyses assessed variation in findings by socioeconomic factors and urbanicity. Results Rural children spent an average of 14 min less sedentary (95% CI of difference: 2.23, 26.32) and 13 min more in light intensity activity (95% CI of difference, 2.81, 24.09) per day than those from urban settlements. No urban-rural differences were found for time spent in MVPA or in total levels of activity. Our walkability index was not associated with any outcome measure. We found no interactions with household equivalised income, but there were urban/rural differences in seasonal variation; urban children engaged in higher levels of MVPA in the spring months (difference: 10 mins, p = 0.06, n.s) and significantly lower levels in winter (difference: 8.7 mins, p = 0.036). Conclusions Extrapolated across one-year, rural children would accumulate approximately 79 h (or just over 3 days) less sedentary time than urban children, replacing this for light intensity activity. With both outcomes having known implications for health, this finding is particularly important. Future work should prioritise exploring the patterns and context in which these differences occur to allow for more targeted intervention/policy strategies.

This study aims to understand how children perceive their environment, exploring the affordances children perceive to influence their physical activity (PA) behaviour when outside. Participants included boys and girls aged 10–12 years (n = 15) living in Scotland. Children's visual and verbal representations of their perceived environment were analysed to assess environmental determinants of PA. The findings suggested that physical affordances that offer a sense of risk were important to children's play spaces. Social affordances influenced where the children went in their environment and the features they utilised as part of play behaviour; strangers were considered threatening depending on whether the activity was recognised.

ObjectivesTo study the extent to which home-to-school distance and neighbourhood walkability were associated with self-reported active travel to school (ATS) (eg, walking, cycling), and to explore how distance moderates the effect of walkability on ATS, among 10–11 years old.DesignCross-sectional study.SettingData were collected between May 2015 and May 2016 in partnership with the Growing Up in Scotland Study, a nationally representative longitudinal cohort study.Participants713 children (male (n=330) and female (n=383) 10–11 years old) from Studying Physical Activity in Children’s Environments across Scotland.Primary and secondary outcome measuresChildren who actively travelled to/from school categorised as active all (100% of ATS) and active 60%+ (at least 60% of ATS); home-to-school road/path network distance (ResultsDistance and walkability were both associated with ATS. The likelihood of ATS for all or most journeys decreased with increasing distance. Compared with ‘most’ walkable areas (Q1), the odds of active all were significantly lower within least walkable areas (Q5 OR 0.45, 95% CI 0.21 to 0.99), and odds of active 60%+ were significantly less in Q2–Q5 (lowest odds Q5 OR 0.20, 95% CI 0.07 to 0.47). Regarding walkability and distance interactions, for all distance categories, higher walkability increased the probability of ATS (for most school journeys).ConclusionWalkability was positively associated with ATS within all distance categories, with the relationship between walkability and ATS more complex than the clear-cut association between distance and ATS. A more walkable environment had a larger effect on the probability of reaching the 60% threshold of school journeys using ATS than the probability of always travelling in an active manner. Investment is needed in existing less walkable neighbourhoods to provide infrastructure to support opportunities for children’s ATS.

Research into how the environment affects health and related behaviour is typically limited in at least two ways: it represents the environment to which people are exposed using fixed areal units, and, it focuses on one or two environmental characteristics only. This study developed a methodology for describing children's mobility and the complexity of their environmental exposure across a 1934 km2 study area, including urban, suburban and rural zones. It conceptualised and modelled this area as a landscape, comprised of spatially discrete amenities, infrastructure features, differing land covers/use and broader environmental contexts. The model used a 25 m2 grid system (∼3 million cells). For each cell, there was detailed built-environment information. We joined data for 100 10/11-year-old children who had worn GPS trackers to provide individual-level mobility information for one week during 2015/16 to our model. Using negative binomial regression, we explored which landscape features were associated with a child visiting that space and time spent there. We examined whether relationships between the features across our study area and children's use of the space differed by their sociodemographic characteristics. We found that children often used specific amenities outside their home neighbourhood, even if they were also available close to home. They spent more time in cells containing roads/transportation stops, food/drink retail (Incidence rate ratio (IRR):4.02, 95%CI 2.33 to 6.94), places of worship (IRR:5.98, 95%CI 3.33 to 10.72) and libraries (IRR:7.40, 95%CI 2.13 to 25.68), independently of proximity to home. This has importance for the optimal location of place-based health interventions. If we want to target children, we need to understand that using fixed neighbourhood boundaries may not be the best way to do it. The variations we found in time spent in certain areas by sex and socio-economic position also raise the possibility that interventions which ignore these differences may exacerbate inequalities., Highlights • We describe children's mobility (using GPS) and their environmental exposures. • We find that children won't necessarily use facilities within their home area. • We developed a novel landscape model across a 1934km2 study area. • The model highlights specific land uses where children spent more or less time. • This is important for the optimal locating of place-based health interventions.

Background The environment in which we live, travel and socialise has a profound influence on health. Existing literature typically uses a fixed ‘neighbourhood’ as the unit of analysis – assuming often that people conduct their lives within that spatially defined unit. The aim of this study is to describe urban mobility and environmental exposure across an entire urban landscape. Methods Using the ‘Studying Physical Activity in Children’s Environments across Scotland’ (SPACES) study, we developed a novel concept to construct a model of the entire urban landscape within the Central Belt of Scotland. The model used a 25 m2 grid system (∼3 million GRID squares). For each cell, there was detailed built-environment information, including characteristics of the road network, retail outlets, greenspace, and walkability measures. SPACES used GPS to collect individual-level mobility information for 100 10-year-old children over the course of one week. Each child’s location was recorded every 10 seconds during waking hours and that data was joined to the urban landscape model. The result was a comprehensive dataset describing of whether and when each child visited each grid cell, how long they spent there, and what the location comprised. Using negative binomial regression, we explored which features of the built environment were associated with the child visiting that space at all, and with time spent there, and examined whether this differed by the sociodemographic characteristics of the child. Results We found land-uses across the urban landscape that were predictive of children spending time, such as: libraries ((coef) 2.0, 95% CI 1.0 to 3.0) and places of worship (1.8, 95% CI 1.2 to 2.5), and a linear relationship between increased walkability of a cell and a greater time spent there. Cells containing playing fields, public parks and play parks were predictive of children spending time, independently of proximity to their home. For most land-uses there were no differences by gender, except for leisure centres where girls spent more time than boys (4.0, 95% CI 1.0 to 7.0). Conclusion We created ‘personalised activity spaces’ which simultaneously assessed all the types of environment children could and did visit. The study found features of the urban landscape that, regardless of distance from home, children were more or less likely to spend time in. The ability to consider how children use their urban area, and the multiple environments they are exposed to, is a significant step towards understanding the urban environment as a complex system.

Objectives To describe the objectively measured levels of physical activity (PA) and sedentary time in a nationally representative sample of 10–11-year-old children, and compare adherence estimates to the UK PA guidelines using two approaches to assessing prevalence.\ud \ud Design Nationally representative longitudinal cohort study.\ud \ud Setting Scotland wide in partnership with the Growing up in Scotland (GUS) study. Data collection took place between May 2015 and May 2016.\ud \ud Participants The parents of 2402 GUS children were approached and 2162 consented to contact. Consenting children (n=1096) wore accelerometers for 8 consecutive days and 774 participants (427 girls, 357 boys) met inclusion criteria.\ud \ud Primary and secondary outcome measures Total PA (counts per minute, cpm); time spent sedentary and in moderate-to-vigorous PA (MVPA); proportion of children with ≥60 min MVPA on each day of wear (daily approach); proportion of children with ≥60 min of MVPA on average across days of wear (average approach)—presented across boys and girls, index of multiple deprivation and season.\ud \ud Results: Mean PA level was 648 cpm (95% CI, 627 to 670). Children spent 7.5 hours (7.4–7.6) sedentary/day and 72.6 min (70.0–75.3) in MVPA/day. 11% (daily) and 68% (average) of children achieved the recommended levels of PA (P

Background: Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. Objectives: In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. Methods: The SPACES (Studying Physical Activity in Children’s Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. Results: Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. Conclusions: We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development. [JMIR Res Protoc 2018;7(4):e110]

BACKGROUND Large-scale primary data collections are complex, costly, and time-consuming. Study protocols for trial-based research are now commonplace, with a growing number of similar pieces of work being published on observational research. However, useful additions to the literature base are publications that describe the issues and challenges faced while conducting observational studies. These can provide researchers with insightful knowledge that can inform funding proposals or project development work. OBJECTIVES In this study, we identify and reflectively discuss the unforeseen or often unpublished issues associated with organizing and implementing a large-scale objectively measured physical activity and global positioning system (GPS) data collection. METHODS The SPACES (Studying Physical Activity in Children’s Environments across Scotland) study was designed to collect objectively measured physical activity and GPS data from 10- to 11-year-old children across Scotland, using a postal delivery method. The 3 main phases of the project (recruitment, delivery of project materials, and data collection and processing) are described within a 2-stage framework: (1) intended design and (2) implementation of the intended design. RESULTS Unanticipated challenges arose, which influenced the data collection process; these encompass four main impact categories: (1) cost, budget, and funding; (2) project timeline; (3) participation and engagement; and (4) data challenges. The main unforeseen issues that impacted our timeline included the informed consent process for children under the age of 18 years; the use of, and coordination with, the postal service to deliver study information and equipment; and the variability associated with when participants began data collection and the time taken to send devices and consent forms back (1-12 months). Unanticipated budgetary issues included the identification of some study materials (AC power adapter) not fitting through letterboxes, as well as the employment of fieldworkers to increase recruitment and the return of consent forms. Finally, we encountered data issues when processing physical activity and GPS data that had been initiated across daylight saving time. CONCLUSIONS We present learning points and recommendations that may benefit future studies of similar methodology in their early stages of development.

Background: The development of accurate methods to measure health-behaviours forms an integral component in behavioural epidemiology. Population surveillance of physical activity often relies on self/proxy reported questionnaires due to cost and relative ease of administration. The aim of this study was to examine the criterion validity and measurement agreement between the Youth Physical Activity Questionnaire (YPAQ) and accelerometry before being included in a Scotland-wide study.\ud \ud Methods: Forty four participants (12–13 years old; 61% girls) completed the YPAQ following 7 days wearing the Actigraph GT3X+. Mean moderate-to-vigorous physical activity (MVPA) per day was derived from YPAQ and accelerometer and validity was assessed using Spearman's correlation; Bland-Altman plots examined absolute agreement between methods.\ud \ud Results: Pearson's and Spearman’s correlations between YPAQ and accelerometer were r = 0.47 and rs = 0.39 (p

The Previous Day Physical Activity Recall (PDPAR) self-report questionnaire asks children to categories their time in 30 min blocks under activity codes and activity intensity (ActInt). Text and visual descriptors of ActInt are used which include posture and stepping intensity. This study aimed to objectively examine postures and stepping activity associated with PDPAR ActInt. Forty-three (19M/24F) 11-13 year children completed the PDPAR and wore a physical activity monitor (8 d). Within 30 min blocks the % sitting/lying, standing and stepping, steps, cadence and sit-to-stand transitions (STS) were examined by PDPAR ActInt across and within all activity codes. Data (14 083 30 min blocks) showed from light to moderate ActInt lower sedentary time, higher standing and stepping time, steps, sit-to-stand transitions and cadence (all P < 0.001). Between moderate and hard ActInt, time sedentary was lower and time stepping, steps and STS higher (all P < 0.005). No significant differences between hard and very hard. There was a wide variation of activity levels between activity codes within ActInt. ActInt within the PDPAR was not used consistently between activity codes. However, over all codes children demonstrated that they could distinguish between light and moderate and in some objective measures between moderate and hard, but not between hard and very hard ActInt.

Background:\ud A number of studies based in the US, Canada, and Australia, have found evidence of associations between the built environment (BE) and mode of transport to school, and links between active travel and deprivation. Limited research in the UK compares potential BE supports for walking to school by area deprivation. Within this study, we gathered data on BE attributes previously linked to active travel, i.e., street/path connectivity, and dwelling density, created a composite ‘walkability score’ (WS) for areas around primary schools across urban Scotland, and explored whether poorer areas exhibit lower scores than more affluent areas, or vice versa. We consider this to be a novel approach as few studies have compared BE features by deprivation across a whole country.\ud \ud Methods:\ud Address and road/path maps were obtained and primary schools (N = 937) across mainland Scotland were mapped. Schools were attributed income deprivation scores (scores divided into quintiles (Q1: least deprived, Q5: most deprived)). Catchment area (CA) boundaries, i.e., the geographic area representing eligibility for local school attendance, were drawn around schools, and WS calculated for each CA. We compared mean WS by income quintile (ANOVA), for all local authorities (LAs) combined (N = 29), and separately for the four LAs with the greatest number of schools included in the analysis.\ud \ud Results:\ud For all LAs combined, the least deprived quintile (Q1) showed a significantly lower WS (−0.61), than quintiles 3, 4 and 5 (Q2: −0.04 (non-sig), Q3: 0.38, Q4: 0.09, Q5: 0.18); while for Glasgow the second least deprived quintile (Q2) showed significantly higher WS (Q1: 1.35, Q2: 1.73), than middling (Q3: 0.18) and most deprived quintiles (Q4: 0.06, Q5: −0.10).\ud \ud Conclusion:\ud WS differ by deprivation with patterns varying depending on the spatial scale of the analysis. It is essential that less walkable areas are provided with the resources to improve opportunities to engage in active travel.

AB Purpose: The term cadence has been used interchangeably to describe both the rate of stepping and the number of steps in a minute epoch. This is only strictly true if walking is continuous within that epoch. This study directly compared these two outcomes in minute epochs of data from free-living adults to assess the scale of any difference between them. Methods: A convenience sample of healthy adults wore an activPAL activity monitor for 7 d. The event record output of the activPAL, providing the start time and duration of each stride to the nearest 0.1 s, was used to calculate step accumulation (number of steps), duration of walking, and cadence (number of steps/duration of walking) for each minute of measurement. Results: Data from 117 individuals (78 females; mean age, 46 +/- 16 yr; mean body mass index, 24.9 +/- 3.7 kg[middle dot]m-2) were analyzed. Twenty-one percent of minutes (n = 310d-1) contained walking. The distribution (most minutes fewer than 40 steps per minute) and mean (34 +/- 9 steps per minute) of step accumulation were very different from that of cadence (most minutes between 60 and 100 steps per minute; mean, 76 +/- 6 steps per minute). Only 12% of minutes with stepping were walked continuously, whereas 69% of minutes with stepping contained less than 30 s of walking. This is key to the difference between step accumulation and cadence, and means that cadence cannot be reconstructed from step accumulation without also knowing the duration that was walked. Conclusion: Step accumulation, the number of steps in a fixed period, and cadence, the rate of stepping while walking, are not interchangeable outcome measures. It is vitally important that unambiguous terminology is used to describe the rate of stepping so that the outcomes of studies can be correctly interpreted

Evidence suggests that behaviours such as standing are beneficial for our health. Unfortunately, little is known of the prevalence of this state, its importance in relation to time spent stepping or variation across seasons. The aim of this study was to quantify, in young adolescents, the prevalence and seasonal changes in time spent upright and not stepping (UNSt(time)) as well as time spent upright and stepping (USt(time)), and their contribution to overall upright time (U(time)). Thirty-three adolescents (12.2 ± 0.3 y) wore the activPAL activity monitor during four school days on two occasions: November/December (winter) and May/June (summer). UNSt(time) contributed 60% of daily U(time) at winter (Mean = 196 min) and 53% at summer (Mean = 171 min); a significant seasonal effect, p0.001. USt(time) was significantly greater in summer compared to winter (153 min versus 131 min, p0.001). The effects in UNSt(time) could be explained through significant seasonal differences during the school hours (09:00-16:00), whereas the effects in USt(time) could be explained through significant seasonal differences in the evening period (16:00-22:00). Adolescents spent a greater amount of time upright and not stepping than they did stepping, in both winter and summer. The observed seasonal effects for both UNSt(time) and USt(time) provide important information for behaviour change intervention programs.

All dental students at the School of Medicine and Dentistry have to undertake a group project on some aspect of Oral Biology. Each group has to make a presentation on their project to their peers and members of staff (including an external assessor). Because of the poor standard of delivery, it was decided to offer each student a short course in presentation skills. The course was devised and run by a professional voice consultant. The aim was to help students develop clear voice production and improve their confidence under stress. Methods used included identifying students’ strengths and pitfalls, breathing exercises, relaxation exercises, vocal exercises&training in voice production, coordination of body movements and advice on the use of overhead transparencies and slides.

Measurements of red cell counts, haemoglobin concentrations, packed cell volumes, reticulocyte percentages and pyruvate kinase levels were carried out daily in rabbits infected with either Trypanosoma brucei brucei S42 or T. b. brucei 427. With both stocks, rabbits became anaemic within 7 days, the anaemia being initially more severe in those animals infected with the S42 stock. Mean cell volumes, percentage of reticulocytes and pyruvate kinase levels increased during the infection, whereas mean cell haemoglobins remained relatively constant and mean cell haemoglobin concentrations decreased. Red cell T50 values were reduced in both infections, especially when the infecting organism was T. b. brucei S42. Bone marrow aspirates showed a general hyperplasia. The evidence is indicative of an anaemia which is haemolytic in origin, in spite of normal serum bilirubin concentrations. Possible mechanisms of haemolysis are discussed and it is concluded that the major cause is red cell damage due to the attachment to the erythrocytes of immune-complex factors, together with sequestration and destruction of red cells in the spleen and other organs of the reticuloendothelial system.

A build-up anti-globulin technique has been used to detect immunoglobulin on the red cells of rabbits infected with Trypanosoma brucei brucei S 42 and 427. The method, which is useful for the detection of immunoglobulin on sparsely coated red cells, involves treating the red cells of infected rabbits with anti-globulin followed by alternate globulin and anti-globulin layers until a lattice is built up which allows agglutination to occur. The red cells of five infected rabbits have been tested with anti-rabbit IgG, -IgM and broad spectrum anti-globulin reagents at intervals after infection and following the administration of Berenil, a drug which destroys trypanosomes. The positive anti-globulin reactions which developed following inoculation with trypanosomes were much reduced after giving Berenil. The tests became more strongly positive again in two rabbits after reinfection.

In this article, we consider children’s perceptions of their social and physical outdoor environment in relation to their physical activity (PA) behaviour in Scotland, United Kingdom. Drawing from a pilot study, participants included three groups of children aged between ten and twelve of mixed gender (n=15). Visual and verbal representations of their perceived environment were analysed to assess environmental determinants of PA. Results found an absence of suitable play affordances, safety, parental restriction, and environmental aesthetics was a key factor to children spending time outdoors. Strengths and limitations of the study are discussed, as are implications for policy and practice.