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Issue Addressed: In Australia only 1 in 12 people will survive an out of hospital cardiac arrest (OHCA). Heart Safe Community (HSC) is a public health initiative being implemented by the Heart Foundation, Victoria in partnership with Ambulance Victoria. It aims to improve survival from OHCA by improving public access to 24 hours Automated External Defibrillators (AEDs) and by building local community skills and confidence in basic resuscitation. Over the period 2017-20, the University of Melbourne was commissioned to evaluate the implementation, effectiveness, and sustainability of three HSC pilots in Victoria, Australia., Methods: Mixed methods were used including eight focus group discussions with 64 local HSC community stakeholders and local HSC pilot site evaluation data., Results: The local HSC pilot community presentation surveys revealed that the HSC pilots delivered hundreds of presentations on bystander resuscitation, with 2772 local community members being exposed to the call to action: 'Call, Push Shock' and 'anyone can save a life'. Focus group discussions revealed that the HSC pilots built local community capacity to respond to OHCA as demonstrated by increased knowledge, confidence and skills to call Emergency Medical Services, attempt chest compression, acquire and use an AED. Community leadership to advocate for improved access to AEDs and to propagate HSC initiatives amongst community settings and cohorts has occurred. HSC implementation enablers and challenges exist. Community capacity-building frameworks can explain what makes the HSC pilot work., Conclusion: HSC can build local community capacity to respond to OHCA. Eight principles are suggested to support the building, implementation and sustainability of future HSC efforts. SO WHAT?: The HSC experience reveals that community members across the lifespan and multiple settings embrace opportunities to improve the safety and response in their community to a cardiac arrest when the action is simplified and community ownership cultivated., (© 2021 Australian Health Promotion Association.)

Objective: We aimed to provide the first national estimates of cardiopulmonary resuscitation (CPR) training and awareness of cardiac arrest., Design: A retrospective analysis of a national cross-sectional survey was undertaken. Data were collected online from adults in July 2017 as part of the Heart Foundation of Australia's HeartWatch survey. We used logistic regression to examine demographic factors associated with CPR training., Participants: A national cohort was invited to participate in the survey using purposive, non-probability sampling methods with quotas for age, gender and area of residence, in order to reflect the wider Australian population. The final sample consisted of 1076 respondents., Main Outcome Measure: To determine an estimation of the prevalence of cardiac arrest awareness and CPR training at a national level and the relationship of training to demographic factors., Results: The majority (76%) of respondents were born in Australia with 51% female and 66% aged between 35 and 64 years. Only 16% of respondents could identify the difference between a cardiac arrest and a heart attack. While 56% reported previous CPR training, only 22% were currently trained (within 1 year). CPR training was associated with younger age (35 to 54 years) (OR 1.45, 95% CI 1.06 to 2.0), being born in Australia (OR 1.59, 95% CI 1.17 to 2.17) and higher levels of education (university, OR 1.86, 95% CI 1.35 to 2.57). CPR training increased confidence in respondents ability to perform effective CPR and use a defibrillator. Lack of CPR training was the most common reason why respondents would not provide CPR to a stranger., Conclusions: There is a need to improve the community's understanding of cardiac arrest, and to increase awareness and training in CPR. CPR training rates have not changed over the past decades-new initiatives are needed., Competing Interests: Competing interests: JF and JB hold appointments with the International Liaison Committee on Resuscitation (ILCOR). JF holds an Adjunct Research Professor appointment with St John Western Australia., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background : Few studies have examined school physical activity policies to assess dose-response on student outcomes. The purpose of this study was to evaluate the association between health-promoting physical activity policies in elementary schools and physical activity behavior. Methods : In this cross-sectional study, physical activity was assessed using self-report measures in fourth-grade students in Texas (N = 1958, x  = 9.66 y) from the School Physical Activity and Nutrition (SPAN) survey. School policies were assessed using the number of health-promoting policies in place taken from the SPAN School Health Survey with principals and their proxies. Multiple linear regressions adjusted for student- and school-level confounders and school clustering were performed. Results : School physical activity policies were significantly associated with student-level physical activity behavior ( P  < .05), even after controlling for the student- and school-level confounding variables. The interactions between physical activity policy-by-economic disadvantage ( P  < .01) and between physical activity policy-by-geographic strata ( P  < .01) were both significant, with stronger direct effects of policies on student physical activity for economically disadvantaged schools and major urban schools. Conclusion : Results from this study provide evidence for the importance of school-based health policies and practices in potentially reducing health disparities, especially in low-income and urban schools.

Objective: Investigate associations between perceived parental/peer support for a healthy diet and adolescent dietary behaviors using data from the 2009-2011 School Physical Activity and Nutrition (SPAN) survey., Design: A secondary analysis of SPAN, a cross-sectional statewide study using a validated self-administered questionnaire, assessed obesity-related behaviors., Setting: Probability-based sample of Texas 8th- and 11th-grade students., Participants: A total of 6,716 8th- and 11th-grade students., Main Outcome Measures: Obtained by self-report and included sugary beverage consumption, fruit and vegetable intake, and SPAN healthy eating score., Analysis: Multiple logistic regression and linear regression were used to determine associations, controlling for demographic variables., Results: For every 1-point increase in parental support (range, 0-12), adolescents had 1.19 times higher odds of consuming ≥1 fruits or vegetables/d (P < .001) and 1.1 times lower odds of consuming ≥2 sugary beverages/d (P < .05), and had a SPAN healthy eating score (range, -100 to 100) that was 1.6 points higher (P < .001). For every 1-point increase in peer support, adolescents had 1.14 times higher odds of consuming ≥1 fruits and vegetables/d (P < .001) and a higher SPAN healthy eating score (P < .05)., Conclusions and Implications: Parental/peer support was associated with healthier dietary behaviors. Future research could conduct pre-post intervention studies to determine whether an increase in parental/peer support is associated with positive changes in healthier eating., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: It is well documented in the literature that low socioeconomic status (SES) is associated with lower consumption of healthy foods and that these differences in consumption patterns are influenced by neighborhood food environments. Less understood is the role that SES differences in physical and social aspects of the home food environment play in consumption patterns., Methods: Using data on 4th grade children from the 2009-2011 Texas School Physical Activity and Nutrition (SPAN) study, we used mixed-effects regression models to test the magnitude of differences in the SPAN Health Eating Index (SHEI) by parental education as an indicator of SES, and the extent to which adjusting for measures of the home food environment, and measures of the neighborhood environment accounted for these SES differences., Results: Small but significant differences in children’s SHEI by SES strata exist (-1.33 between highest and lowest SES categories, p<0.01). However, incorporating home food environment and neighborhood environment measures in this model eliminates these differences (-0.7, p=0.145). Home food environment explains a greater portion of the difference. Both social (mealtime structure) and physical aspects (food availability) of the home food environment are strongly associated with consumption of healthy and unhealthy foods., Conclusions: Our findings suggest that modifiable parent behaviors at home can improve children’s eating habits and that the neighborhood may impact diet in ways other than through access to healthy food.

Purpose: To determine the association between youth sport team participation and dietary behaviors among elementary school-aged children., Design: Cross-sectional survey., Setting: Public schools in Texas during 2009-2010., Subjects: A total of 5035 ethnically diverse fourth graders., Measures: Participation in organized sports teams, consumption of select food items (fruits, vegetables, beverages, sweets/snacks)., Analysis: Multiple logistic regression was used to assess the association between each food item (eaten at least once on the previous day) and number of sports teams as the independent class variable (0, 1 ,2, ≥3), adjusting for body mass index physical activity, socioeconomic status, and ethnicity., Results: Significant dose-response associations were observed between number of sports teams and consumption of fruits and vegetables. For boys, the likelihood of eating fruit and fruit-flavored drinks was significantly higher and the odds of drinking soda were lower with the number of teams. For girls, the likelihood of consuming green vegetables increased as sports teams participation increased, and participation was positively associated with diet soda consumption. A positive association was observed between the number of sports teams and scores on the Healthy Food Index for boys and girls., Conclusion: The findings that sports participation is associated with consumption of fruits and vegetables and lower consumption of soda suggest that efforts should be focused on supporting youth team sports to promote healthier food choices. Since sports are available to all ages, sports may be an important venue for promoting healthier dietary behaviors.

Objectives: The aim of this study was to compare the duration and severity of postoperative pain for two different tonsillotomy techniques (radiofrequency [RF] and microdebrider [MD]) with the standard tonsillectomy., Methods: This non-randomised retrospective study, carried out from February 2011 to September 2012, investigated 128 children in two independent centres: Heim Pál Children's Hospital in Budapest, Hungary, and Muscat Private Hospital in Muscat, Oman. Those undergoing conventional tonsillectomies acted as the control group. One centre tested the MD technique (n = 28) while the other centre tested the RF technique (n = 31)., Results: The pain-free period after the tonsillotomies was similar between the two techniques and ranged up to three days. Other indicators of pain resolution, like the use of a single analgesic, reduced night-time waking and the time taken to resume a normal diet, were also similar for the two groups. However, patients benefited significantly from having a tonsillotomy rather than a tonsillectomy., Conclusion: The partial resectioning of tonsillar tissue using the MD and RF techniques showed promising outcomes for a better postoperative quality of life when compared to a traditional tonsillectomy. In this study, the results of both the MD and RF tonsillotomy methods were almost identical in terms of the duration of postoperative pain and recovery time.

Uterine size, endometrial thickness and ovarian volume were measured ultrasonically and the results compared with caliper measurements made shortly afterwards at the time of total hysterectomy and bilateral salpingo-oophorectomy. The results establish the validity of ultrasound measurements. Histological studies also confirmed the diagnosis made with ultrasound of polycystic ovaries in women complaining of pain due to pelvic congestion.

A microsurgical method for the injection of cells into the postimplantation mouse embryo whilst it is in utero is described. Specific regions of the 9.5-day-old mouse embryo brain have been injected with marker substances, such regions including the intraventricular cavity of the telencephalon and the trigeminal facialis ganglion bulge of the forebrain. Histological study of the injected embryos shows that the injection method is precise and able to avoid damage to other nearly embryonic tissues. The method should have wide application in the study of questions of normal cell lineage, neoplasia, teratology, and toxicology.