Imperial College School of Medicine (ICSM) is the medical school of Imperial College London in England, and one of the United Hospitals. It is part of the college's Faculty of Medicine, and was formed by the merger of several historic medical schools, with core campuses at South Kensington, St Mary's, Charing Cross, Hammersmith and Chelsea and Westminster. The school ranked 4th in the world for medicine in the 2018 Times Higher Education World University Rankings.
Objectives:To examine associations between The Daily Mile, a school-based active mile intervention, and pupils' physical activity, mental health and educational performance. Methods:Year 1 pupils (aged 5-6 years) from Greater London primary schools were invited. Schools were allocated to The Daily Mile or non-Daily Mile group based on their reported Daily Mile participation. We measured weekday school hours mean minutes of moderate-to-vigorous physical activity (MVPA) using GENEActiv accelerometers. Other outcomes included time spent sedentary and in light activity, mental health and educational performance. Multi-level linear regression models examined differences accounting for repeated measurements (day) clustered by pupils-, class- and school-level, with adjustments for sex, ethnic group, area-level deprivation and month of assessment. Results:A total of 1004 pupils/40 schools were recruited and assessed between October 2021 and January 2023; 21 schools/499 pupils comprised The Daily Mile group; 19 schools/505 pupils the non-Daily Mile group. Daily Mile pupils spent 2.2 min more in MVPA compared with non-Daily Mile pupils, but the difference was not significant (0.78, 95% CI -2.14 to 3.69). Daily Mile pupils spent less time sedentary and more time in light activity compared with the non-Daily Mile pupils, but not significantly (-5.06, 95% CI -15.37 to 5.26 and 3.27, 95% CI -4.26 to 10.81, respectively). There were no differences in mental health or educational performance. Conclusions:We found no associations between The Daily Mile and pupils' physical activity, mental health and educational performance. Pupils in our study were in year 1 with early exposure to the intervention; assessments over longer periods are needed to understand any benefits.
Microplastics (MPs), a new class of pollutants that pose a threat to aquatic biodiversity, are of increasing global concern. In tandem, the amphibian chytrid fungus Batrachochytrium dendrobatidis (Bd) causing the disease chytridiomycosis is emerging worldwide as a major stressor to amphibians. We here assess whether synergies exist between this infectious disease and MP pollution by mimicking natural contact of a highly susceptible species (midwife toads, Alytes obstetricans) with a Bd-infected reservoir species (fire salamanders, Salamandra salamandra) in the presence and absence of MPs. We found that MP ingestion increases the burden of infection by Bd in a dose-dependent manner. However, MPs accumulated to a greater extent in amphibians that were not exposed to Bd, likely due to Bd-damaged tadpole mouthparts interfering with MP ingestion. Our experimental approach showed compelling interactions between two emergent processes, chytridiomycosis and MP pollution, necessitating further research into potential synergies between these biotic and abiotic threats to amphibians.
Introduction Misclassification errors have been reported in rapid diagnostic HIV tests (RDTs) in sub-Saharan African countries. These errors can lead to missed opportunities for prevention-of-mother-to-child-transmission (PMTCT), early infant diagnosis and adult HIV-prevention, unnecessary lifelong antiretroviral treatment (ART) and wasted resources. Few national estimates or systematic quantifications of sources of errors have been produced. We conducted a comprehensive assessment of possible sources of misclassification errors in routine HIV testing in Zimbabwe. Methods RDT-based HIV test results were extracted from routine PMTCT programme records at 62 sites during national antenatal HIV surveillance in 2017. Positive- (PPA) and negative-percent agreement (NPA) for HIV RDT results and the false-HIV-positivity rate for people with previous HIV-positive results ("known-positives") were calculated using results from external quality assurance testing done for HIV surveillance purposes. Data on indicators of quality management systems, RDT kit performance under local climatic conditions and user/clerical errors were collected using HIV surveillance forms, data-loggers and a Smartphone camera application (7 sites). Proportions of cases with errors were compared for tests done in the presence/absence of potential sources of errors. Results NPA was 99.9% for both pregnant women (N = 17224) and male partners (N = 2173). PPA was 90.0% (N = 1187) and 93.4% (N = 136) for women and men respectively. 3.5% (N = 1921) of known-positive individuals on ART were HIV negative. Humidity and temperature exceeding manufacturers' recommendations, particularly in storerooms (88.6% and 97.3% respectively), and premature readings of RDT output (56.0%) were common. False-HIV-negative cases, including interpretation errors, occurred despite staff training and good algorithm compliance, and were not reduced by existing external or internal quality assurance procedures. PPA was lower when testing room humidity exceeded 60% (88.0% vs. 93.3%; p = 0.007). Conclusions False-HIV-negative results were still common in Zimbabwe in 2017 and could be reduced with HIV testing algorithms that use RDTs with higher sensitivity under real-world conditions and greater practicality under busy clinic conditions, and by strengthening proficiency testing procedures in external quality assurance systems. New false-HIV-positive RDT results were infrequent but earlier errors in testing may have resulted in large numbers of uninfected individuals being on ART.
Each decade, the American Heart Association (AHA) develops an Impact Goal to guide its overall strategic direction and investments in its research, quality improvement, advocacy, and public health programs. Guided by the AHA's new Mission Statement, to be a relentless force for a world of longer, healthier lives, the 2030 Impact Goal is anchored in an understanding that to achieve cardiovascular health for all, the AHA must include a broader vision of health and well-being and emphasize health equity. In the next decade, by 2030, the AHA will strive to equitably increase healthy life expectancy beyond current projections, with global and local collaborators, from 66 years of age to at least 68 years of age across the United States and from 64 years of age to at least 67 years of age worldwide. The AHA commits to developing additional targets for equity and well-being to accompany this overarching Impact Goal. To attain the 2030 Impact Goal, we recommend a thoughtful evaluation of interventions available to the public, patients, providers, healthcare delivery systems, communities, policy makers, and legislators. This presidential advisory summarizes the task force's main considerations in determining the 2030 Impact Goal and the metrics to monitor progress. It describes the aspiration that these goals will be achieved by working with a diverse community of volunteers, patients, scientists, healthcare professionals, and partner organizations needed to ensure success.
