Exercise Research Articles

Effects of school closure on lifestyle behaviours and health outcomes in children during the COVID-19 pandemic in Chile: A time-matched analysis.

The COVID-19 pandemic led to school closures, potentially impairing children's behaviours and health. We aimed to explore the effects of school closure on lifestyle behaviours (dietary habits, physical activity) and health outcomes (adiposity, fitness, self-esteem, self-concept) in children. We measured 247 children before school closure (October-November 2019) and after school reopening (October-November 2021) (COVID-19 group). To distinguish the changes due to school closure from changes due to growth, we included 655 age-matched children with cross-sectional measurements in October-November 2019 (control group). The response of this group (i.e., differences between children with 2 years of difference) was considered the expected response to growth. Two-way ANOVA was used to test age-by-group interactions, indicating an effect of school closure. In 7-to-9-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.4 points), resulting in higher physical inactivity prevalence (by 19 percent points) at 9 years. This was accompanied by larger-than-expected increases in fat percentage (by 6.1 percent point). In 8-to-10-year-old children, the COVID-19 group had higher physical inactivity prevalence at 10 years (by 20 percent points). This was accompanied by larger-than-expected increases in fat percentage (by 8.3 percent points), z-score BMI (by 0.90 units), and waist circumference (by 6.1 cm). In 9-to-11-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.3 points) and increases in self-concept (by 0.2 points). The response in dietary habits, fitness, or self-esteem was not different between groups. Overall, school closure negatively impacted physical activity and adiposity, particularly in the youngest children.

Physical Activity Levels, Cardiorespiratory Fitness, and Physical Literacy in Children With a Chronic Medical Condition

Purpose: This study investigated differences in cardiorespiratory fitness (CRF) and other physical literacy domains between children with a chronic medical condition (CMC) who adhered to with the physical activity guideline and those who did not. Method: Forty children with a CMC (7-12 years) wore an accelerometer for 7 days to measure moderate-to-vigorous physical activity. CRF and muscle power were assessed with a maximal cardiopulmonary exercise test, and motor performance was measured with an exercise course. Motivation, confidence, knowledge, and understanding were assessed with a questionnaire. Results: Children who adhered to the PA guideline (n = 13) scored significantly higher for CRF, muscle power, motivation and confidence than children who did not adhere to the PA guideline (n = 27). No significant differences were found for motor performance, knowledge and understanding. Conclusion: Future research should investigate the effect of paying specific attention to motivation and confidence in children with a CMC to stimulate their adherence to the PA guideline.

Effectiveness of a Digital Health Intervention Leveraging Reinforcement Learning: Results From the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) Randomized Clinical Trial.

Digital and mobile health interventions using personalization via reinforcement learning algorithms have the potential to reach large number of people to support physical activity and help manage diabetes and depression in daily life. The Diabetes and Mental Health Adaptive Notification and Tracking Evaluation (DIAMANTE) study tested whether a digital physical activity intervention using personalized text messaging via reinforcement learning algorithms could increase step counts in a diverse, multilingual sample of people with diabetes and depression symptoms. From January 2020 to June 2022, participants were recruited from 4 San Francisco, California-based public primary care clinics and through web-based platforms to participate in the 24-week randomized controlled trial. Eligibility criteria included English or Spanish language preference and a documented diagnosis of diabetes and elevated depression symptoms. The trial had 3 arms: a Control group receiving a weekly mood monitoring message, a Random messaging group receiving randomly selected feedback and motivational text messages daily, and an Adaptive messaging group receiving text messages selected by a reinforcement learning algorithm daily. Randomization was performed with a 1:1:1 allocation. The primary outcome, changes in daily step counts, was passively collected via a mobile app. The primary analysis assessed changes in daily step count using a linear mixed-effects model. An a priori subanalysis compared the primary step count outcome within recruitment samples. In total, 168 participants were analyzed, including those with 24% (40/168) Spanish language preference and 37.5% (63/168) from clinic-based recruitment. The results of the linear mixed-effects model indicated that participants in the Adaptive arm cumulatively gained an average of 3.6 steps each day (95% CI 2.45-4.78; P<.001) over the 24-week intervention (average of 608 total steps), whereas both the Control and Random arm participants had significantly decreased rates of change. Postintervention estimates suggest that participants in the Adaptive messaging arm showed a significant step count increase of 19% (606/3197; P<.001), in contrast to 1.6% (59/3698) and 3.9% (136/3480) step count increase in the Random and Control arms, respectively. Intervention effectiveness differences were observed between participants recruited from the San Francisco clinics and those recruited via web-based platforms, with the significant step count trend persisting across both samples for participants in the Adaptive group. Our study supports the use of reinforcement learning algorithms for personalizing text messaging interventions to increase physical activity in a diverse sample of people with diabetes and depression. It is the first to test this approach in a large, diverse, and multilingual sample. ClinicalTrials.gov NCT03490253; https://clinicaltrials.gov/study/NCT03490253. RR2-10.1136/bmjopen-2019-034723.

School-induced fatigue: Theoretical analysis of the concept of school burnout

School burnout is a set of detrimental symptoms that include emotional exhaustion, cynicism, and reduced personal accomplishment. In children and adolescents it is associated with many physical and mental health problems, including heart diseases, hormonal disorders, disrupted sleep quality, depressive symptoms, and diminished life satisfaction. It corresponds with a higher likelihood of poor academic performance and drop-out rates. The text includes a theoretical analysis of factors corresponding with the development and maintenance of school burnout. The data presented in the literature proves that students dealing with extreme schoolwork overload, accompanied with poor time management, and unrealistic goals, faced with excessive family demands, experiencing disturbances in sleep habits, poor eating habits, and limited or no physical exercise are more prone to develop and sustain symptoms of school burnout. Besides the excessive workload and problems in relationships with parents and peers among risk factors there are usually mentioned feelings of lack of control over things, high demands, and pressure an individual experiences. Protective factors include social support and a positive school atmosphere. Application of knowledge concerning school burnout in real educational settings may result in increase of well-being and resilience of students, and decrease in symptoms of mental problems. It will also help create a meaningful school environment.

Influence of Physical Exercise on the Rehabilitation of Volumetric Muscle Loss Injury Reconstructed with Autologous Adipose Tissue

Background: In volumetric muscle loss (VML) injuries, spontaneous muscle regeneration capacity is limited. The implantation of autologous adipose tissue in the affected area is an option to treat these lesions; however, the effectiveness of this therapy alone is insufficient for a complete recovery of the damaged muscle. This study examined the influence of treadmill exercise on the rehabilitation of VML injuries reconstructed with autologous adipose tissue, as a strategy to counteract the limitations of spontaneous regeneration observed in these injuries. Methods: Forty adult male Wistar rats were divided into eight groups of five individuals each: normal control (NC), regenerative control (RC), VML control (VML), VML injury reconstructed with fresh autologous adipose tissue (FAT), exercise-rehabilitated control (RNC), exercise-rehabilitated regenerative control (RRC), exercise-rehabilitated VML injury (RVML), and exercise-rehabilitated VML injury reconstructed with fresh autologous adipose tissue (RFAT). Histological and histochemical staining techniques were used for the analysis of structural features and histomorphometric parameters of the tibialis anterior muscle. Grip strength tests were conducted to assess muscle force. Results: Exercise rehabilitation decreased the proportion of disoriented fibers in RFAT vs. FAT group. The percentage of fibrosis was significantly higher in FAT and RFAT groups versus NC and RNC groups but did not vary significantly between FAT and RFAT groups. Overall, muscle grip strength and fiber size increased significantly in the exercise-rehabilitated groups compared to control groups. Conclusions: To conclude, rehabilitation with physical exercise tended to normalize the process of muscle repair in a model of VML injury reconstructed with fresh autologous adipose tissue, but it did not reduce the intense fibrosis associated with these injuries.

Relationship of Pain, Depression, Fatigue, and Sleep Problems with Functional Capacity, Balance, and Fear of Falling in Women with Fibromyalgia: Cross-Sectional Study

(1) Background: Fibromyalgia (FM) is a syndrome marked by chronic widespread pain, fatigue, sleep issues, and other symptoms. Interventions like physical exercise can potentially enhance physical function in individuals with FM. This study aimed to assess physical function, perceived physical fitness, balance confidence, and fear of falling in women with FM based on their levels of pain, depression, fatigue, and sleep problems. (2) Methods: Participants underwent a series of tests and questionnaires to evaluate physical and perceptual aspects. These included the Time Up and Go, Four Step Square Test, 6-Minute Walking Test, Maximum Handgrip Strength, Back Scratch, International Fitness Scale, Activities-Specific Balance Confidence Scale, and Fall Efficacy Scale—International. Participants were categorised by the severity of their pain, depression, fatigue, and sleep problems (mild, moderate, severe). A Kruskal–Wallis test assessed intergroup differences, while Spearman’s rho evaluated correlations between the study variables and symptom levels. (3) Results: Perceived physical condition varied significantly with symptom severity. Symptoms and sleep problems were notably linked to fear of falling, though no significant differences emerged in the physical tests. (4) Conclusions: In women with fibromyalgia, symptom severity was primarily related to perceptual and subjective aspects of physical condition and fall safety.

Dietary Habits and Nutritional Knowledge of Pregnant Women: The Importance of Nutrition Education

A good diet during pregnancy is associated with improvements to maternal and fetal health. Nevertheless, excessive weight gain during pregnancy has been reported in several studies. The aim of this review is to determine the dietary habits of pregnant women (measured according to their degree of adherence to the Mediterranean diet, a reference in dietary quality), their knowledge of food and nutrition, and their perceptions of the nutritional education received during their pregnancy, in order to detect intervention needs within that group. The bibliographic search was conducted on three databases (Medline, PubMed central, and Web of Science), using the keywords “pregnancy”, “Mediterranean diet”, “nutrition knowledge”, “nutritional education”, and some synonyms. The final selection included 68 original articles. The available evidence indicated that, although pregnant women were aware of the importance of nutrition during pregnancy, their habits showed some room for improvement in terms of diet and physical exercise. Lack of adequate advice was the main barrier to the practice of healthy habits that pregnant women encountered; they considered that the information they received during pregnancy follow-up visits was inadequate. However, the success of interventions within different countries is a source of hope for well-structured nutrition education throughout pregnancy. The lack of nutrition-related knowledge among pregnant women could be originally related to poorly planned nutrition education from healthcare providers. Research focused on the consultations with these healthcare providers could be of help when proposing strategies to improve the content, the depth, and the duration of nutrition education sessions. It should, in any case, be noted that the available evidence in this field is limited to certain geographical origins. Therefore, research that uncovers evidence in different countries will be useful for learning about the factors that condition the habits of pregnant women and, in that way, guide strategies for the improvement of the health of expectant mothers during that stage in their lives.

Physical activity motivations and psychological well-being among university students: a canonical correlation analysis

With increasing concern about mental health issues and active lifestyles among university students, understanding the interplay between different physical activity motivations and various dimensions of psychological well-being is important. The present study aims to explore the canonical relationship between physical activity motivations based on self-determination theory and psychological well-being according to Ryff’s model in university students. Nine hundred and sixty-six Chinese university students participated in this study. A canonical correlation analysis was conducted using six variables of motivations as predictors of six variables of psychological well-being. The canonical correlation analysis yielded two canonical functions. The first canonical function, which was primary, indicated that intrinsic motivation, integrated regulation, identified regulation, and introjected regulation contributed the most to psychological well-being. The second canonical function indicated that a decrease in external motivation and amotivation accounted for an increase in personal growth. This study underscores the importance of elucidating the underlying motivations driving physical activity behaviors in order to enhance psychological well-being in this population.

Gender differences in the relationship between the systemic immune-inflammation index and all-cause and cardiovascular mortality among adults with hypertension: evidence from NHANES 1999-2018

BackgroundThere are gender differences in hypertension and the effect of gender on the relationship between systemic immune-inflammation index (SII) and mortality in hypertensive patients is unclear.MethodsHypertensive patients (n=7444) from ten cycles of the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018 were enrolled in this study. The maximally selected rank statistics method was employed to identify the optimal cut-off value for the SII. Survey-weighted Cox regression analysis was utilized to explore the links between SII and all-cause and cardiovascular mortality. Kaplan-Meier method and time-dependent receiver operating characteristic curve analysis was conducted to assess the predictive accuracy of SII for mortality.ResultsWhether SII was considered as a numerical variable or as a binary variable (higher- and lower-SII groups), higher SII levels were associated with a higher risk of all-cause and cardiovascular mortality in female hypertensive patients (all P &amp;lt; 0.001), but no such association was observed in the males. The area under the curve of the SII was 0.602, 0.595, and 0.569 for 3-, 5-, and 10-year all-cause mortality, respectively, in females, but was 0.572, 0.548, and 0.554 in males. High SII levels interacted with the poverty income ratio and physical activity to affect mortality in the male population (P for interaction &amp;lt; 0.05), and there was an interaction between race and SII in the female cardiovascular mortality rate (P for interaction &amp;lt; 0.05).ConclusionHigher levels of SII may be closely related to the high risk of all-cause and cardiovascular mortality in hypertensive patients, and the results showed that this relationship is more significant and stable in the female group. High SII interacts with PIR, physical activity, and race to affect the mortality rate in different gender populations.

Feasibility of ecological momentary assessment in measuring physical activity and sedentary behaviour in shift and non-shift workers

BackgroundPrevious studies assessing shift workers’ behaviours have mainly used self-report recall questionnaires, however these measures don’t always account for variations in work schedules. Alternative methods that allow for real-time assessments tailored to capture variations in work patterns might provide more accurate measures of physical activity (PA) and sedentary behaviour (SB). Therefore, the aim of this study was to evaluate the feasibility of Ecological Momentary Assessment (EMA), which provides real-time evaluations of PA and SB in shift workers. A secondary aim was to compare shift workers and non-shift worker responses.MethodsParticipants (n = 120; 58% female, mean Mage=36.0), included 69 shift workers and 51 non-shift workers. After downloading the EMA app, shift workers received either interval-contingent tailored (SW-T) or standardized EMA prompts (SW-S) over 7–10 days, while non-shift workers received standardized prompts (NSW-S) for seven days. Prompts were scheduled five times daily, every three hours. The EMA survey asked participants to report their current activity, including type, duration, and location of physical activity and sitting. Feasibility was assessed by analysing recruitment, retention, and compliance rates (EMA surveys completed) across SW-T, SW-S, and NSW-S groups.ResultsApproximately 78% of invited workers enrolled, and all enrolled workers completed at least one prompt on 4 out 7 days in the NSW-S and 7 out of 10 days in the SW group. Workers who chose not to participate reported unwillingness to travel for meetings (n = 14), while others did not respond (n = 20). Participants completed an average of 24 surveys per day, each one taking less than 30 s to complete. Overall, 64% of EMA surveys were started and completed. SW-S completed the least prompts (57%), while SW-T and NSW-S completed 64% and 68%, respectively (p = 0.90). On average, workers missed 36% EMA surveys which was similar for SW and NSW (p = 0.05).ConclusionOur study represents one of the few studies that has used EMA in the shift work population with adaptation to shift schedules. The findings showed a modest compliance to EMA. Strategies are needed to enhance compliance rates. However, EMA shows promise for capturing real-time behaviours in shift workers’ natural work environments.

Rapid Lifestyle Recommendations to Improve Urologic, Heart and Overall Health.

This literature review is intended to highlight recent correlations between urologic, heart and overall health by emphasizing healthy eating patterns, physical activity, alcohol minimization and tobacco elimination, healthy sleep, weight, cholesterol, blood sugar, blood pressure management, and mental health awareness. Meta-analyses, systematic reviews, and clinical studies espouse a unified message for prevention, reducing the risk of disease recurrence, progression, complementing conventional medical intervention efficacy, and mitigating treatment side effects. Limiting or eliminating alcohol consumption could be considered an independent recommendation and adding a mental health and miscellaneous (genetic risk and lifestyle, planetary health, HPV or other vaccination awareness, spirituality, etc.) category could allow for individualized educational opportunities, synergism appreciation, and self-improvement. Urologic healthcare professionals have the potential to strengthen the collective public health goal of improving the quality and quantity of the lives of patients able to adhere to these heart healthy recommendations.

Retinol-binding protein 4 is a potential biomarker of changes in lean mass in postmenopausal women.

Identifying biomarkers can help in the early detection of muscle loss and drive the development of new therapies. Research suggests a potential link between retinol-binding protein 4 (RBP4) and muscle mass, particularly in postmenopausal women. This study aimed to examine the association between baseline RBP4 levels and changes in appendicular lean mass (ALM), an indicator of muscle mass, in postmenopausal women. A 12-month follow-up period (n=153) included baseline and 12-month ALM assessments using DXA. ALM was normalized to squared height (ALMI). Baseline evaluations encompassed insulin resistance via HOMA-IR and immunoassay magnetic bead panel measurements of RPB4, IL-6, TNF-α, and IL-10. Postmenopausal women were categorized into higher (n=77) and lower (n=76) RPB4 groups based on baseline RPB4 values. Their changes in ALMI were compared using Mann-Whitney tests. General linear model was employed to evaluate the predictive power of baseline RBP4 for ALMI changes, adjusting for confounding variables: age, physical activity, smoking status, body fat, HOMA-IR, inflammatory markers (TNF-α and IL-6), and anti-inflammatory factor (IL-10). The higher RBP4 group exhibited a more pronounced reduction in ALMI compared to the lower RBP4 group (Higher RBP4 = -0.39kg/m2, 95% CI: -0.48 to -0.31kg/m2vs. Lower RBP4 = -0.24kg/m2, 95% CI: -0.32 to -0.15kg/m2, P=0.011). After adjusting for confounding factors, the association between baseline RBP4 changes and ALMI remained (b = -0.008, SE=0.002, P<0.001), indicating higher baseline RBP4 values linked to greater ALMI reduction. Our findings support RBP4 as a potential biomarker for changes in muscle mass in postmenopausal women.

The impact of an organized physical activity program on the health indicators of students from differ-ent cultural groups in second chance school setting

The primary objective of this research was to assess the impact of a structured physical activity program on the health indicators of adult students attending a multicultural Second Chance School (SCS). The study encompassed a total of 62 SCS students aged 19 to 57, who were divided into two groups: experimental and control. The intervention program consisted of two sessions per week spanning 20 weeks, with each session lasting 60 minutes. The exercise intensity ranged from 65% to 85% of HRmax and included various activities such as aerobics, weight exercises, dumbbell routines, and hiking. Measurements were taken at both the commencement and conclusion of the organized physical activity program. Specialized equipment, including a wall-mounted stadiometer, precision scales, a unique tape measure, an automated sphygmomanometer, and the DXA machine, was employed for data collection. Data analysis involved ANOVA variance analyses, descriptive statistics, and T-Tests utilizing the SPSS software. The results revealed a statistically significant primary influence attributed to the 'measurement' factor (p&lt;.001) across all health indicators, except for total BMD and total BMC, when comparing the experimental and control groups. In terms of gender disparities, men exhibited higher measurements in body mass, fat-free mass, belly size, and blood pressure, while women displayed greater fat mass and total body fat. To conclude, the intervention program had a positive impact on improving the health indicators of adult SCS students. Future research endeavors should explore the implementation of Physical Activity programs in other SCSs throughout Greece. Keywords: Adult Students; Health Indicators; Organized Physical Activity; Second Chance Schools

Co-Designing a Conversational Agent With Older Adults With Chronic Obstructive Pulmonary Disease Who Age in Place: Qualitative Study.

As a reaction to the global demographic increase in older adults (aged 60+ years), policy makers call for initiatives to enable healthy aging. This includes a focus on person-centered care and access to long-term care for older adults, such as developing different services and digital health technologies. This can enable patients to engage in their health and reduce the burden on the health care systems and health care professionals. The European Union project Smart Inclusive Living Environments (SMILE) focuses on well-being and aging in place using new digital health technologies. The novelty of the SMILE project is the use of a cocreational approach focused on the needs and preferences of older adults with chronic obstructive pulmonary disease (COPD) in technology development, to enhance access, adaptation, and usability and to reduce stigma. The study aimed to describe the perspective, needs, and preferences of older adults living with COPD in the context of the design and development of a conversational agent. This study carried out a data-driven thematic analysis of interview data from 11 cocreation workshops with 33 older adults living with COPD. The three particular features that the workshop participants wanted to implement in a new technology were (1) a "my health" function, to use technology to manage and learn more about their condition; (2) a "daily activities" function, including an overview and information about social and physical activities in their local area; and (3) a "sleep" function, to manage circadian rhythm and enhance sleep quality, for example, through online video guides. In total, 2 overarching themes were identified for the 3 functions: measurements, which were actively discussed and received mixed interest among the participants, and health literacy, due to an overall interest in learning more about their condition in relation to everyday life. The future design of digital health technology must embrace the complexities of the everyday life of an older adult living with COPD and cater to their needs and preferences. Measurements should be optional and personalized, and digital solutions should be used as a supplement to health care professionals, not as substitute.

Exploring lifestyle components and associated factors in newly injured individuals with spinal cord injury.

Cross-sectional analysis from the Inception Cohort of the Swiss Spinal Cord Injury Study (SwiSCI). To describe five lifestyle components in newly injured individuals with spinal cord injury (SCI), explore co-occurrence of these components, and identify associated personal and clinical factors. Initial rehabilitation stay following traumatic and non-traumatic SCI. Lifestyle components including overweight/obesity, low diet score, physical inactivity, smoking, and alcohol consumption were used independently and to calculate a composite lifestyle score. Analyses were conducted using descriptive statistics, co-occurrence analysis, and multivariate logistic regression. We included 251 individuals, of whom 77.7% were male, 73.7% suffered from traumatic SCI, and 59.8% had paraplegia. The median age was 51 years (IQR 36-64). Approximately twelve weeks after the injury, more than two-thirds of the study population met the criteria for overweight/obesity, and consumed insufficient amounts of fruits and vegetables, and excessive amounts of meat. Alcohol was consumed by 85.3% of individuals, and 26.8% were current smokers. Almost all study participants met the physical activity guidelines (90 min of moderate to strenuous activity physical activity per week). One-quarter of study participants experienced the co-occurrence of overweight/obesity, low diet score and alcohol consumption. Female sex, younger age and higher education were associated with healthier lifestyle components. Despite methodological limitations, this study underscores the complexities of healthy lifestyle adherence among individuals newly injured with SCI. It highlights the necessity of improving and implementing screening strategies throughout the continuum of SCI care as early as possible following the trauma.

Modal and harmonic analysis of femur bone using different boundary conditions by Finite Element Analysis.

The longest and largest bone in the human body is the femur. Pelvic bone sustains the weight of the body to which the femur bone is connected. Many researches have been carried out to identify the behaviour of the femur bone. The study aimed to explore the natural frequencies and mode shapes of vibrating devices to gain insights into the dynamic behavior of the femur bone during various physical activities. Examining the impact of patient-specific bone shape and density on bone natural frequencies is crucial. The primary goals of femur bone analysis involve employing computer simulations for fracture detection and employing Finite Element (FE) models to determine natural frequencies and vibration modes. To obtain the natural frequency of the femur bone, different boundary conditions such as free-fixed and fixed-fixed are applied. Avoiding the coincidence of the natural frequency with external excitation frequencies is crucial to prevent femur bone fractures. Also, for different magnitude of loads, femur bone is involved in harmonic analysis is to identify the amplitude and stress against acceleration.

Assessment of prevalence, risk factors, and neuropsychiatric symptoms of mild neurocognitive disorder among elderly in Suez Canal Area

Abstract Background Mild neurocognitive disorder is mild reduction in cognitive abilities than a previous level, requiring compensatory strategies that help maintain independence, and is associated with behavioral and psychiatric symptoms. This cross-sectional comparative study aimed to evaluate prevalence of mild neurocognitive disorder, its risk factors, and associated neuropsychiatric symptoms. It included a sample of 156 elderly people ≥ 60 years old in Suez Canal Area from geriatric homes and primary health care centers. Study tools included a semi-structured clinical interview to assess sociodemographic, clinical, and lifestyle risk factors, DSM-5 criteria for diagnosis of neurocognitive disorders, the Montreal Cognitive Assessment Scale, and the Neuropsychiatric Inventory Questionnaire. Results Prevalence of mild neurocognitive disorder was 37.2% in total sample with mean total score of 22.7 ± 6.1 by Montreal Cognitive Assessment Scale. The most common subtype was amnestic multiple domain subtype (72.4%). Its predicting factors included advanced age, lower education, physical work, non-adherence to treatment, less physical activity, bone and joint disorders, and family history of cognitive impairment. The neuropsychiatric symptoms with highest scores were sleep/nighttime behavior, depression, irritability, and eating/appetite, respectively. Among the two study groups, geriatric home residents had highly significant lower cognitive scores (p &lt; 0.001) and higher Neuropsychiatric Inventory Questionnaire scores. Conclusion Mild neurocognitive disorder is common among elderly people and is associated with neuropsychiatric symptoms that need screening and management. Modifiable risk factors should be identified to provide interventions.

Modifiable and non-modifiable risk factors of early-onset colorectal cancer: National Health Interview Survey analysis

Background and aimsAlthough the incidence of colorectal cancer (CRC) diagnosed in individuals younger than 50 years, early-onset CRC (EO-CRC), is rapidly increasing, the risk factors for EO-CRC are still being identified. This study aimed to confirm the modifiable and non-modifiable characteristics identified as risk factors for EO-CRC. MethodsThis cross-sectional study used 2004–2018 National Health Interview Survey (NHIS) data, which provides comprehensive health information gathered from national annual household interview surveys. Demographic, clinical, and behavioral characteristics of EO-CRC patients were compared with those without. In addition, their non-age-related characteristics (gender, race/ethnicity, region, body mass index [BMI], alcohol consumption, and smoking status) were compared with individuals with average-onset CRC (AO-CRC). For both comparisons, multivariable logistic regression analyses were performed. ResultsWe identified 156 patients with EO-CRC, 204,846 with non-CRC, and 1972 with AO-CRC. Comparison between the EO-CRC and the non-CRC groups showed that higher odds of having EO-CRC was associated with older age (Odds Ratio [OR]=1.11, 95 % CI=1.08–1.14, p<0.001), living in the Midwest (vs. South) (OR=1.64, 95 % CI=1.06–2.55, p=0.03), and history of alcohol consumption (vs. lifetime abstainer) (OR=2.09, 95 % CI=1.01–4.36, p=0.049). Lower odds of having EO-CRC were associated with being Hispanic (OR=0.43, 95 % CI=0.22–0.84, p=0.01) or Asian (OR=0.38, 95 % CI=0.16–0.92, p=0.03) (vs. non-Hispanic White) and having moderate or vigorous physical activities (vs. no activity) (OR=0.58, 95 % CI=0.34–0.999, p=0.0496 and OR=0.34; 95 % CI=0.21–0.55, p<0.0001, respectively). Compared with patients with AO-CRC, patients with EO-CRC were more likely to be Hispanic (vs. non-Hispanic White) (OR=2.21, 95 % CI=1.13–4.33, p=0.02). ConclusionThis study verified several modifiable (i.e., alcohol consumption and physical activity) and non-modifiable (i.e., race/ethnicity) risk factors while also discovering a new factor (i.e., geographical region) associated with EO-CRC.

The Influence of Adolescent Physical Activity on Bone Mineral Density among Adult Runners.

This study aimed to determine the influence of sport type and training volume during adolescence on low bone mineral density (BMD) in long-distance runners. In total, 125 competitive long-distance runners (64 males; 21.3±4.2 years, 61 females; 21.4±3.1 years) participated in this retrospective cohort study. We collected training history data during adolescence using a questionnaire and measured BMD of the lumbar spine and whole body using dual-energy X-ray absorptiometry (DXA). Male runners with low BMD ran for more hours (p=0.02) and had a smaller proportion of multidirectional loading activity (p=0.03) in elementary school than those with normal BMD. Although female runners with low BMD performed multidirectional activity for more hours in middle school than those with normal BMD (p=0.01), running volume was similar between groups. There was an increasing trend in the total number of hours of physical activity in middle school in female runners with low BMD (p=0.05). These results suggest that avoiding specialization in long-distance running, increasing the proportion of multidirectional sports, and preventing overload during the bone growth phase may reduce the risk of low BMD among runners.

Effects of health at every size based interventions on health-related outcomes and body mass, in a short and a long term

ObjectiveThis study aims to provide rapid and up-to-date evidence on the effectiveness of Health at Every Size (HAES) interventions compared to controls or other conventional approaches in individuals with overweight or obesity, with the goal of developing more effective and body-diverse respectful strategies.MethodsA review of literature was carried out using the following databases: PubMed, Scopus, Embase, Web of Science, and SciELO. Research articles were selected based on predefined inclusion and exclusion criteria. Extracted data included study characteristics (design, setting, population demographics, sample size, intervention characteristics, study duration, and follow-up period) and health-related outcomes.ResultsThe search yielded 324 articles, of which 20 articles met the inclusion and exclusion criteria. The majority of studies focused on lifestyle improvement, particularly in nutrition, body image, and relationships with food, utilizing a HAES approach. Additionally, other studies examined outcomes such as general well-being, body weight, body composition, cardiovascular risk, and changes in physical activity. Long-term results were particularly noted in studies incorporating physical activity interventions.ConclusionHAES interventions appear to be a feasible strategy for promoting overall health and wellness, regardless of body size or shape. However, further evaluation is needed to assess the sustainability of these changes and their long-term impact, as current evidence suggest a they may not be maintained over time.