Exercise Opportunities Research Articles

Weight as an indicator of enclosure suitability in Livingstone's fruit bats (Pteropus livingstonii).

Obesity is common in zoo animals, and both dietary management and the provision of adequate opportunities for exercise are needed to tackle it. We used 30 years of records from Jersey Zoo to compare the weight and forearm length of wild and captive-born Livingstone's fruit bats (Pteropus livingstonii), and to assess the impact on weight of enclosure space. The mean capture weight of wild-caught male Livingstone's bats was 657 g, significantly higher than that of females (544 g). In both wild and captive-born bats, males had significantly longer forearms than females, but there was no effect of birth location. Males weighed more in the mating season than at other times of year. Both sexes gained more weight during development if born in enclosures that restricted flight rather than a large aviary; this was particularly noticeable in females. After reaching maturity at 3 years, weights of bats born in restricted enclosures continued to increase, reached a peak of over 1000 g at 8-10 years, and then declined in both sexes. The weight of bats born in the aviary remained more stable after the age of three. Like wild bats, adult females born in the aviary weighed less than males. However, females born in restricted enclosures weighed more than males born in the same enclosures. Enclosure designs that maximize opportunities for flight can limit excessive weight gain in captive fruit bats and may therefore improve fitness and health, essential in planning for future reintroduction programs.

Abstract P219: Moderated-Mediated Effects of Environmental Barriers and Income Level on Exercise Determinants Among Black Americans With Hypertension

Introduction: Black individuals are disproportionately affected by hypertension and due to racial disparities have fewer opportunities to engage in preventive measures such as exercise compared to their White counterparts. There is a dearth of research employing a theory-driven approach to comprehensively investigate the factors contributing to disparities in exercise participation among racial groups, both at the individual and environmental levels. The I-Change Model is a contemporary health behavior model comprising three primary pillars hypothesized to influence health behavior: Awareness, Motivation, and Action/Planning. What sets this model apart is its unique emphasis on the proximity of the barrier construct to predicting behavior execution, a feature that may contribute to disparities in exercise participation, including racial disparities. Hence, this observational study aimed to apply the ‘I-Change model’ to identify factors that contribute to exercise behaviors among Black and White individuals with Hypertension. Methods: We used the I-Change model, which includes mediating behavioral determinants, along with moderators that include environmental barriers (e.g., access and transportation to a supportive exercise environment), and income (low vs. moderate and above) to gain a better understanding of racial disparities in exercise participation. Individuals with hypertension (n= 370) that comprised of Black (n= 142) and White (n= 228) adults who were recruited via an online recruitment platform and completed a survey that included validated theoretical constructs. Hayes PROCESS 4.0 Macro (model #16) for SPSS was used to construct the theoretical model and analyze the data. The model included race (x), exercise time (y), behavioral determinants (mediators), environmental behaviors, and income (moderators between mediators and exercise time). Results: I-Change determinants (risk of heart disease, planning, exercise knowledge, exercise partner/social support) mediated the relationship between race and exercise time (β= .24, 95% CI .098, .394) in favor of White participants. Moderated-mediation effects were found on barriers that interacted between planning and exercise time (β= .03, 95% CI .0018, .0674), and income which interacted between social support and exercise time, (β= .05, 95% CI .0004, .1056). Conclusion: Intervention work at the community level for low-income Black individuals with hypertension supported by a theoretical framework is needed. Specifically, an exercise promotion program that supports the development of I-Change determinants, which provides an accessible and supportive environment, would be helpful in providing equitable exercise opportunities for Black individuals with hypertension.

Physiological changes in captive elephants in northern Thailand as a result of the COVID-19 tourism ban-stress biomarkers.

The international travel ban instituted by the Thai government in March 2020 in response to the COVID-19 pandemic greatly affected how tourist camp elephants were managed, with reductions in exercise opportunities, longer chaining hours, and diminished food provisioning. This study was conducted to determine how those changes affected health and welfare biomarkers in individual elephants over the 2 years of the countrywide lockdown (April 2020-April 2022). Blood and fecal samples were collected from 58 elephants at six camps (monthly in Year 1, quarterly in Year 2) and analyzed for stress biomarkers - fecal glucocorticoid metabolites (fGCM), serum oxidative stress [malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG)], and stress leukograms. Overall, fGCM concentrations increased within the first few months and remained higher than pre-COVID levels, as did the H/L ratio, a measure affected by cortisol. Serum 8-OHdG, an indicator of DNA oxidative damage, also increased over time, while monocytosis and lymphopenia further suggested alterations in immune function as a result of stress. By contrast, another marker of oxidative stress, serum MDA, declined, possibly in response to reduced roughage and supplement intake. A notable finding was a seasonal pattern of fGCM that was significantly different from previous studies. Whereas higher fGCM during the rainy season were observed in this study, previously, concentrations were highest during the winter, high tourist season. Thus, ironically, both the presence and absence of tourists have been associated with increased fGCM concentrations, albeit for different reasons. Camp management factors negatively affecting stress outcomes included shorter chain lengths, longer chain hours, lack of exercise, and reduced roughage and supplements. Overall, it was clear that camps struggled to maintain adequate care for elephants during the COVID-19 pandemic, highlighting the importance of tourist income and need for contingency plans to cope with potential future disruptions to tourism.

Impact of Perch Provision Timing on Activity and Musculoskeletal Health of Laying Hens.

Laying hens can experience a progressive increase in bone fragility due to the ongoing mobilization of calcium from bones for eggshell formation. Over time, this escalates their susceptibility to bone fracture, which can reduce their mobility and cause pain. The provision of perches as an exercise opportunity could potentially enhance bone strength, but the timing of exposure to perches during the birds' development may modulate its impact. The objective of this study was to investigate the enduring impacts of perch provision timing on the musculoskeletal health of laying hens. A total of 812 pullets were kept in different housing conditions (seven pens/treatment, 29 birds/pen) with either continuous access to multi-tier perches from 0 to 40 weeks of age (CP), no access to perches (NP), early access to perches during the rearing phase from 0 to 17 weeks of age (EP), or solely during the laying phase from 17 to 40 weeks of age (LP). At weeks 24, 36, and 40 of age (n = 84 birds/week), three birds per pen were monitored for individual activity level, and blood samples were collected from a separate set of three birds per pen to analyze serum levels of tartrate-resistant acid phosphatase 5b (TRACP-5b) and C-terminal telopeptide of type I collagen (CTX-I) as markers of bone demineralization. At 40 weeks of age, three birds per pen (n = 84) were euthanized for computed tomography scans to obtain tibial bone mineral density (BMD) and cross-sectional area (CSA) with further analysis including muscle deposition, tibial breaking strength, and tibial ash percent. During week 24, hens from CP, EP, and LP pens had the highest overall activity compared to hens from NP pens (p < 0.05) with no differences between treatments for overall activity level during weeks 36 or 40 (p > 0.05). During weeks 24, 36, and 40, hens from CP and LP pens showed greater vertical and less horizontal activity compared to hens from EP and NP pens (p < 0.05). TRACP-5b and CTX-I concentrations did not differ between treatments at week 24 of age (p > 0.05). Hens from CP pens had the lowest TRACP-5b and CTX-I concentrations at 36 weeks of age with EP and LP hens showing intermediate responses and NP hens having the highest concentration (p < 0.05). At 40 weeks of age, CP hens had the lowest TRACP-5b and CTX-I concentrations compared to NP hens (p < 0.05). Total bone CSA did not differ between treatments (p > 0.05), but CP had greater total BMD than NP (p < 0.05) with no differences between EP and LP treatments. CP and LP hens had larger biceps brachii, pectoralis major, and leg muscle groups as well as greater tibial breaking strengths than EP and NP treatments (p < 0.05). CP hens had higher tibial ash percentages compared to EP, LP, and NP (p < 0.05). Our results indicate that providing continuous perch access improves the musculoskeletal health and activity of laying hens at 40 weeks of age compared to no access and that late access to perches has a beneficial impact on activity, muscle deposition, and bone strength.

Green space and stroke: A scoping review of the evidence

BackgroundGlobal industrialisation and urbanisation has led to an increased interest in the link between the environment and health. Stroke is a major cause of morbidity and mortality, and there is increased evidence that environmental factors may affect both the incidence and severity of stroke. This review summarises the evidence for relationship between green space exposure and stroke incidence and outcomes. MethodsWe conducted a literature search in Medline and Scopus until 1 August 2023, and screened references of relevant articles. Selected articles were appraised for their relevance, and critically reviewed. The findings were thematically categorised. ResultsOf the 1342 papers identified, 27 were included. These involved a mix of study designs (cohort, cross-sectional, quasi-experimental, time stratified case crossover and ecological). There was consistent evidence indicating a protective association between green space exposure and disability and stroke-related death with mortality hazard ratios between 0.66 and 0.95. Most studies also showed that green space was inversely associated with stroke risk, with risk estimates from studies showing a protective effect ranging between 0.4 and 0.98; however, results were more mixed and some did not reach statistical significance. The moderating effects of green spaces on ambient temperatures, noise and air pollution, and psychosocial health plus greater enjoyment and opportunity for exercise and enrichment of the human microbiome may underly these associations. ConclusionThere is likely some protective effect of green space on stroke, with the benefits most convincingly shown for post-stroke outcomes. More research is recommended to confirm the protective association between green space exposure and reduced stroke risk.

A qualitative study of barriers and facilitators for health behavior change in low-income men with prostate cancer.

Low-income prostate cancer survivors, who typically have worse outcomes and greater all-cause mortality, often have poor health-promoting behaviors. Our objective was to assess perceived facilitators of and barriers to healthy behavior change by interviewing low-income men with prostate cancer who received no-cost treatment through a state-funded program. Between September 2021 and April 2022, we conducted semi-structured interviews with 19 men (ages 60-75). Purposive sampling was utilized from participants of a cohort of men with prostate cancer from low-income backgrounds. Interviews were recorded, transcribed, and then coded by the authors to generate salient themes via thematic analysis. We found internal characteristics and structural characteristics that functioned independently and in concert to promote and/or hinder healthy behavior change. Internal characteristics such as motivations (prostate cancer diagnosis, self-perceptions, support system, and preferences) and determination, defined as level of motivation, drove behavior actualization. Structural characteristics that influenced behavior change included resources (access to food and opportunities for exercise) and social support. These outcomes suggest that motivation and determination can serve as protective facilitators encouraging healthy behaviors despite structural barriers low-income prostate cancer survivors may face. However, motivations challenged by financial constraints were not sufficient to guide healthy behavior change. With this in mind, we recommend that interventions promoting healthy behavior change among this population should focus on identifying and strengthening internal assets such as motivations, self-perceptions, preferences, and support systems.

Path Analysis to Assess Diversity of Occupational Opportunities Within Walking Distance and Community Health.

Built environment structures affect a population's occupational participation and health outcomes. To examine how occupational opportunities available within walking distance are related to a community's overall health. Secondary data analysis. Community. Community-dwelling adults. Data from the AARP Livability Index and Walk Score® for 78 zip codes were used for path analysis and multiple regression analysis to investigate the relationship between various community factors and the health of the community. Path analysis for 78 zip codes revealed that the primary determinants of health score were destination diversity and social walk score. Multiple regression analysis revealed that destination diversity (β < .001) and exercise opportunity (β < .001) were significant factors for health score. Multiple regression analysis revealed that destination diversity (β < .001) was a significant factor for social score. The results suggest that increased diversity of destinations in a community and opportunities available for social participation within walking distance are associated with better health of residents in the community. Plain-Language Summary: This study highlights how the built environment and opportunities for social participation are associated with a community's overall health. This study found that participation in a variety of group activities contributes to community members' well-being. Understanding how the built environment is related to health outcomes may better equip occupational therapy practitioners to improve the health of an individual, group, or population.

ASSOCIATIONS BETWEEN DISABILITY, CHRONIC DISEASES, AND DEPRESSIVE SYMPTOMS IN VIETNAMESE OLDER ADULTS

Abstract After the fall of Saigon in 1975, several waves of Vietnamese immigrants/refugees migrated to the U.S. currently comprising 2.2 million individuals, the 4th-largest Asian-origin subgroup in the U.S. Despite the large number and their traumatic, adverse lifelong experiences, health research on this population is scarce. To fill this gap, we developed the Vietnamese Aging and Care Survey and collected health data on older Vietnamese in Houston, Texas, the 2nd-largest Vietnamese-populated metropolitan area in the nation. The purpose of this study was to examine the associations between their physical disability, chronic diseases, and depressive symptoms. Respondents (N=210) were 76 years old (mean), married (63%), and female (56%) with 8 years of education. They lived in the U.S. for 25 years (mean) and spoke Vietnamese only (88%) in multi-generation (80%) low-income households (91%, ≤$25K). They self-rated their health as fair/poor (80%) with ≥1 chronic condition (76%). Those with higher depressive symptoms were less likely to be married (p=0.004) and have more chronic diseases (p=0.004) compared to those without depressive symptoms. Regression analyses showed significant associations between arthritis (β=2.73), liver disease (β=6.24), ADL disability (β=0.72), and higher depressive symptoms. Limited control over their basic function (ADL disability) would restrict their daily lives, and mobility issues and pain (arthritis and liver disease) might impact them psychologically. While older Vietnamese may leverage their multi-generation living condition, and receive tangible support with ADL disability within their families, healthcare professionals should connect them with culturally and linguistically relevant adult daycare centers that provide social and exercise opportunities.

ACCESS TO NEIGHBORHOOD AMENITIES AND RISK OF INSTITUTIONALIZATION AMONG PERSONS WITH DEMENTIA

Abstract Compared to only 2% of the total population between ages 65 and 84, 15% of persons with dementia (PWD) transition to nursing homes. This may be due to caregiving challenges associated with the behavioral symptoms PWD exhibit and their reduced capacities to perform daily tasks. Access to neighborhood amenities (e.g., parks, food access, libraries, service providers) may reduce the risk of institutionalization by helping PWD maintain their health and independence through the provision of opportunities for physical exercise, nutritious diets, social interaction, and cognitive stimulation while providing their caregivers with supportive services. Using data from the2006-2016 waves of the Health and Retirement Study (HRS), the HRS Contextual Data Resource, and the National Neighborhood Data Archive, this study aimed to identify neighborhood factors that are associated with transition into a nursing home among PWD who lived in the community (N=3,366). A series of logistic regression models were estimated adjusting for sociodemographic characteristics, health status, and neighborhood characteristics. Findings suggest that access to more park areas, healthy food outlets (i.e., grocery stores, supermarkets, supercenters), social amenities (e.g., museums, libraries), and social services for older adults and those with disabilities (e.g., senior centers, adult day care centers, disability support groups) were significantly associated with a lower risk of 2-year institutionalization. Retail stores and home health services were not significantly associated with the risk of institutionalization. These findings emphasize the importance of neighborhood amenities, such as parks and healthy food outlets, in enabling PWD to age in place.

AGING IN JAIL: CHALLENGES AND IMPROVEMENTS

Abstract The increase in incarcerated older people has created challenges in correctional facilities, including settings ranging from large prisons to smaller county jails. Aging while incarcerated brings a new dimension of difficulties for older people, and to the correctional system as a whole. The resources and environments are unsuitable for an aging population and ultimately result in greater health complications. The COVID-19 pandemic exacerbated existing challenges experienced by older adults. To further assess the issues that incarcerated older people face, researchers from UMass Boston partnered with a local jail to determine the current needs and deficiencies experienced by older men. Focus groups were conducted in person with incarcerated older men regarding their experiences, opinions on having a unit specifically for older adults, and institutional changes that occurred during the COVID-19 pandemic. Zoom interviews were also carried out with staff. These conversations suggest that older incarcerated men encounter unique conditions that challenge their well-being. Such challenges include limited access to medical care and proper diets, lack of environmental accommodations, and inadequate exercise opportunities. These challenges exacerbate the burden of being in jail and can lead to higher risks of chronic illness. As well they have potential implications for the communities to which the men are released. Older men and jail staff were receptive to creating a unit specifically for older adults as a means of remedying some of these challenges. This poster offers policy suggestions to improve correctional facilities that better align with the unique needs of incarcerated older people.

MAINTAINING BRAIN HEALTH VIA TELEHEALTH-BASED CHAIR YOGA FOR RURAL UNDERSERVED OLDER ADULTS

Abstract We conducted a randomized control pilot trial in an underserved, racially/ethnically diverse community, to examine the efficacy of (1) computer literacy training provided by high school students meeting rural older adults in their homes, followed by 2) telehealth-based online chair yoga (OCY) or computer brain games (CBG). First, high school students engaged in a “train the trainer” computer skills course using a previously-tested curriculum designed for the target population. Students mentored the older adults in learning computer skills and to access either the OCY (n = 15) or CBG (n=15), which were randomly assigned. Outcomes measured at pre, post, and three months following the 12-week intervention included computer proficiency, cognitive function, pain levels, and psychosocial well-being. In a linear mixed growth model with random intercepts, there was a significant linear trend in computer-based competency, t(50, 19) = 2.56, p = .013. Computer proficiency (computer basics, Internet and email use, communication, and calendaring) increased significantly in both the OCY and CBG groups. Importantly, there was a significant linear change in pain by group, controlling for age and living alone, F(1, 14) = 6.64, p = .022, η2 = .32 (large effect size). Chronic pain in the OCY group decreased significantly from baseline to 3-month follow-up (18.89 to 11.35) but increased in the CBG group (14.27 to 17.28). Increases in cognitive function increased pre/post t(29) = -2.98, p = .003 (one-tailed). These results are promising for older adults with limited exercise opportunities, who also face cognitive risk exacerbated by elevated pain levels.

Physical Exercise and Health, 3: The Health Care Professional and Patient's Guide to Understanding What to Do, How, and Why-Part 1.

Physical activity and exercise are associated with important short- and long-term health benefits. It does not take much effort to reap these benefits; every little bit of activity counts, including activities that are performed as part of daily life. Everybody can exercise, even those with existing medical conditions, and even those with existing cardiac or orthopedic conditions; all that is necessary is to tailor the exercise to individual capacity with appropriate dos and don'ts. This article, addressed to health care professionals, their patients, and the general public, provides practical guidance on exercise, mostly in the form of points and short paragraphs, so that the reader can easily understand and assimilate what to do, how, and why. The article explains what the health benefits of exercise are; how much exercise one ideally needs to perform for optimal health outcomes; what targets to set for exercise; what effects exercise has on muscles, bones, and the heart; and how these effects are beneficial. The article offers suggestions on how to create time and opportunity for exercise, how to motivate oneself for exercise, and how to avoid boredom and discouragement. Most important of all, this article provides a detailed discussion on exercise-related risks, especially orthopedic risks, and how to avoid these risks. Protecting the knee joint from injury receives particular attention. Practical guidance on what to actually do appears in the next article in the series.

Exercise Immunology Applied to Pediatric Sport and the Importance of Monitoring Stages of Puberty and Biological Maturation

Context: Exercise immunology is aimed at understanding how exercise sessions can affect the immune system in athletic subjects of different age groups. The objective of the current study was to discuss in which stage of biological maturation (BM) young athletes may be more vulnerable in relation to the immune system, and whether there is a BM range in which it is safer to perform sports training with strenuous exercise loads. Evidence Acquisition: Evidence from scientific research from several scientific disciplines (eg, immunology, sport immunology, pediatrics, sports medicine, human development) was gathered to holistically examine the main particularities of exercise immunology as applied to pediatric sport. Study Design: Narrative review. Level of Evidence: Level 5. Results: In pediatric patients, lymphoid tissue expands during puberty and involutes after puberty until it returns to pre-expansion values. This suggests that there is a specific period in which the immune system may be stronger, which may provide opportunities for strenuous exercise in pediatric athletes. However, the chronological period when puberty occurs will be determined by BM, which is the rate at which the biological systems of the human body improves. This may affect the period of lymphoid tissue expansion and, consequently, the behavior of the immune system in pediatric subjects of the same age category. Conclusion: During puberty, there is a significant increase in the proinflammatory profile; to compensate for this, there is an expansion of lymphoid tissue that may favor the efficiency of the immune system. The period in which puberty is reached may vary according to the stages of BM. Therefore, in exercise immunology applied to pediatric sports, in addition to external and internal training loads, it is necessary to consider BM and puberty, which have been shown to be safer biomarkers than chronological age for determining immune system behavior in pediatric athletes. Strength-of-Recommendation Taxonomy (SORT): Evidence B level 3.

Associations between physical activity, sedentary behaviour, and alcohol consumption among UK adults: Findings from the Health Behaviours during the COVID-19 pandemic (HEBECO) study.

The COVID-19 pandemic and attendant lockdowns have had a substantial negative effect on alcohol consumption and physical activity globally. Pre-pandemic evidence in the adult population suggests that higher levels of physical activity were associated with higher levels of drinking, but it is unclear how the pandemic may have affected this. Therefore, this study aims to assess the association between alcohol consumption and physical activity in a UK cohort established during the COVID-19 pandemic. Analyses utilized data from the Health Behaviours during the COVID-19 pandemic (HEBECO) study involving 2,057 UK adults (≥18 years). Participants completed self-report measures of alcohol consumption [frequency, quantity, frequency of heavy episodic drinking (HED) and AUDIT-C score] and physical activity [moderate-vigorous physical activity (MVPA), frequency of muscle strengthening activity (MSA) and sedentary behaviour] between November 2020 and January 2021. Ordinal logistic regression models were conducted, adjusting for sociodemographic factors. Fifteen percent of the sample reported abstinence from drinking. Overall, 23.4% of participants drank ≥4 times/week, 13.9% drank more than 6 units/single drinking occasion (HED), 7.5% reported HED daily/almost daily and 4.2% scored ≥11 on AUDIT-C. MSA 3 days/week compared with no MSA was significantly associated with higher odds of alcohol frequency [OR (95 CI%) = 1.41 (1.04-1.91)], quantity [OR (95 CI%) = 1.38 (1.02-1.87)], HED [OR (95 CI%) = 1.42 (1.05-1.94)] and possible dependence [OR (95 CI%) = 1.47 (1.05-2.06)]. The association of MVPA and sedentary behaviour with drinking measures was not significant (p>0.05). In contrast with previous research, MSA rather than aerobic physical activity was associated with increased alcohol consumption during the COVID-19 pandemic. It is conceivable that during lockdown while drinking was used as a coping strategy, limited opportunities for aerobic exercise made MSA a more convenient form of physical activity. To guide public health interventions, more research is required to examine the temporal relationship between different forms of physical activity and alcohol consumption.

Exercise prescription for persons with spinal cord injury: a review of physiological considerations and evidence-based guidelines.

Persons with spinal cord injury (SCI) experience gains in fitness, physical and mental health from regular participation in exercise and physical activity. Due to changes in physiological function of the cardiovascular, nervous, and muscular systems, general population physical activity guidelines and traditional exercise prescription methods are not appropriate for the SCI population. Exercise guidelines specific to persons with SCI recommend progressive training beginning at 20min of moderate to vigorous intensity aerobic exercise twice per week transitioning to 30min three times per week, with strength training of the major muscle groups two times per week. These population-specific guidelines were designed considering the substantial barriers to physical activity for persons with SCI and can be used to frame an individual exercise prescription. Rating of perceived exertion (i.e., perceptually regulated exercise) is a practical way to indicate moderate to vigorous intensity exercise in community settings. Adapted exercise modes include arm cycle ergometry, hybrid arm-leg cycling, and recumbent elliptical equipment. Body weight-supported treadmill training and other rehabilitation modalities may improve some aspects of health and fitness for people with SCI if completed at sufficient intensity. Disability-specific community programs offer beneficial opportunities for persons with SCI to experience quality exercise opportunities but are not universally available.

A Study on the Inheritance Status and Enhancement Path of Chinese Ancient Poetry Art Songs Integrated into Vocal Music Teaching in Contemporary Colleges and Universities

Traditional culture with refined and meaningful words, beautiful verses and rich connotations. As a product of the fusion of East and West, Chinese ancient poetry art songs is a perfect fusion of the profound Chinese poems and Western elegant music creation techniques, which is the continuous development of the excellent traditional Chinese culture. Colleges and universities, as the main channel for the training of high-quality music talents, shoulder the important responsibilities of talent training, cultural inheritance and scientific research. Since the birth of Chinese ancient poetry art songs, there have been high requirements in vocal singing, mood shaping and cultural expression, etc. Therefore, integrating Chinese ancient poetry art songs into vocal teaching in colleges and universities can not only improve the students' vocal singing level and comprehensive cultural literacy, but also enhance the students' cultural self-confidence in learning and singing. However, it is found that the inheritance status of Chinese ancient poetry art songs integrated into vocal music teaching in colleges and universities is not optimistic, and there are problems such as insufficient attention of students, irrational curriculum facilities, lack of attention to the improvement of comprehensive quality, confusing use of teaching materials, and fewer opportunities for students to practise, and so on. Through the analysis of the causes, it is found that there are misunderstandings in the students' cognition, the teaching objectives are not clear enough, the teaching faculty is scarce, and the teaching ability needs to be improved. In view of the above problems, this study proposes that students should be guided to improve their value cognition and set up a correct sense of inheritance; teachers should clarify the teaching objectives and create a reasonable curriculum system; institutions should strengthen the training of teachers and enhance the ability of diversified teaching; institutions should encourage teachers to reasonably prepare teaching materials and provide a scientific teaching basis; and institutions and teachers should also actively develop practical activities and provide sufficient opportunities for exercise.

Exercise for optimizing bone health after hormone-induced increases in bone stiffness.

Hormones and mechanical loading co-regulate bone throughout the lifespan. In this review, we posit that times of increased hormonal influence on bone provide opportunities for exercise to optimize bone strength and prevent fragility. Examples include endogenous secretion of growth hormones and sex steroids that modulate adolescent growth and exogenous administration of osteoanabolic drugs like teriparatide, which increase bone stiffness, or its resistance to external forces. We review evidence that after bone stiffness is increased due to hormonal stimuli, mechanoadaptive processes follow. Specifically, exercise provides the mechanical stimulus necessary to offset adaptive bone resorption or promote adaptive bone formation. The collective effects of both decreased bone resorption and increased bone formation optimize bone strength during youth and preserve it later in life. These theoretical constructs provide physiologic foundations for promoting exercise throughout life.

Online and Remote Training Experience in the Engine Room Simulator Training Courses using the IMO Model Course 2.07 Exercises

In the age of technology, changes are experienced in many areas such as globalization, information society, new basic technology, the spread of the Internet, and the realization of competition on a global scale. New methods used in education and training have been developed and kept up with technological developments. With the widespread use of the Internet, online and remote training has become more possible than ever. Technology was ready for online education and training for the past decades, yet the COVID-19 pandemic caused the traditional training to be disrupted and training institutions had to carry out studies for traditional training to be conducted online and remotely. This caused a paradigm change in the training methods. Online or remote education, even in training using the engine room simulator (ERS), has become more popular as an alternative to traditional classroom teachings, even though the pandemic is disappearing. Additionally, the progress in autonomous ships and recent regulatory studies indicates the importance of a better understanding of the engineering data in remote or autonomous ship operations. The authors have been offering Engine Room Simulator (ERS) training courses using online methods since the first semester of 2020, totaling six semesters of online training so far. This paper presents the online training process used in courses including the technological setup and method of teaching and assessment. Experiences and lessons learned by the lecturers in providing operational and management level ERS courses and feedback from students are examined and presented. The use of IMO Model Course 2017 Edition became helpful as it describes exercises for each training objective in accordance with IMO STCW 2010. An Engine Room Simulator (ERS) called Ship ERS or SERS™ was utilized as the remote training tool in the pilot implementation of these courses that were spread over two semesters. The advantages and disadvantages of online ERS training was presented and discussed. A particular and interesting observation has been that the students could have longer duration of exercise opportunities when using SERS™ in the remote training than in traditional ones.

'I saw it as a marriage-You can't have one without the other': A qualitative study of patient and physiotherapist experiences with a therapeutic combined strength and aerobic physical activity exercise programme for hip osteoarthritis.

To explore physiotherapist and patient experiences with, and acceptability of, a 12-week physiotherapist-guided combined strength and aerobic physical activity exercise programme for hip osteoarthritis (OA). A qualitative study using semi-structured interviews with 13 people with hip OA and four physiotherapists. Patients underwent a 12-week home exercise programme customised by weekly visits with one of the four physiotherapists. The programme aimed for patients to participate in 150min of moderate-intensity aerobic physical activity, and 20-30min of strengthening exercise 2-3 times per week in concordance with American College of Sports Medicine (ACSM) dosage guidelines. Following the programme, patients and physiotherapists participated in individual semi-structured interviews to explore the acceptability of the exercise programme and barriers and facilitators to participation. Data were audio-recorded, transcribed and analysed using a thematic approach. Five over-arching themes (supporting subthemes) were identified from both patient and physiotherapist interviews: (i) positive outcomes (functional improvements, pain relief, empowerment through experience, commitment to continue); (ii) combined benefits of aerobic and strength exercises (complimentary effects, strengthening exercises key); (iii) valuing support from the physiotherapist (personalised care, skill performance feedback, coach effect, accountability); (iv) motivation and opportunity for exercise (positive symptom loop, integration into daily routine, prior exercise experience, Fitbit motivation); and (v) time-consuming commitment (physiotherapy visit frequency, travel inconvenience, time for exercise). Experiences of participants in this study indicate that, although time-consuming, a combined aerobic physical activity and strengthening programme prescribed at ACSM dosage guidelines is acceptable and confers positive outcomes in individuals with hip OA.

The significance of green exercise for the health and wellbeing of Italian immigrants in Norway: a mixed-methods study

BackgroundGreen exercise (physical activity in presence of nature) has beneficial effects for health and wellbeing. Green exercise is a popular form of recreation in the Nordic countries, but participation is lower among the immigrant population from non-Western countries. However, no attention has been given to immigrants from the European Economic Area regarding this topic. Given the cultural and structural differences that surround green exercise in Italy and Norway, the case of the Italian immigrants in Norway is of interest to enrich our understanding of green exercise and its significance for health and wellbeing among immigrants in the Nordic countries.MethodsThis convergent mixed methods study investigated the pathways that link green exercise to health and wellbeing among Italian immigrants in Norway. Quantitative data were collected through an online survey (n = 321), which was oversampled to better reflect the sociodemographic profile of the reference population. Logistic regression was used to model the association of green exercise with self-rated health (SRH) or satisfaction with life (SWL) before and after controlling for selected confounders (age, gender, educational level, language proficiency, social support, and childhood experiences with green exercise). Qualitative data were collected through semi-structured in-depth interviews (n = 14) and analysed thematically. Merging of the two strands was done using a simultaneous bidirectional approach.ResultsThe logistic regression found a significant bivariate association of green exercise with both SRH and SWL, though the association remained significant only for SWL after controlling for confounders. From the thematic analysis, three themes were identified: Green exercise opportunities contributing to overall satisfaction, Closeness to nature, and Embracing a new lifestyle. The integrated findings indicate that green exercise supported the immigrants’ wellbeing, especially by providing stress relief, though socioeconomic status and acculturation may have a major impact on general health. Familiarity, appreciation of nature benefits, social support, and acculturation were identified as facilitating factors.ConclusionsThis study provides novel insights into how green exercise supports health, wellbeing, and inclusion among immigrants to the Nordic countries and emphasizes the importance of developing culturally adapted strategies to enhance this health-promoting activity among immigrant populations.