Background: The COVID-19 pandemic interfered with delivery of childhood weight management programs. Get Up & Go is a community group program for children 6-14 years with BMI>85th%ile and their ...families that provides fun learning about healthy nutrition, physical activity, and behavior change at no cost to families. The program is effective in improving %BMIp95, reported healthy lifestyle, and physical endurance. This study evaluates the participation and effect of a virtual delivery option offered starting winter 2021. Methods: Groups of 5-12 families met in-person at a YMCA or via synchronous virtual delivery. Parents chose setting. Each of the 10 weekly lessons lasted 60-90 minutes. Data include demographics and pre- and post- measured weights, heights, and parent-completed behavior assessment questionnaires (BAQ), with score range of 0100, higher indicating healthier behavior. Graduation criterion is attendance at 6 of 9 non-orientation classes. Results: Among the registered families, 46 of 82 (56%) who chose virtual actually attended vs 40 of 56 (71%) who chose in-person (p = 0.07). Baseline characteristics of attenders did not differ (we report virtual, then in-person): mean age (SD) 11.1 (2.5) vs 11.1 (2.2) years, male 29 (63.0%) vs 23 (57.5%), Spanish-speaking 18 (39.1%) vs 12 (31.6%), severe obesity (>120% BMIp95) in 39 (84.8%) vs 30 (75.0%), and baseline BAQ scores 34.9 (13.2) vs 37.2 (12.1). Virtual participants attended more classes than in-person participants: 7.3 (2.3) vs 6.1 (2.9), p = 0.04. More virtual participants met graduation criterion: 35 (87.5%) vs 24 (63.2%), p = 0.01. Among graduates with post-measures, mean change in %BMIp95 was -3.27 (6.20) for n = 32 virtual vs -1.09 (3.84) for n = 23 in-person, p = 0.11, and mean BAQ increase was 15.4 (13.1) for n = 34 virtual vs 11.4 (10.6) for n = 21 in-person, p = 0.25. Conclusions: The synchronous, group virtual delivery of the Get Up & Go program engaged similar participants, with higher attendance and no difference in %BMIp95 and BAQ outcomes, compared with contemporaneous in-person delivery. Continued virtual delivery option could expand the availability of this program without compromising effect.
Women's empowerment has gained attention as critical for child nutrition during the first 1000 days of life. However, the ways in which various women's empowerment measures are applied and the ...evidence for how they are differentially related to child nutrition is unclear. In this systematic review, therefore, we 1) systematically parse the many ways in which women's empowerment has been quantitatively measured in the context of child nutrition through the use of a theoretically driven application of dimensions and domains of empowerment; 2) summarize evidence for each of the various pathways between women's empowerment and child nutrition, based on dimensions and domains of empowerment; and 3) offer suggestions for future research to better articulate the relationship between women's empowerment and child nutrition. A search of evidence yielded 62 quantitative studies that used 200 unique indicators of women's empowerment, tested in 1316 associations with various child nutrition outcomes. Despite the large number of unique indicators, indicators for time resource allocation and reproductive decisions and indicators for men's engagement in child care and nutrition, all pertinent to child nutrition, were missing. Overall, the findings indicated an inconclusive relationship between women's empowerment and child nutrition: 379 out of 461 (82% weighted) and 217 out of 258 (84% weighted) associations found with stunting and wasting outcomes, respectively, were not significant. The current lack of evidence is likely not due to the absence of an underlying relationship between women's empowerment and child nutrition, but rather limitations in study design. Future research should carefully select women's empowerment indicators in context-specific ways, aggregate them meaningfully, and use a longitudinal study design to conduct pathway and lifecycle analysis in appropriate populations to clarify the relationship between women's empowerment and child nutrition.
Because of the COVID-19 pandemic, the Get Up & Go program, an established effective 10-week healthy weight program for children ages 6-14 years provided free to families, has offered the option of a ...synchronous virtual delivery. Pre- and postassessments include a parental questionnaire about child's health behaviors, and weight and height measurements of children. Over 3 cycles, 116 and 107 families registered for virtual and in-person delivery, respectively, with 70 (60.3%) and 84 (78.5%) attending ≥1 session (
= 0.003). More families in virtual delivery spoke Spanish (41.4% vs. 22.6%,
= 0.01), but children did not differ in age, gender, and severe obesity status, and baseline behavior scores and graduation rates were similar. Improvement from baseline in BMI
was -3.71 standard deviation (SD) 5.26 for virtual delivery and -1.95 (3.69) (
= 0.06) for in-person. Behavior questionnaire improvement +15.9 (12.9) vs. +14.2 (12.0),
= 0.51 did not differ. The virtual implementation demonstrated good effect and may be useful in nonpandemic environments.
Purpose
Surgical trainees are exposed to less procedures with increasing need for simulation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become increasingly implemented for ...hemorrhage control, yet most courses are catered to faculty level with little data on trainees. We propose that routine training in this critical procedure will improve trainee performance over time.
Methods
This is a prospective, observational study at a level I trauma center involving a monthly trauma procedural program. Early in the month, trainees received hands-on REBOA training; at the end, trainees underwent standardized, class-based evaluation on a perfused trainer. Score percentages were recorded (0–100%). Endpoints included early, mid and late performance (2–12 months). Paired T-test and Pearson’s coefficient were used to evaluate differences and strength of association between time between training and performance.
Results
25 trainees participated with 5 and 11 repeat learners in the PGY-2 and PGY-3 classes, respectively. Median early performance score was 62.5% (IQR 56–81) for PGY-2s and 91.6% (IQR 75–100) in PGY-3s. Pearson’s coefficient between time between and training and score demonstrated a weak correlation in the PGY-2s (
r
2
= − 0.13), but was more pronounced in the PGY-3s (
r
2
= − 0.44) with an inflection point at 5 months.
Conclusions
Routine REBOA training in trainees is associated with improvement in performance within a short period of time. Skill degradation was most pronounced in trainees who did not receive training for more than 5 months. Trainees can be successfully trained in REBOA; however, this should be done at shorter intervals to prevent skill degradation.
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