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1.
Background:Developing appropriate concussion prevention and management paradigms in middle school(MS)settings requires understanding parents’general levels of concussion-related knowledge and attitudes.This study examined factors associated with concussion-symptom knowledge and care-seeking attitudes among parents of MS children(aged 10-15 years).Methods:A panel of 1224 randomly selected U.S.residents,aged ≥18 years and identifying as parents of MS children,completed an online questionnaire capturing parental and child characteristics.The parents’concussion-symptom knowledge was measured using 25 questions,with possible answers being“yes”,“maybe”,and“no”.Correct answers earned 2 points,“maybe”answers earned 1 point,and incorrect answers earned 0 point(range:0-50;higher scores=better knowledge).Concussion care-seeking attitudes were also collected using five 7-point scale items(range:5-35;higher scores=more positive attitudes).Multivariable ordinal logistic regression models identified predictors of higher scores.Models met proportional odds assumptions.Adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs)(excluding 1.00)were deemed statistically significant.Results:Median scores were 39(interquartile range:32-44)for symptom knowledge and 32(interquartile range:28-35)for care-seeking attitude.In multivariable models,odds of better symptom knowledge were higher in women vs.men(aOR=2.28;95%CI:1.71-3.05),white/non-Hispanics vs.other racial or ethnic groups(aOR=1.88;95%CI:1.42-2.49),higher parental age(10-year-increase aOR=1.47;95%CI:1.26-1.71),and greater competitiveness(10%-scale-increase aOR=1.24;95%CI:1.13-1.36).Odds of more positive care-seeking attitudes were higher in white/non-Hispanics vs.other racial or ethnic groups(aOR=1.45;95%CI:1.06-1.99)and in older parental age(10-year-increase aOR=1.24;95%CI:1.05-1.47).Conclusion:Characteristics of middle school children’s parents(e.g.,sex,race or ethnicity,age)are associated with their concussion-symptom knowledge and care-seeking attitudes.Parents’variations in concussion knowledge and attitudes warrant tailored concussion education and prevention.  相似文献   

2.
PurposeThis study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise (MSE) recommendations and identify correlates of meeting the MSE recommendations.MethodsCross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study, a nationally representative sample of Chinese children and adolescents (n = 80,413; mean age = 13.7 years; 53.9% girls) and their parents, were analyzed. Children and adolescents who reported engaging ≥3 days (up to 7 days) of MSE per week were classified as meeting the MSE recommendations. MSE, demographics, lifestyle behaviors (sport participation, moderate-to-vigorous physical activity, screen time, and sleep duration), exercise intention, peer and parental support, and parental MSE participation were assessed through self-reports. Logistic regression models were used to determine the correlates of meeting the MSE recommendations. The analyses were completed in 2020.ResultsOverall, 39.3% of children and adolescents met the MSE recommendations. Girls, 10th–12th graders, minorities, those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations. Children and adolescents who were proficient in ≥2 sports were more likely to meet the MSE recommendations (adjusted odds ratio (aOR) = 1.44, 95% confidence interval (95%CI): 1.26–1.65), as were those with more moderate-to-vigorous physical activity (aOR = 1.57, 95%CI: 1.53–1.61). Additionally, children and adolescents with high exercise intention (aOR = 1.60, 95%CI: 1.51–1.69), those whose parents met the adult MSE recommendations (aOR = 1.46, 95%CI: 1.40–1.52), and those who received high peer (aOR = 1.27, 95%CI: 1.20–1.34) and parental support (aOR = 1.07, 95%CI: 1.04–1.12) were more likely to meet the MSE recommendations.ConclusionLess than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations. The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.  相似文献   

3.
Purpose:The study aimed to conduct a comprehensive systematic review and meta-analysis of injury incidence in professional skiers and snowboarders.Methods:We systematically searched PubMed,Web of Science,and MEDLINE for studies on injury incidence published from inception to April 2020.Injury data were extracted,alongside information on injury location,severity,type,cause,and sport discipline.Incidence of injuries was presented per 1000 athlete-days,with 95%confidence intervals(95%CIs).Results:The search identified 462 articles,and 22 were included in our review.The overall incidence of injuries among professional skiers and snowboarders was 3.49 per 1000 athlete-days(95%CI:2.97-4.01).Lower extremity had the highest injury incidence(1.54 per 1000 athletedays,95%CI:1.24-1.84).Incidence rates of slight,mild,moderate,and severe injuries were 0.26,0.31,0.57,and 0.59 per 1000 athlete-days,respectively.Contusion had the highest incidence rate(1.82 per 1000 athlete-days,95%CI:1.01-2.63).The most common cause of injury was contact trauma(3.20 per 1000 athlete-days,95%CI:1.32-5.08).Freestyle skiing had the highest incidence rate(6.83 per 1000 athlete-days,95%CI:4.00-9.66),and Nordic skiing had the lowest rate(2.70 per 1000 athlete-days,95%CI:1.94-3.46).Conclusion:Professional skiers and snowboarders have a substantial risk of sustaining injuries.Our findings can be used to inform the planning and provision of healthcare for elite participants in different snow sports.  相似文献   

4.
Background:The tandem gait test has gained interest recently for assessment of concussion recovery.The purpose of our study was to determine the prognostic and diagnostic use of the single-and dual-task tandem gait test,alongside other clinical measures,within 10 days of pediatric concussion.Methods:We assessed 126 patients post-concussion(6.3§2.3 days post-injury,mean§SD)at a pediatric sports medicine clinic and compared them to 58 healthy controls(age:15.6§1.3 years;43%female).We also compared the 31 patients with concussion who developed persistent post-concussion symptoms(PPCS)(age=14.9§2.0 years;48%female)to the 81 patients with concussion who did not develop PPCS following the initial assessment(age:14.1§3.0 years;41%female).All subjects completed a test battery,and concussion patients were monitored until they experienced concussion-symptom resolution.The test battery included tandem gait(single-task,dual-task(performing tandem gait while concurrently completing a cognitive test)conditions),modified Balance Error Scoring System(mBESS),and concussion symptom assessment(Health and Behavior Inventory).We defined PPCS as symptom resolution time>28 days post-concussion for the concussion group.Measurement outcomes included tandem gait time(single-and dual-task),dual-task cognitive accuracy,mBESS errors(single/double/tandem stances),and symptom severity.Results:The concussion group completed the single-task(mean difference=9.1 s,95%confidential interval(95%CI):6.1-12.1)and dual-task(mean difference=12.7 s,95%CI:8.716.8)tandem gait test more slowly than the control group.Compared to those who recovered within 28 days of concussion,the PPCS group had slower dual-task tandem gait test times(mean difference=7.9 s,95%CI:2.0-13.9),made more tandem-stance mBESS errors(mean difference=1.3 errors,95%CI:0.2-2.3),and reported more severe symptoms(mean difference=26.6 Health and Behavior Inventory rating,95%CI:21.1-32.6).Conclusion:Worse dual-task tandem gait test time and mBESS tandem stance performance predicted PPCS in pediatric patients evaluated within 10 days of concussion.Tandem gait assessments may provide valuable information augmenting common clinical practices for concussion management.  相似文献   

5.
BackgroundAdopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens. However, the lifestyles of children with mental, behavioral, and developmental disorders (MBDDs) remains under-described within the literature of public health field. This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.MethodsData were from the 2016–2020 National Survey of Children's Health—A national, population-based, cross-sectional study. We used the data of 119,406 children aged 6–17 years, which included 38,571 participants with at least 1 MBDD and 80,835 without. Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity, screen time, and sleep duration.ResultsAmong children with MBDDs, 20.3%, 37.0%, 60.7%, and 77.3% met the physical activity, screen time, sleep, and at least 1 of the 24-hour movement guidelines. These rates were lower than those in children without MBDDs (22.8%, 46.2%, 66.7%, and 83.4%, respectively; all p < 0.001). Children with MBDDs were less likely to meet these guidelines (odds ratio (OR) = 1.21, 95% confidence interval (95%CI): 1.13–1.30; OR = 1.37, 95%CI: 1.29–1.45; OR = 1.29, 95%CI: 1.21–1.37; OR = 1.45, 95%CI: 1.35–1.56) than children without MBDDs. Children with emotional disorders had the highest odds of not meeting these guidelines (OR = 1.43, 95%CI: 1.29–1.57; OR = 1.48, 95%CI: 1.37–1.60; OR = 1.49, 95%CI: 1.39–1.61; OR = 1.72, 95%CI: 1.57–1.88) in comparison to children with other MBDDs. Among children aged 12–17 years, the difference in proportion of meeting physical activity and screen time guidelines for children with vs. children without MBDD was larger than that among children aged 6–11 years. Furthermore, the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.ConclusionChildren with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs. In educational and clinical settings, the primary focus should be on increasing physical activity and limiting screen time in children aged 12–17 years who have MBDDs; and specifically for white children who have MBDDs, increasing physical activity may help.  相似文献   

6.
ObjectiveThis cross-sectional study examined environmental correlates of sedentary behavior (SB) and physical activity (PA) in preschool children in the urban area of Tianjin, China.MethodsData were collected from the Physical Activity and Health in Tianjin Chinese Children study, involving healthy children 3–6 years old and their families. In all children (n = 980), leisure-time SB (LTSB) and leisure-time PA (LTPA) were reported in min/day by parents. In a subgroup (n = 134), overall sedentary time, light PA, and moderate-to-vigorous PA (MVPA) were objectively measured using ActiGraph accelerometry (≥3 days, ≥10 h/day). Environmental correlates were collected using a questionnaire that included home and neighborhood characteristics (e.g., traffic safety, presence of physical activity facilities) and children's behaviors. Potential correlates were identified using linear regression analysis.ResultsMultiple linear regression analysis showed that “having grandparents as primary caregivers” (βs and 95% confidence intervals (95%CIs) for overall sedentary time: 29.7 (2.1–57.2); LTSB (ln): 0.19 (0.11–0.28)) and “having a television (for LTSB (ln): 0.13 (0.00–0.25)) or computer (for LTSB (ln): 0.13 (0.03–0.23)) in the child's bedroom” were both associated with higher SB. Furthermore, “having grandparents as primary caregivers” was associated with less MVPA (β (95%CI): ?7.6 (?14.1 to ?1.2)), and “active commuting to school by walking” correlated with more MVPA (β (95%CI): 9.8 (2.2–17.4)). The path model showed that “more neighborhood PA facilities close to home” was indirectly related to higher LTPA (ln), which was partly mediated by “outdoor play” (path coefficients (95%CI): 0.005 (0.002–0.008)) and “going to these facilities more often” (path coefficients (95%CI): 0.013 (0.008–0.018)). Traffic safety was not a correlate.ConclusionFamily structure and media exposure in the home maybe important factors in shaping preschoolers’ PA patterns. Built environmental correlates could indirectly influence preschoolers’ LTPA through parental help with engaging in active behaviors.  相似文献   

7.
BackgroundMeeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide.MethodsFour electronic databases (MEDLINE, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021. Studies that were conducted with apparently healthy participants and reported the overall (non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.ResultsSixty-three studies comprising 387,437 individuals (51% girls) aged 3–18 years from 23 countries were included. Overall, 7.12% (95% confidence interval (95%CI): 6.45%–7.78%) of youth met all three 24-Hour Movement Guidelines, and 19.21% (95%CI: 16.73%–21.69%) met none of the 3 recommendations. Concerning sex, adherence to all recommendations was significantly lower in girls (3.75%, 95%CI: 3.23%–4.27%) than in boys (6.89%, 95%CI: 5.89%–7.89%) (p < 0.001). However, there were no sex differences regarding adherence to any of the 3 individual recommendations (girls, 15.66%, 95%CI: 8.40%–22.92%; boys, 12.95%, 95%CI: 6.57%–19.33%). In terms of age group, adherence to the 3 recommendations was 11.26% (95%CI: 8.68%–13.84%), 10.31% (95%CI: 7.49%–13.12%), and 2.68% (95%CI: 1.78%–3.58%) in preschoolers, children, and adolescents, respectively. Conversely, 8.81% (95%CI: 5.97%–11.64%) of preschoolers, 15.57% (95%CI: 11.60%–19.54%) of children, and 28.59% (95%CI: 22.42%–34.75%) of adolescents did not meet any of the recommendations. South America was the region with the lowest adherence (all: 2.93%; none: 31.72%). Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index (β = –0.37, 95%CI: –0.65 to –0.09; p = 0.010).ConclusionMost young people fail to meet the three 24-Hour Movement Guidelines, particularly adolescents, girls, and those who are from countries with a lower Human Development Index. Moreover, 1 in 5 young people did not meet any of these recommendations. Therefore, these results highlight the need to develop age- and sex-specific strategies to promote these movement behaviors from the early stages of life.  相似文献   

8.
PurposeThe coronavirus disease-2019 (COVID-19) pandemic in the United States led to nationwide stay-at-home orders and school closures. Declines in energy expenditure resulting from canceled physical education classes and reduced physical activity may elevate childhood obesity risk. This study estimated the impact of COVID-19 on childhood obesity.MethodsA microsimulation model simulated the trajectory of a nationally representative kindergarten cohort's body mass index z-scores and childhood obesity prevalence from April 2020 to March 2021 under the control scenario without COVID-19 and under the 4 alternative scenarios with COVID-19—Scenario 1: 2-month nationwide school closure in April and May 2020; Scenario 2: Scenario 1 followed by a 10% reduction in daily physical activity in the summer from June to August; Scenario 3: Scenario 2 followed by 2-month school closure in September and October; and Scenario 4: Scenario 3 followed by an additional 2-month school closure in November and December.ResultsRelative to the control scenario without COVID-19, Scenarios 1, 2, 3, and 4 were associated with an increase in the mean body mass index z-scores by 0.056 (95% confidence interval (95%CI): 0.055–0.056), 0.084 (95%CI: 0.084–0.085), 0.141 (95%CI: 0.140–0.142), and 0.198 (95%CI: 0.197–0.199), respectively, and an increase in childhood obesity prevalence by 0.640 (95%CI: 0.515–0.765), 0.972 (95%CI: 0.819–1.126), 1.676 (95%CI: 1.475–1.877), and 2.373 (95%CI: 2.135–2.612) percentage points, respectively. Compared to girls and non-Hispanic whites and Asians, the impact of COVID-19 on childhood obesity was modestly larger among boys and non-Hispanic blacks and Hispanics, respectively.ConclusionPublic health interventions are urgently called to promote an active lifestyle and engagement in physical activity among children to mitigate the adverse impact of COVID-19 on unhealthy weight gains and childhood obesity.  相似文献   

9.
Objective:Since concussion is the most common injury in ice hockey,the objective of the current study was to elucidate risk factors,specific mechanisms,and clinical presentations of concussion in men’s and women’s ice hockey.Methods:Ice hockey players from 5 institutions participating in the Concussion Assessment,Research,and Education Consortium were eligible for the current study.Participants who sustained a concussion outside of this sport were excluded.There were 332(250 males,82 females)athletes who participated in ice hockey,and 47(36 males,11 females)who sustained a concussion.Results:Previous concussion(odds ratio(OR)=2.00;95%confidence interval(95%CI):1.02‒3.91)was associated with increased incident concussion odds,while wearing a mouthguard was protective against incident concussion(OR=0.43;95%CI:0.22‒0.85).Overall,concussion mechanisms did not significantly differ between sexes.There were specific differences in how concussions presented clinically across male and female ice hockey players,however.Females(9.09%)were less likely than males(41.67%)to have a delayed symptom onset(p=0.045).Additionally,females took significantly longer to reach asymptomatic(p=0.015)and return-to-play clearance(p=0.005).Within the first 2 weeks post-concussion,86.11%of males reached asymptomatic,while only 45.50%of females reached the same phase of recovery.Most males(91.67%)were cleared for return to play within 3 weeks of their concussion,compared to less than half(45.50%)of females.Conclusion:The current study proposes possible risk factors,mechanisms,and clinical profiles to be validated in future concussions studies with larger female sample sizes.Understanding specific risk factors,concussion mechanisms,and clinical profiles of concussion in collegiate ice hockey may generate ideas for future concussion prevention or intervention studies.  相似文献   

10.
PurposeThis study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise (MSE) recommendations and identify correlates of meeting the MSE recommendations.MethodsCross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study, a nationally representative sample of Chinese children and adolescents (n = 80,413; mean age = 13.7 years; 53.9% girls) and their parents, were analyzed. Children and adolescents who reported engaging ≥3 days (up to 7 days) of MSE per week were classified as meeting the MSE recommendations. MSE, demographics, lifestyle behaviors (sport participation, moderate-to-vigorous physical activity, screen time, and sleep duration), exercise intention, peer and parental support, and parental MSE participation were assessed through self-reports. Logistic regression models were used to determine the correlates of meeting the MSE recommendations. The analyses were completed in 2020.ResultsOverall, 39.3% of children and adolescents met the MSE recommendations. Girls, 10th–12th graders, minorities, those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations. Children and adolescents who were proficient in ≥2 sports were more likely to meet the MSE recommendations (adjusted odds ratio (aOR) = 1.44, 95% confidence interval (95%CI): 1.26–1.65), as were those with more moderate-to-vigorous physical activity (aOR = 1.57, 95%CI: 1.53–1.61). Additionally, children and adolescents with high exercise intention (aOR = 1.60, 95%CI: 1.51–1.69), those whose parents met the adult MSE recommendations (aOR = 1.46, 95%CI: 1.40–1.52), and those who received high peer (aOR = 1.27, 95%CI: 1.20–1.34) and parental support (aOR = 1.07, 95%CI: 1.04–1.12) were more likely to meet the MSE recommendations.ConclusionLess than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations. The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.  相似文献   

11.
ABSTRACT

To comprehensively shed light on whether viewing football games is associated with a higher risk of cardiovascular disease (CVD). Electronic databases were searched through 17 May 2018. All studies focusing on the association between viewing football matches and the fatal or non-fatal CVD were identified. Viewing football matches was associated with a higher risk of fatal overall CVD (RR: 1.06, 95%CI: 1.01–1.12) in both men (RR: 1.13, 95%CI: 1.004–1.28) and women (RR: 1.08, 95%CI: 1.01–1.15). Subgroup analysis showed that failure of the team has a higher risk of fatal overall CVD (RR: 1.29, 95%CI: 1.15–1.45). However, lower risk of fatal overall CVD from spectators was observed when team obtained a victory (RR: 0.80, 95%CI: 0.66–0.96). For non-fatal CVD, viewing football matches was associated with a higher risk of non-fatal overall CVD (RR: 1.24, 95%CI: 1.09–1.41) in both men (RR: 1.73, 95%CI: 1.12–2.69) and women (RR: 1.25, 95%CI: 1.08–1.45). Subgroup analysis showed that viewing football matches was associated with a higher risk of non-fatal myocardial infarction (RR: 1.20, 95%CI: 1.04–1.38) in both men and women (RR: 1.51, 95%CI: 0.99–2.28; RR: 1.21, 95%CI: 1.08–1.36, respectively). No significant increase was found in fatal or non-fatal stroke. Viewing football matches was associated with a higher risk of the fatal and non-fatal CVD, especially in male spectators. The victory of team could have a lower risk of fatal CVD. Therefore, precautionary measures should be required for the reduction of healthcare burden in football matches.  相似文献   

12.
PurposeThis study aimed to examine the effects of plyometric jump training (PJT) on lower-limb stiffness.MethodsSystematic searches were conducted in PubMed, Web of Science, and Scopus. Study participants included healthy males and females who undertook a PJT programme isolated from any other training type.ResultsThere was a small effect size (ES) of PJT on lower-limb stiffness (ES = 0.33, 95% confidence interval (95%CI): 0.07–0.60, z = 2.47, p = 0.01). Untrained individuals exhibited a larger ES (ES = 0.46, 95%CI: 0.08–0.84, p = 0.02) than trained individuals (ES = 0.15, 95%CI: ‒0.23 to 0.53, p = 0.45). Interventions lasting a greater number of weeks (>7 weeks) had a larger ES (ES = 0.47, 95%CI: 0.06–0.88, p = 0.03) than those lasting fewer weeks (ES = 0.22, 95%CI: ‒0.12 to 0.55, p = 0.20). Programmes with ≤2 sessions per week exhibited a larger ES (ES = 0.39, 95%CI: 0.01–0.77, p = 0.04) than programmes that incorporated >2 sessions per week (ES = 0.20, 95%CI: –0.10 to 0.50, p = 0.18). Programmes with <250 jumps per week (ES = 0.50, 95%CI: 0.02–0.97, p = 0.04) showed a larger effect than programmes with 250–500 jumps per week (ES = 0.36, 95%CI: 0.00–0.72, p = 0.05). Programmes with >500 jumps per week had negative effects (ES = –0.22, 95%CI: –1.10 to 0.67, p = 0.63). Programmes with >7.5 jumps per set showed larger effect sizes (ES = 0.55, 95%CI: 0.02–1.08, p = 0.04) than those with <7.5 jumps per set (ES = 0.32, 95%CI: 0.01–0.62, p = 0.04).ConclusionPJT enhances lower-body stiffness, which can be optimised with lower volumes (<250 jumps per week) over a relatively long period of time (>7 weeks).  相似文献   

13.
BackgroundCardiorespiratory fitness (CRF) is inversely associated with mortality in apparently healthy subjects and in some clinical populations, but evidence for the association between CRF and all-cause and/or cardiovascular disease (CVD) mortality in patients with established CVD is lacking. This study aimed to quantify this association.MethodsWe searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up. Pooled hazard ratios (HRs) were calculated using random-effect inverse-variance analyses.ResultsData were obtained from 21 studies and included 159,352 patients diagnosed with CVD (38.1% female). Pooled HRs for all-cause and CVD mortality comparing the highest vs. lowest category of CRF were 0.42 (95% confidence interval (95%CI): 0.28–0.61) and 0.27 (95%CI: 0.16–0.48), respectively. Pooled HRs per 1 metabolic equivalent (1-MET) increment were significant for all-cause mortality (HR = 0.81; 95%CI: 0.74–0.88) but not for CVD mortality (HR = 0.75; 95%CI: 0.48–1.18). Coronary artery disease patients with high CRF had a lower risk of all-cause mortality (HR = 0.32; 95%CI: 0.26–0.41) than did their unfit counterparts. Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients (HR = 0.83; 95%CI: 0.76–0.91) but not lower among those with heart failure (HR = 0.69; 95%CI: 0.36–1.32).ConclusionA better CRF was associated with lower risk of all-cause mortality and CVD. This study supports the use of CRF as a powerful predictor of mortality in this population.  相似文献   

14.
PurposeTo evaluate the potential of a year-round school calendar (180-day school year distributed across 12 months) as an intervention compared to a traditional school calendar (180-day school year distributed across 9 months) for mitigating children's weight gain and fitness loss via a natural experiment.MethodsHeight, weight, and cardiorespiratory fitness (CRF) (i.e., Fitnessgram Progressive Aerobic Cardiovascular Endurance Run) were measured in children (5–12 years old) in 3 schools (2 traditional, 1 year-round, n = 990 students, age = 8.6 ± 2.4 years, 53.1% male, 68.9% African American) from 1 school district. Structure (represented by the presence of a school day) was the independent variable. Changes in body mass index (BMI), age- and sex-specific BMI z-scores (zBMI), BMI percentile, percent of overweight or obese children, and CRF (Progressive Aerobic Cardiovascular Endurance Run laps completed) were assessed for summer 2017 (May–August 2017), school year 2017/2018 (August 2017–May 2018), and summer 2018 (May–August 2018). Primary analyses examined the overall change in weight and CRF from summer 2017 until summer 2018 via multilevel mixed effects regression, with group (traditional vs. year-round calendar), time, and a group-by-time interaction as the independent variables. Secondary regression analyses estimated differences in change within and between groups during each time period, separately.ResultsYear-round students gained less BMI (difference in ∆ = –0.44, 95% confidence interval (CI): –0.67 to –0.03) and less CRF (difference in ∆ = –1.92, 95%CI: –3.56 to –0.28) than students attending a traditional school overall. Compared with traditional students, during both summers, year-round students gained less BMI (summer 2017 difference in ∆ = –0.15, 95%CI: –0.21 to –0.08; summer 2018 difference in ∆ = –0.16, 95%CI: –0.24 to –0.07) and zBMI (summer 2017 difference in ∆ = –0.032, 95%CI: –0.050 to –0.010; summer 2018 difference in ∆ = –0.033, 95%CI: –0.056 to –0.009), and increased CRF (summer 2017 difference in ∆ = 0.40, 95%CI: 0.02–0.85; summer 2018 difference in ∆ = 0.23, 95%CI: –0.25 to 0.74). However, the opposite was observed for the school year, with traditional students gaining less BMI and zBMI and increasing CRF compared with year-round students (difference in BMI ∆ = 0.05, 95%CI: 0.03–0.07; difference in zBMI ∆ = 0.012, 95%CI: 0.005–0.019; difference in Progressive Aerobic Cardiovascular Endurance Run laps ∆ = –0.43, 95%CI: –0.58 to –0.28).ConclusionThe year-round school calendar had a small beneficial impact on children's weight status but not CRF. It is unclear if this benefit to children's weight would be maintained because gains made in the summer were largely erased during the school year. Trajectories of weight and CRF gain/loss were consistent with the structured days hypothesis.  相似文献   

15.
BackgroundThe trade-off between the benefits of regular physical activity (PA) and the potentially detrimental effects of augmented exposure to air pollution in highly polluted regions remains unclear. This study aimed to examine whether ambient fine particulate matter (PM2.5) exposure modified the impacts of PA volume and intensity on hypertension risk.MethodsWe included 54,797 participants without hypertension at baseline in a nationwide cohort of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. PA volume and intensity were assessed by questionnaire, and high-resolution (1 km ×1 km) PM2.5 estimates were generated using a satellite-based model.ResultsDuring 413,516 person-years of follow-up, 12,100 incident hypertension cases were identified. PM2.5 significantly modified the relationship between PA and hypertension incidence (pinteraction < 0.001). Increased PA volume was negatively associated with incident hypertension in the low PM2.5 stratum (<59.8 μg/m3, ptrend < 0.001), with a hazard ratio of 0.81 (95% confidence interval (95%CI): 0.74–0.88) when comparing the fourth with the first quartile of PA volume. However, the health benefits were not observed in the high PM2.5 stratum (≥59.8 μg/m3, ptrend = 0.370). Moreover, compared with light PA intensity, vigorous intensity was related to a 20% (95%CI: 9%–29%) decreased risk of hypertension for participants exposed to low PM2.5, but a 17% (95%CI: 4%–33%) increased risk for those with high PM2.5 levels.ConclusionPA was associated with a reduced risk of hypertension only among participants with low PM2.5 exposure. Our findings recommended regular PA to prevent hypertension in less polluted regions and reinforced the importance of air quality improvement.  相似文献   

16.
BackgroundThis study examined the joint associations of sleep patterns and physical activity (PA) with all-cause, cardiovascular disease (CVD), and cancer mortality.MethodsA total of 341,248 adults (mean age = 39.7 years; men: 48.3%) were included in the study, with a 15-year follow-up. Participants reported sleep duration and disturbances (difficulty falling asleep, easily awakened, or use of sleeping medication). PA was classified into 4 levels: <7.5, 7.5–14.9, 15.0–29.9, and ≥30.0 metabolic equivalent hours per week (MET-h/week). To understand the joint associations of sleep patterns and PA with mortality, Cox proportional hazard models were conducted, with exposure variables combining sleep duration/disturbances and PA.ResultsCompared with the reference group (sleeping 6–8 h/day), individuals who slept >8 h/day had higher risk for all-cause mortality (hazard ratio (HR) = 1.307, 95% confidence interval (95%CI): 1.248–1.369), CVD mortality (HR = 1.298, 95%CI: 1.165–1.445), and cancer mortality (HR = 1.128, 95%CI: 1.042–1.220). Short sleep duration was not associated with mortality risk. Increased risk of all-cause and CVD mortality was found in participants who had difficulty falling asleep (HR = 1.120, 95%CI: 1.068–1.175; HR = 1.163, 95%CI: 1.038–1.304, respectively), and used sleeping medication (HR = 1.261, 95%CI: 1.159–1.372; HR = 1.335, 95%CI: 1.102–1.618, respectively) compared with those who slept well. Long sleep duration and sleep disturbances were not associated with risk of all-cause and CVD mortality among individuals achieving a PA level of ≥15 MET-h/week, and in particular among those achieving ≥30 MET-h/week.ConclusionLong sleep duration, difficulty falling asleep, and use of sleeping medication were related to a higher risk of death. Being physically active at a moderate intensity for 25–65 min/day eliminated these detrimental associations.  相似文献   

17.
Abstract

This study examined the agreement between estimates of thigh volume (TV) with anthropometry and dual-energy x-ray absorptiometry (DXA) in healthy school children. Participants (n=168, 83 boys and 85 girls) were school children 10.0–13.9 years of age. In addition to body mass, height and sitting height, anthropometric dimensions included those needed to estimate TV using the equation of Jones & Pearson. Total TV was also estimated with DXA. Agreement between protocols was examined using linear least products regression (Deming regressions). Stepwise regression of log-transformed variables identified variables that best predicted TV estimated by DXA. The regression models were then internally validated using the predicted residual sum of squares method. Correlation between estimates of TV was 0.846 (95%CI: 0.796–0.884, Sy·x=0.152L). It was possible to obtain an anthropometry-based model to improve the prediction of TVs in youth. The total volume by DXA was best predicted by adding body mass and sum of skinfolds to volume estimated with the equation of Jones & Pearson (R=0.972; 95%CI: 0.962–0.979; R 2=0.945).  相似文献   

18.
Background:Cross-sectional evidence and small-scale trials suggest positive effects of stair climbing on cardiometabolic disease and glucose regulation.However,few studies have examined the long-term association between stair climbing and the incidence of type 2 diabetes(T2D).We aimed to prospectively evaluate the association of stair climbing with T2D and assess modifications by genetic predisposition to T2D.Methods:We included 451,699 adults(mean age=56.3±8.1 years,mean±SD;55.2% females) witho...  相似文献   

19.
BackgroundPhysical inactivity and insomnia symptoms are independently associated with increased risk of depression and anxiety; however, few studies jointly examine these risk factors. This study aimed to prospectively examine the joint association of physical activity (PA) and insomnia symptoms with onset of poor mental health in adults.MethodsParticipants from the 2013 to 2018 annual waves of the Household Income and Labour Dynamics in Australia panel study who had good mental health (Mental Health Inventory-5 >54) in 2013, and who completed at least 1 follow-up survey (2014–2018), were included (n = 10,977). Poor mental health (Mental Health Inventory-5 ≤ 54) was assessed annually. Baseline (2013) PA was classified as high/moderate/low, and insomnia symptoms (i.e., trouble sleeping) were classified as no insomnia symptoms/insomnia symptoms, with 6 mutually exclusive PA-insomnia symptom groups derived. Associations of PA–insomnia symptom groups with onset of poor mental health were examined using discrete-time proportional-hazards logit-hazard models.ResultsThere were 2322 new cases of poor mental health (21.2%). Relative to the high PA/no insomnia symptoms group, there were higher odds (odds ratio and 95% confidence interval (95%CI)) of poor mental health among the high PA/insomnia symptoms (OR = 1.87, 95%CI: 1.57–2.23), moderate PA/insomnia symptoms (OR = 1.93, 95%CI: 1.61–2.31), low PA/insomnia symptoms (OR = 2.33, 95%CI: 1.96–2.78), and low PA/no insomnia symptoms (OR = 1.14, 95%CI: 1.01–1.29) groups. Any level of PA combined with insomnia symptoms was associated with increased odds of poor mental health, with the odds increasing as PA decreased.ConclusionThese findings highlight the potential benefit of interventions targeting both PA and insomnia symptoms for promoting mental health.  相似文献   

20.
BackgroundCurrent protein biomarkers are only moderately predictive at identifying individuals with mild traumatic brain injury or concussion. Therefore, more accurate diagnostic markers are needed for sport-related concussion.MethodsThis was a multicenter, prospective, case-control study of athletes who provided blood samples and were diagnosed with a concussion or were a matched non-concussed control within the National Collegiate Athletic Association–Department of Defense Concussion Assessment, Research, and Education Consortium conducted between 2015 and 2019. The blood was collected within 48 h of injury to identify protein abnormalities at the acute and subacute timepoints. Athletes with concussion were divided into 6 h post-injury (0–6 h post-injury) and after 6 h post-injury (7–48 h post-injury) groups. We applied a highly multiplexed proteomic technique that used a DNA aptamers assay to target 1305 proteins in plasma samples from athletes with and without sport-related concussion.ResultsA total of 140 athletes with concussion (79.3% males; aged 18.71 ± 1.10 years, mean ± SD) and 21 non-concussed athletes (76.2% males; 19.14 ± 1.10 years) were included in this study. We identified 338 plasma proteins that significantly differed in abundance (319 upregulated and 19 downregulated) in concussed athletes compared to non-concussed athletes. The top 20 most differentially abundant proteins discriminated concussed athletes from non-concussed athletes with an area under the curve (AUC) of 0.954 (95% confidence interval: 0.922‒0.986). Specifically, after 6 h of injury, the individual AUC of plasma erythrocyte membrane protein band 4.1 (EPB41) and alpha-synuclein (SNCA) were 0.956 and 0.875, respectively. The combination of EPB41 and SNCA provided the best AUC (1.000), which suggests this combination of candidate plasma biomarkers is the best for diagnosing concussion in athletes after 6 h of injury.ConclusionOur data suggest that proteomic profiling may provide novel diagnostic protein markers and that a combination of EPB41 and SNCA is the most predictive biomarker of concussion after 6 h of injury.  相似文献   

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