Active Lifestyle Research Articles

Role of physical activity for glycemic control among patients with type 2 diabetes mellitus

Background: Lifestyle modification and physical activity are very important parts of diabetes management. Regular physical activity has been shown to improve glycemic control through increased insulin sensitivity and glucose tolerance. The aims of this study were to assess the glycemic level and pattern of physical activity among type 2 diabetic patients. Methods: This hospital-based cross-sectional study was carried out from July 2022 to October 2022 among 305 purposively recruited diabetic patients who came to receive care at the outpatient department of a teaching hospital in Dhaka, Bangladesh. A semi-structured questionnaire was used to describe socio-demographic information. Physical activity was assessed using the validated version of international physical activity questionnaire short form/ global physical activity questionnaire (IPAQ/GPAQ). Glycemic control was measured by HbA1C report done within 120 days of the interview. Blood pressure and body mass index were also measured at the time of inclusion. The physical activity level was categorized according to IPAQ scoring protocol as high level, moderate level and low level. Chi square test was carried out to determine the association of physical activity with type-2 DM, body mass index, glycemic and blood pressure control. Statistical significance was defined as p<0.05. Results: Among the participants only 0.3% had high level of physical activity. Moderate level of physical activity was found among 32.8% and low level of physical activity has been found among 66.9%. Among the participants 92.1% spent their time sitting during the weekdays while the time spent at home, at work, while doing course or class and during leisure activities. Among them 21% had the maximum 10 hours sitting time during the last week. The study showed that the persons who spent walking on at least 7 days has negative correlation with blood glycemic level and among them who spent time on sitting has positive correlation with blood glycemic level. Nearly two thirds of the respondents were female. The mean age was 53.09 ± 12.15 years. Majority of the participants were from urban area (69.83%) and the rest are from rural (21.31%) and sub urban (8.2%) area. There was no significant relation of level physical activity with any sociodemographic factors except monthly income, which showed low monthly income was associated with higher level of physical activity. Conclusion: The findings of our study focus on developing more awareness and providing facilities for physical activity to achieve the glycemic goal. BIRDEM Med J 2024; 14(3): 143-150

Navigating online perils: Socioeconomic status, online activity lifestyles, and online fraud targeting and victimization of old adults in China

Online fraud poses a growing threat to the well-being of old adults. This study examines the causes and correlates of online fraud targeting and victimization among old adults in China. Drawing insights from the digital inequality theory and lifestyle routine activity theory and utilizing a nationally representative survey of Chinese old adults (N = 4293), this study examines how socioeconomic status and online lifestyle patterns affect their susceptibility to online fraud. The results show that old adults of better socioeconomic status are more likely to be targeted by online frauds, though not necessarily experiencing financial loss. Latent class analysis identifies four online activity lifestyles among old adults: basic, entertainment, risky, and advanced users. Subsequent analysis demonstrates that these lifestyle types predict different risks of online fraud targeting and victimization. Basic users face a heightened risk of being targeted but not necessarily monetary loss. Risky users, while not exhibiting elevated targeting risks compared to basic users, are more susceptible to financial loss once targeted. Advanced users, in contrast to basic users, face elevated risks of being targeted and monetary loss. This study offers new insights into the risk factors for online fraud targeting and victimization among old adults in China, informing the development of effective online fraud prevention programs.

Advancing school education: A proposal for modernizing the school subject “Physical Education” for today’s needs

Individual behavior is considered the most significant determinant of health (GoInvo, 2017). There are six primary lifestyle factors—physical activity (PA), diet, substance use, sleep, stress, and relationships—that collectively contribute to a holistic concept of health and well-being (American College of Lifestyle Medicine, n.d.). Evidence shows that the widespread adoption of unhealthy lifestyle habits is associated with contemporary changes in children’s phenotypes, making them more vulnerable to chronic health issues that can persist into adulthood (Hruby & Hu, 2015). This is linked to the increasing prevalence of overweight and obesity among children and adolescents, which has risen dramatically from 8% in 1990 to 20% in 2022 (World Health Organization, 2024). Educational settings provide an ideal environment for developing lifelong healthy habits, as the cultivation of such habits requires prolonged commitment. Physical education (PE) is a school-based subject with the potential to promote an active lifestyle; however, concerns persist regarding its adequacy and effectiveness in other aspects of health promotion (United Nations Educational, Scientific and Cultural Organization, 2014). This perspective study discusses the theoretical and practical aspects of modernizing PE curriculum, including its implications for public health policy. Methods We conducted a concise overview of the literature for this perspective study, highlighting school-based health programs and identifying key advocative approaches, with the aim of providing foundational insights for the present health-policy proposal. Results From a holistic perspective, we propose that PE should evolve into lifestyle education (LE), aiming to integrate all six factors of lifestyle medicine within the educational framework. Through the LE approach, children and adolescents can acquire a comprehensive package of health-related knowledge, skills, and competencies that extend beyond PA and encompass all lifestyle components. However, transitioning from PE to LE may impact the structure of the curricula and necessitate stablishing a supplementary curriculum titled sport education (SE), aiming to enhance students’ sport-related skills such as teamwork, leadership, resilience, and strategic thinking, while also promoting abilities in stress management, concentration, and emotional regulation. To effectively transition from PE to LE and SE, educational authorities and policymakers must provide comprehensive demonstrations outlining vision, mission, goals, roles, and detailed guidelines tailored to diverse school levels and student demographics, considering factors such as gender, BMI, (dis)abilities, and socioeconomic status. Conclusion Establishing school-based LE appears crucial for addressing the growing pandemic of chronic health conditions from their earliest origins. Alongside its direct effects of individual health, LE also appears to be beneficial in promoting children’s social and cognitive growth, optimizing their academic performance, and increasing the likelihood of their future occupational success. Therefore, implementing LE is crucial before expecting children and adolescents to adhere to the existing health-related recommendations. References American College of Lifestyle Medicine. (n.d.). What is lifestyle medicine? https://lifestylemedicine.org/ GoInvo. (2017). Determinants of health. https://www.goinvo.com/vision/determinants-of-health/ Hruby, A., & Hu, F. B. (2015). The epidemiology of obesity: A big picture. Pharmacoeconomics, 33, 673-689. https://doi.org/10.1007/s40273-014-0243-x United Nations Educational, Scientific and Cultural Organization. (2014). World-wide survey of school physical education: Final report 2013. https://unesdoc.unesco.org/ark:/48223/pf0000229335 World Health Organization. (2024). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Abstract B159: Could cultural adaptation of nutrition education improve survivorship outcomes among African American/black women with reproductive cancers?

Abstract Background/Significance: Cancer epidemiological data suggest African American/Black women experience the lowest relative survival rate for reproductive cancers compared to other racial/ethnic groups, despite these cancers being most prevalent among White women. Findings from recent studies suggest contributors to these adverse outcomes include socio-cultural and lifestyle factors, including diet, physical activity, and smoking. As an intervention strategy, it has been recommended dietary changes may enhance overall health and survival among AA/B women with reproductive cancers. However, inequalities in access to nutritious foods and culturally and linguistically appropriate nutrition information may serve as an impediment to making healthy food choices. Methods: An environmental scan was conducted by reviewing peer reviewed literature and online nutrition information sources to identify available, easily accessible, culturally adapted nutrition education for AA/B reproductive cancer survivors. Focus groups with breast and endometrial cancer survivors will ensure to inform the development of culturally targeted nutritional programs for cancer survivors. Results: Our literature review reveals a growing body of evidence indicating the potential benefits of culturally adapted dietary modifications post-diagnosis for African American/Black women with reproductive cancers, suggesting improved outcomes. Notably, the review underscores the critical role of culturally relevant nutrition information, disseminated by culturally affiliated individuals, with technology playing a pivotal role in accessibility facilitation. This research study aims to clarify the barriers and facilitators encountered by African American/Black women in accessing culturally and linguistically appropriate information, thereby enhancing understanding of factors influencing cancer survivorship outcomes. Conclusion and Implications/Discussion: Seeking to improve the survivorship of reproductive cancers in AA/B women through enhanced dietary patterns, this study merges insights from a systematic literature review and an environmental scan. Offering a comprehensive understanding of available nutritional information for AA/B women. Recognizing both strengths and gaps in existing resources, our research serves as a foundation for developing or adapting culturally specific nutritional programs to improve survivorship outcomes for reproductive cancers. Anticipating that our findings will contribute to understanding barriers and facilitators in accessing culturally and linguistically appropriate information, we aim to enhance cancer survivorship outcomes for AA/B women. Acknowledgement of Funding: The project described was supported by Award Number CHERC-MSI-21-166-01-CHERC-MSI. from the American Cancer Society (ACS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the ACS. Citation Format: Desiree Rivers, Zakirah L Abdul-Hameed. Could cultural adaptation of nutrition education improve survivorship outcomes among African American/black women with reproductive cancers? [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B159.

Active Child, Accomplished Youth: Middle Childhood Active Leisure Fuels Academic Success by Emerging Adulthood.

Background/Objectives: Physical activity is an important protective factor throughout life. However, little research has observed the associations between the practice of physical activity and academic success longitudinally, and none have done so with a pan-Canadian sample. This article aims to examine the prospective associations between active leisure in middle childhood and academic achievement in emerging adulthood, for both boys and girls, beyond several family factors. Methods: Participants are 2775 children from the National Longitudinal Study on Children and Youth (NLSCY) aged between 12 and 20 years. Active leisure was self-reported by children at age 12 years regarding their weekly organized sport, artistic sport, and unstructured physical activity participation outside of school hours. Academic success was measured by self-reported school average at age 18 years and the obtention of high school diploma at age 20 years. Results: Girls who engaged in more organized or artistic sports at age 12 years had better academic results at age 18 years (respectively β = -0.082, p < 0.01; β = -0.228, p < 0.001). Both boys and girls who partook in more organized sports at age 12 years were more likely to graduate from high school by age 20 years (respectively β = -0.146, p < 0.001; β = -0.071, p < 0.05). However, girls who engaged in more unstructured physical activity at age 12 years had lower academic achievement at age 18 years (β = 0.077, p < 0.001). Conclusions: Policy makers should aim to reduce the many barriers to an active lifestyle in childhood. Parents should be encouraged to lead their children to go play outside with friends to allow them to fully reap the benefits of an active lifestyle from a young age.

Sedentarism and Chronic Health Problems.

Increased mechanization and technological advances have simplified our lives on the one hand and increased sedentary behaviors on the other hand, paving the way for emerging global health concerns, i.e., sedentarism, which could be the leading cause of all major chronic health problems worldwide. Sedentarism is a habitual behavior of choosing and indulging in low-energy expenditure activities (≤1.5 metabolic equivalents), such as chairtype (sitting, studying, traveling) or screen-type activities (TV, computers, mobile). With technological advancements, there is a significant transition in the lifestyles of people from being active (walking) to being more deskbound (sitting). Prolonged sitting can have unintended consequences for health with sitting time >7 h/d, leading to a 5% increase in all-cause mortality with each additional hour spent sitting (i.e., +7 h/d), while considering physical activity levels. This review will highlight how sedentarism is emerging as a major risk factor for the rising incidence of non-communicable diseases, especially among young adults and adults. Chronic diseases, such as obesity, diabetes, coronary heart disease, and cancer, are the leading causes of death worldwide. Hence, there is an urgent need for collective action to mitigate the burgeoning public health crisis posed by sedentarism in the 21st century. This paper intends to set in motion a call for all policymakers and public health professionals placed nationally or internationally to reach a consensus on ending sedentarism and provide viable resolutions for effective management of excessive sedentary behaviors and healthy adoption and maintenance of active lifestyles among individuals of all age groups.

Associations Between Fundamental Motor Skill Domains and Physical Fitness Components in 5-11-Year-Old Children

High competence in fundamental motor skills (FMS) and adequate physical fitness (PF) levels are a solid foundation for acquiring an active and healthy lifestyle during childhood and adolescence. In this cross-sectional study, we aimed to compare gender and age groups and identify correlations between FMS and PF in young elementary school students. We used a structured questionnaire to gather sociodemographic information from parents, and we characterized the children’s economic profile with the Brazil Social Economic Status Criterion. We collected FMS data using the Furtado-Gallagher Children Observational Movement Pattern Assessment System (FG-COMPASS), and we used the Brazil Sports Project Battery Test to measure PF levels. Statistical analyses involved descriptive data and inferential tests to determine group differences in FMS and PF levels. Hierarchical regression helped identify the associations between FMS and PF, as controlled by sociodemographic factors. Participants were 720 students (and parents) of both genders (383 girls, 337 boys; M age = 8.8, SD = 1.52 years) from grades 1 to 5 in an elementary school in a municipality in the western region of the Paraná state in Brazil. The results showed significant differences in children’s motor skills and PF based on gender and age. The hierarchical regression model showed different combinations of flexibility, abdominal resistance, upper limb strength, agility, speed, and lower limb strength, which explained 33.7% of the variability in the global FMS index, 41% of the variability in manipulative skills, and 12.7% of the variability in locomotor skills. In addition, there was a positive association between FMS and PF related to neuromuscular development for both sexes, regardless of age.

Burial of a Golden Horde Nomad from the Kovalevka Kurgan Cemetery

Introduction. The article introduces into scientific circulation the archaeological and anthropological materials from the Golden Horde burial of the Kovalevka Kurgan Cemetery. Kurgan No. 35 dating back to the early Iron Age was studied in the course of the fieldwork carried out by the Volgograd State University expedition in the Oktyabrsky district of the Volgograd region in 2021. The Kurgan is located in the southern part of the cemetery on the upper terrace of the right bank of the river Aksai Esaulovsky in an arable field. Methods and materials. Two burials were examined because of the archaeological excavations. The main burial No. 2 dates back to the late Sarmatian period, while the intake burial No. 1 dates back to the middle age period. Analysis and results. New anthropological materials were obtained in the course of the excavations, which complement our understanding of the nomadic population from the Lower Volga region. The bone remains belonged to a male individual of mesomorphic build of about 164.5 cm tall with a long and narrow skull. A set of pathological conditions were recorded on his bones, appearing because of an active lifestyle and professional activity. The outcomes of the archaeological study of the Kurgan No. 35 from the Kovalevka Kurgan cemetery as of 2021 can be used in the museum and local history work, as well as in studies of the Lower Volga regional ancient history. Authors’ contributions. In this study, V.I. Moiseev and V.Yu. Moiseeva prepared a descriptive part of the archaeological material, carried out the funeral rites and grave goods analyses, and prepared conclusions based on the results of the research. E.V. Pererva conducted a study of anthropological material and defined the craniological, osteological, and pathological features of the individual from burial 1 of the Kurgan No. 35.

Sport and physical activities: actual Ukraine’s strategic narrative (in terms of encyclopedias)

Background and purpose Outline the importance of sports encyclopedias as a form of spreading and promoting a healthy lifestyle and popularizing high-achieving sports for the social and humanitarian development of Ukraine. Material and methods In the article, the primary used research methods are overview and descriptive analysis (an overview of academic publications indexed in Scopus, PubMed, Google Scholar, and National Library of Ukraine, as well as data on Ukrainian encyclopedias from the Corpus of Ukrainian Encyclopedias). This is a basis for descriptive analysis the capability of sports activities to improve the physical and mental (emotional, moral-volitional) resilience of the Ukraine’s population during wartime difficulty, the overall health level of the nation, and the demographic and accordingly economic situation in the country. Additionally, based on descriptive analysis, the potential of encyclopedias on sports and athletes in promoting a healthy lifestyle and physical activities among the population is examined). Reflection method is also used: authors offer a vision of how encyclopedic knowledge about sports and athletes should be structured to help improve the nation’s health, demographic, and economic situations, and thus resistance to Russian aggression). Results The war in Ukraine significantly damages the population’s health, adversely affecting the demographic and economic situation in the country. As a result, state humanitarian policy must focus on finding ways to counter these threats and emerging from this crisis. The article emphasizes that targeted, systematic development of sports and physical culture should be among the state policy priorities, as sports and physical activities improve population health. Authors show that promoting physical culture and a healthy lifestyle is crucial in this process, necessitating the studying of various information sources that can disseminate sports relevant knowledge and identifying the most effective ones. Conclusions Based on extensive justifications, the article proposes the idea of creating a Ukrainian sports encyclopedia as a means of promoting a healthy lifestyle among the Ukrainians, particularly essential in the post-war period. This would contribute to Ukraine's restoration by improving its demographic, socio-economic situation, and encouraging the return of Ukrainian refugees. The potential of a sports encyclopedia lies in highlighting and popularizing distinguished athletes who have achieved success and are respected globally, serving as role models, especially for the young generation of the country. The encyclopedic promotion of famous Ukrainian athletes is considered an effective mechanism for fostering a healthy lifestyle and patriotic feelings among Ukrainian citizens. The preparation of such a publication should rely on global encyclopedic-biographical experience, modern information technologies, and academic knowledge.

A Qualitative Exploration of Participants' Experiences in a Randomized Controlled Trial of Weight Reduction Through a Nurse-Led Intervention.

Background Obesity presents a significant global health challenge, increasing the risk of various health complications. Nurse-led interventions offer a promising, patient-centered approach to weight reduction. However, qualitative research on participants' experiences in nurse-led weight reduction programs is limited. Objective The objective of this study was to explore the lived experiences of participants in a nurse-led weight reduction program over a period of 12 months. Methods Following a randomized controlled trial within a sequential mixed-methods study, in-depth interviews were conducted with 13 volunteers who successfully reduced their weight by at least 5% through a nurse-led intervention (NLI). The data were analyzed using interpretative phenomenological analysis, with careful attention to ensuring both data credibility and participant confidentiality. Results Participants reported positive health improvements over 12 months, including reductions in weight, BMI, waist circumference, blood pressure, and glucose levels. Four primary themes that surfaced were nutritional choices and habits, active lifestyle, support system and motivation, insights, and strategies from health journey participants. Participants adapted to healthier eating habits, incorporating protein-rich foods, millets, and seasonal fruits and vegetables. Walking and yoga were primary physical activities, with participants emphasizing their importance and strategies to overcome barriers. Family support, healthcare guidance, and work-life balance played crucial roles in participants' weight loss journeys. Conclusion The study highlights the effectiveness of NLIs in promoting sustainable weight loss and improving metabolic health. Insights from participants' experiences underscore the importance of dietary modifications, regular physical activity, and social support in successful weight management. Further research is needed to validate these findings and develop tailored interventions.

From Screen to Depression: An Integrative Review Link Between Sedentary Lifestyle and Mental Health Issues

Background: Sedentary lifestyles, particularly high screen time, have been increasingly associated with mental health issues such as anxiety and depression among youth. Understanding these associations is crucial for developing effective interventions.Objective: This review aimed to assess the relationship between sedentary lifestyles and mental health outcomes, focusing on anxiety and depression in young populations globally.Methods: A comprehensive search of PubMed, Google Scholar, and APA PsycInfo was conducted using keywords such as "sedentary lifestyle," "screen time," "anxiety," "depression," and "mental health." Studies included cross-sectional, longitudinal, systematic reviews, and randomized controlled trials. Data on odds ratios, prevalence rates, and statistical connections were extracted and synthesized, following the PRISMA guidelines for narrative reviews.Results: The review included 40 studies published from 2011 to 2024. Findings indicated that screen time-related inactivity rates ranged from 23.2% to 62%, with depression prevalence between 15% and 25%, and anxiety prevalence from 10% to 20%. High screen time was strongly associated with increased mental health risks.Conclusion: Sedentary behavior and high screen time significantly impact youth mental health, emphasizing the need for targeted public health interventions to reduce screen time and promote active lifestyles.

Improving Exercise Tolerance: Blood Transfusions and Physical Well-being in HIV Patients

Individuals living with HIV often experience reduced exercise tolerance due to anemia, fatigue, and muscle deconditioning, significantly impacting their quality of life. Blood transfusions emerge as a critical intervention to improve physical well-being by increasing hemoglobin levels and enhancing oxygen delivery to tissues. This review article explores the mechanisms by which blood transfusions positively influence exercise tolerance in HIV patients, highlighting the physiological benefits of improved oxygenation and energy levels, which facilitate greater participation in physical activities. In addition to the physiological benefits, enhanced exercise tolerance can lead to psychological improvements, reducing symptoms of anxiety and depression commonly faced by individuals with HIV. Engaging in physical activities fosters a sense of accomplishment and boosts self-esteem, creating a positive feedback loop that encourages a more active lifestyle. This multifaceted approach underscores the importance of integrating blood transfusion therapy into comprehensive HIV care to support both physical and mental health. Keywords: anemia, blood transfusions, exercise tolerance, HIV, physical well-being

Analysis of Physical Activity on Mental Hyperactivity, Sleep Quality, and Bodily Pain in Higher Education Students-A Structural Equation Model.

The university population is at a vital stage of human development for acquiring an active lifestyle. Following this lifestyle will bring benefits in adulthood. This study seeks to analyse the relationship between physical activity and bodily pain, mental hyperactivity, and sleep quality as a function of the intensity of physical activity. A comparative, descriptive, and exploratory study is presented in a sample of 506 university students. The International Physical Activity Questionnaire, the Chronic Pain Grade Questionnaire, the Mental Hyperactivity Questionnaire, and the Pittsburgh Sleep Quality Index were used. The proposed model analyses the relationships of physical activity to bodily pain, mental hyperactivity, sleep disturbances, and time to fall asleep. The fit of the different adjustment indices is satisfactory (X2 = 0.47, df = 1, pl = 0.48, IFI = 0.99, CFI = 0.97; NFI = 0.91; RMSEA = 0.01). The relational analysis shows a positive relationship of physical activity to bodily pain (r = 0.02; p < 0.01), mental hyperactivity (r = 0.054; p < 0.01), sleep disturbances (r = 0.029; p < 0.01), and time to fall asleep (r = 0.047; p < 0.01). Multi-group structural equation analysis indicates that there are differences in the causal relationships of physical activity to sleep quality, mental hyperactivity, and bodily pain as a function of exercise intensity. The conclusion is that the intensity at which physical activity is performed plays a key role in mental and physical health.

Potential Impact of Physical Activity on Measures of Well-Being and Quality of Life in People with Rare Diseases: A Nationwide Cross-Sectional Study in Italy.

Rare diseases constitute a heterogeneous group of approximately 7000-8000 conditions, distinguished by their low prevalence. Collectively, they present a significant global health challenge, affecting millions of people worldwide. It is estimated that rare diseases affect approximately 10% of the global population, which places a significant burden on individuals, families, and society. It is, therefore, important to consider strategies to improve the overall well-being and quality of life of individuals with rare diseases. One potential avenue for exploration is the incorporation of physical activity (PA). The scope of this study was to ascertain whether PA has a positive impact on measures of well-being and to determine its potential to enhance the quality of life of these individuals. The data were collected via an online survey. The one-way ANOVA test for multiple groups and multivariate Poisson models were employed to identify the significant predictors of the outcomes of interest. The protective effects of PA become evident with a minimum of six hours of activity per week. Our data confirm that the weekly hours devoted to PA can serve as a significant protective factor for QoL. The study also provided some insights into the motivations behind patients' engagement in PA. These included improving QoL and physical well-being, as well as the desire to interact socially, with the goal of meeting friends or making new acquaintances. Finally, for adults and older adults, engaging in PA can also be a way to control weight. It is becoming increasingly clear that individuals with rare diseases stand to benefit greatly from PA, so it is only sensible to educate them on the advantages of an active lifestyle.

A new patient-reported outcome measure for the evaluation of ankle instability: description of the development process and validation protocol

BackgroundAcute ankle sprains represent one of the most common traumatic injuries to the musculoskeletal system. Many individuals with these injuries experience unresolved symptoms such as instability and recurrent sprains, leading to chronic ankle instability (CAI), which affects their ability to maintain an active lifestyle. While rehabilitation programs focusing on sensorimotor, neuromuscular, strength and balance training are primary treatments, some patients require surgery when rehabilitation fails. A critical analysis of the patient-reported outcome tools (PROs) used to assess CAI surgical outcomes raises some concerns about their measurement properties in CAI patients, which may ultimately affect the quality of evidence supporting current surgical practice. The aim of this research is to develop and validate a new PRO for the assessment of ankle instability and CAI treatment outcomes, following recent methodological guidelines, with the implicit aim of contributing to the generation of scientifically meaningful evidence for clinical practice in patients with ankle instability.MethodsFollowing the COnsensus-based Standards for the selection of Health Measurement Instruments (COSMIN), an Ankle Instability Treatment Index (AITI) will be developed and validated. The process begins with qualitative research based on face‒to‒face interviews with CAI individuals to explore the subjective experience of living with ankle instability. The data from the interviews will be coded following an inductive approach and used to develop the AITI content. The preliminary version of the scale will be refined through an additional round of face‒to‒face interviews with a new set of CAI subjects to define the AITI content coverage, relevance and clarity. Once content validity has been examined, the AITI will be subjected to quantitative analysis of different measurement properties: construct validity, reliability and responsiveness.DiscussionThe development of AITI aims to address the limitations of existing instruments for evaluating surgical outcomes in patients with CAI. By incorporating patient input and adhering to contemporary standards for validity and reliability, this tool seeks to provide a reliable and meaningful assessment of treatment effects.Trial registrationNot applicable.

Impact of awareness of sports policies, school, family, and community environmental on physical activity and fitness among children and adolescents: a structural equation modeling study

BackgroundUnderstanding the impact of environmental factors on physical activity (PA) and physical fitness (PF) is crucial for promoting a healthy lifestyle among children and adolescents. This study examines how awareness of sports policies, school, family, and community environments influence PA and PF in Chinese youth.MethodsA cross-sectional study was conducted with 2747 children and adolescents (mean age 12.90 ± 2.49; 48.2% male) from 17 schools across five Chinese cities. Environmental factors were assessed via questionnaires, and PA levels were measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). PF metrics, including BMI, waist-to-height ratio, grip strength, vertical jump, and 20-m shuttle run test (20-mSRT), were measured onsite. Structural Equation Modeling (SEM) was used to explore relationships between environmental factors and PA/PF outcomes.ResultsThe school environment scored highest (78.0 ± 9.5), while the community environment scored lowest (38.7 ± 18.0). Family environment positively influenced low-intensity PA (LPA) (β = 0.102, P < 0.001) but negatively affected moderate-to-vigorous PA (MVPA) (β = -0.055, P = 0.035). Community environment and awareness of sports policies positively impacted MVPA (β = 0.216, P < 0.001; β = 0.072, P = 0.009, respectively). Family environment positively influenced BMI reduction (β = -0.103, P < 0.001) but negatively affected grip strength (β = -0.063, P = 0.018). Community environment improved grip strength and 20-mSRT performance (β = 0.088, P = 0.002; β = 0.065, P = 0.027).ConclusionsSchool environments, despite high scores, do not significantly impact PA and PF. Community environments, though scoring lower, positively affect MVPA, grip strength, and 20-mSRT. Awareness of sports policies boosts MVPA, while family environments support LPA and BMI but are inversely related to MVPA and grip strength. Integrated strategies involving community infrastructure, family support, and policy awareness are essential for promoting active lifestyles among children and adolescents.

Anti-Aging Medicine: Mitochondrial-Directed Antioxidants and Physical Activity

Mitochondria are an important source of reactive oxygen species in skeletal muscle. Mitochondrial dysfunction accompanies the development of age-related human diseases. Increased production of reactive oxygen species contributes to muscle atrophy caused, for example, by physical inactivity. Many regulatory pathways involved in mitochondrial biogenesis are targets of anti-aging therapies. Active lifestyle and exercise prevent age-related damage to skeletal muscle mitochondria. Another way to correct the action of reactive oxygen species is the use of antioxidants directly targeted to the mitochondria. Treatment with mitochondria-targeted antioxidants attenuates mitochondrial degeneration, improves age-related skeletal muscle function, and protects muscles from atrophy. This review presents data on the use of mitochondrial-directed antioxidants and exercise to maintain the structural and functional state of mitochondria, and protect muscles from sarcopenia.

The sustainability of exercise following colorectal surgery: A qualitative study of participants in the PREPARE-ABC trial

Objective This study aimed to explore perceptions regarding the sustainability of exercise following participation in a pre- and post-colorectal surgery exercise intervention trial (PREPARE-ABC). Design Qualitative interview study. Data were analysed using framework analysis and independently coded by two researchers. Setting Six United Kingdom National Health Service Trusts. Participants Eighteen interviews (hospital-based exercise n = 9, home-based exercise n = 3, standard care n = 6) were conducted with patients 12–15 months after being randomised in the trial, after their 12 month appointment. Intervention Individuals who participated in one of two exercise intervention groups (hospital-supervised or home-supported exercise) or a standard care control group of the PREPARE-ABC trial were invited to interview. Results The exercise interventions were reported to influence participants’ recovery and future sustainability of exercise behaviour change. Several participants continued to engage in exercise over a year after their surgery. Reasons for this included being engaged with exercise prior to diagnosis, psychological benefits of exercise and wanting to be engaged with something to help recovery. Perceptions about the sustainability of active lifestyles were influenced by confidence to engage in structured exercise or physical activity and beliefs about its potential to promote future wellness. Conclusions Sustainability varies among individuals and early assessment of physical activity engagement could be beneficial. Physical activity interventions immediately following surgery may be important for future engagement.

Arthroscopic Reconstruction of an Anterior Cruciate Ligament Tear Using the Anatomic Single-Bundle Technique: A Clinical and Functional Outcome Evaluation.

The anterior cruciate ligament (ACL) consists of an anteromedial bundle and a posterolateral bundle giving anteroposterior and rotational stability to the knee. An ACL tear might lead to secondary changes in the knee joint if not operated in time. The aim of the study was to evaluate the clinical and functional results in patients with ACL tears treated by arthroscopic reconstruction using the anatomic single-bundle technique. This was a prospective study conducted between June 2015 and December2017 at a teaching institute in Kolkata, India, on patients who underwent single-bundle arthroscopic reconstruction of an ACL tear. A minimum follow-up of nine months was considered for all patients. The functional outcome was assessed via the Lysholm knee score. A total of 45 patients were included in this study, of which 34 (75.56%) and eight (17.78%) patients showed excellent and good results, respectively, at the final follow-up. The mean age in this study was 29.88±9.02 years. No complication was seen in 95.6% of patients. The mean Lysholm score by the end of nine months was 95.31±6.55. At the time of the final follow-up, all the patients returned to their same activity status prior to injury. Arthroscopic anatomic single-bundle ACL reconstruction using hamstring autograft is an effective treatment modality for ACL injuries. It restores the stability of the knee and is associated with good recovery of joint function with an early return to active lifestyle and sports activities. This procedure achieves excellent clinical and functional outcomes without any long-term disability.

Navigating the Maze: A Mini-Guide for the Management and Therapy of Metabolic Dysfunction-associated Steatotic Liver Disease

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as Nonalcoholic Fatty Liver Disease (NAFLD), poses a significant global health challenge with a prevalence of 30% worldwide. Alarming projections anticipate a substantial increase in MASLD cases, highlighting the urgent need for preparedness and effective policies. The pathophysiology of MASLD involves a complex interplay of metabolic, genetic and lifestyle factors. Although liver biopsy remains the gold standard for the diagnosis of MASLD, non-invasive methods such as abdominal ultrasound, transient elastography with controlled attenuation parameter, shear wave elastography, and non-invasive serum fibrosis scores have been developed and validated. Effective risk stratification in primary care with non-invasive fibrosis scores, such as fibrosis 4 (FIB-4) index and NAFLD fibrosis score (NFS), optimizes healthcare resource utilization, ensuring appropriate referrals for high-risk patients while minimizing unnecessary referrals. Lifestyle intervention, including diet and physical activity, remains the primary therapy for MASLD. Notably, with the FDA approval of resmetirom, the first authorized medication for fibrotic metabolic dysfunction-associated steatohepatitis (MASH), and several antifibrotic agents under investigation, the therapeutic landscape for MASLD is rapidly evolving. Despite its increasing prevalence, morbidity and mortality, MASLD is frequently underdiagnosed in primary care. In this review, we aim to provide primary care physicians an update on the diagnosis, management and treatment of MASLD.