A 24-hour waist-worn accelerometry protocol implemented in U.S. children produced 22.6 out of 24 hours of possible wear time, and 61.8 more minutes/day of waking wear time than a similarly implemented and processed waking wear time waist-worn accelerometry protocol. Consistent results were obtained internationally. The 24-hour protocol may produce an important increase in wear time compliance that also provides an opportunity to study the total sleep episode time separate and distinct from physical activity and sedentary time detected during waking-hours.
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Other researchers have attempted to extend wear time compliance using wrist-worn monitors assuming that this attachment site is more convenient and/or comfortable for participants [6]. Wearing time from a 24-hour wrist worn protocol is indeed longer than that obtained from a waking-hours waist-worn protocol, however, it is difficult to discern whether the improvement results from the attachment site (waist versus hip) or the length of the wearing protocol (waking day versus 24-hour) if both attachment site and instructed wear time differ between conditions, as is being implemented in current NHANES data collection cycles [6]. It remains possible that at least some of the observed difference in wear time compliance between the U.S. children studied in ISCOLE and NHANES was due to differential implementation of compliance enhancing strategies. Specifically, the U.S. ISCOLE site conducted reminder phone calls and gave participating children small incentives (e.g., erasers, stickers) for wearing compliance. However, the consistently higher wear time apparent with implementation of the 24-hour accelerometer protocol across all ISCOLE sites (some of which did not visit schools, provide small incentives, or conduct phone calls) relative to the NHANES enhances confidence in our conclusion that merely extending the duration of a waist-worn accelerometer protocol enhances wear time compliance. It is important to point out, however, that ISCOLE accelerometers were distributed in a school setting and multiple children within the same peer group were simultaneously assessed. In contrast, NHANES distributed accelerometers to individual children at a single face-to-face testing center encounter, data collection staff were available only by phone to answer questions or concerns, a reminder post card was mailed to encourage return of the accelerometer, and a monetary incentive was provided for its return. A carefully planned prospective study focused only on the impact of different accelerometer wear time protocol requirements on actual wear time compliance is warranted to rule out competing explanations.
The vaccine was not intended for marketing in malaria-free areas, and the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency was asked to review the Phase 3 data and to provide a scientific opinion based on vaccine quality and the risk/benefit assessment from a regulatory perspective. This process is known as article 58, and is invoked for medicinal products manufactured for human use in a European Union (EU) state that are intended exclusively for markets outside the EU, yet it requires that products meet the same standards as those marketed in the EU. The CHMP performed a scientific evaluation of the vaccine and issued a positive opinion in July 2015, indicating that the risk/benefit assessment is favorable. The CHMP noted that the benefits may be especially important for children in high transmission areas.
Sedentary behaviour The odds ratio for obesity increased linearly as the number of hours of television viewing increased (χ2 test for linear trend 26.7). For children reported to watch television for 4-8 hours per week at age 3 the adjusted odds ratio for obesity at age 7 was 1.37 (1.02 to 1.83). For those reported to watch more than eight hours per week the adjusted odds ratio was 1.55 (1.13 to 2.12).
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