Physical Exposure Research Articles

Risk assessment of healthcare workers’ exposure to physical load in relation to patient handling and movement: a feasibility study of the instrument TilThermometer

BackgroundWork-related musculoskeletal disorders are common among healthcare workers (HCWs) but might be prevented by risk assessment and further promotion of occupational safety and health.The aim of this study was to investigate if the risk assessment instrument TilThermometer can be used to identify risk profiles of physical exposure in HCWs working with patient handling and movement (PHM). Further aims were to describe HCWs’ perceptions and experiences of using the TilThermometer.MethodsThis feasibility study has a mixed design methodology. In total, 54 HCWs from 17 Swedish care units participated and performed risk assessments with the TilThermometer. Data collected from the risk assessments were used to identify risk profiles of physical exposure. HCWs’ experiences of using the TilThermometer were collected from activity logs and analysed qualitatively. Three questionnaires were used to assess perceived acceptability, appropriateness, and feasibility of the risk assessment, and eight study specific questions were used for perceived usefulness.ResultsThe TilThermometer was used at the care units by assessing each care recipient, and when compiling the data at a group level, a summarized risk profile for the care unit could be provided. Risk for physical exposure was reported as high in two work tasks; no care unit used the high-low adjustable seat when showering care recipients sitting down, and 13% used the recommended assistive devices when putting compression stockings on. However, 99% used high-low adjustable assistive devices when caring and bathing care recipients lying down. TilThermometer was described as easy to use, enabling team reflections and providing an overview of the care units’ recipients and workload, but difficulties in categorizing for mobility groups were also reported. The TilThermometer was, on a five-point scale, perceived as acceptable (mean 3.93), appropriate (mean 3.9), and feasible (mean 3.97). These scores are in line with questions evaluating usefulness.ConclusionThe risk assessment provided risk profiles with potential to contribute to care units’ development of a safe patient handling and movement practice. The findings suggest that the TilThermometer can be used to assess risks for physical exposure in relation to patient handling and movement in care units at hospital and nursing homes.

Early physical rehabilitation dosage in the IntensiveCare Unit predicts hospital outcomes after criticalCOVID-19.

to examine the relationship between physical rehabilitation parameters including a novel approach to quantifying dosage with hospital outcomes for patients with critical COVID-19. Retrospective practice analysis from March 5, 2020, to April 15, 2021. Intensive care units (ICU) at four medical institutions. n = 3,780 adults with ICU admission and diagnosis of COVID-19. We measured the physical rehabilitation treatment delivered in ICU and patient outcomes: 1) mortality; 2) discharge disposition; and 3) physical function at hospital discharge measured by the Activity Measure-Post Acute Care (AM-PAC) "6-Clicks" (6-24, 24=greater functional independence). Physical rehabilitation dosage was defined as the average mobility level scores in the first three sessions (a surrogate measure of intensity) multiplied by the rehabilitation frequency (PT + OT frequency in hospital). The cohort was a mean 64 ± 16 years old, 41% female, mean BMI of 32 ± 9 kg/m2 and 46% (n=1739) required mechanical ventilation. For 2191 patients with complete data, rehabilitation dosage and AM-PAC at discharge were moderately, positively associated (Spearman's rho [r] = 0.484, p < 0.001). Multivariate linear regression (model adjusted R2= 0.68, p <0.001) demonstrates mechanical ventilation (β = -0.86, p = 0.001), average mobility score in first three sessions (β = 2.6, p <0.001) and physical rehabilitation dosage (β = 0.22, p = 0.001) were predictive of AM-PAC scores at discharge when controlling for age, sex, BMI, and ICU LOS. Greater physical rehabilitation exposure early in the ICU is associated with physical function at hospital discharge.

The suffering of students in physical education. Unsettling experiences and situational conditions

ABSTRACT Background The state of research on unsettling experiences of students in physical education can be characterized as fragmented. The available studies focus on select emotions (e.g. fear), specific forms of discrimination (e.g. ableism), or different types of social interactions (e.g. bullying). In this way, the state of research reveals different aspects of students’ suffering in physical education (PE) in a puzzle-like manner, while systematic investigations of the overall picture of PE as a complex meaningfully structured phenomenon remain open. Purpose The study presented in this paper aims to systematically capture the breadth of unsettling PE experiences by taking different perspectives of students into account, while also doing justice to PE in its situational logic. Based on a social constructivist approach, the following research questions will be addressed: (1) What kind of experiences are interpreted as unsettling by students in PE? (2) Which situational conditions are associated with students’ unsettling PE experiences? Methods A qualitative research approach based on written short narratives was employed to answer the research questions. Current and former secondary school students (N = 677) from Germany participated. Grounded theory coding methods and sequential analysis were used for the data analysis. Results Our data indicates a wide range of students’ unsettling PE experiences (e.g. public humiliation, social exclusion, and forms of violence). On a supra-individual level, two major categories of unsettling PE experiences were identified: (1) The vulnerability of the students perceived through revealed inadequacies and (2) the social oppression of the supposedly ‘lazy, weak and unfit’. Students’ experience of vulnerability can be traced back to situations of physical exposure and performance failure while their experience of social oppression draws back to suppressive actions by teachers and fellow students. For each of these categories, we identify typical ways in which students deal with their unsettling experience. On a structural level, a hierarchizing culture of PE that fosters unsettling experiences is revealed. Discussion As a central strength, our study can provide condensed explanations for the emergence and consequences of unsettling PE experiences from the students’ perspective. Our findings relate to and enrich existing discourses regarding the situational emergence of vulnerability, overarching mechanisms of marginalization, and the hierarchizing culture of PE as a basis for social oppression. It is particularly tragic that affected students feel left alone and can hardly escape harmful situations, which perpetuates their suffering. Thus, pedagogical concepts that emphasize students’ diversity and the dismantling of hierarchies are needed and should be advanced further.

Physical and Environmental Work Exposures and Prevalence of Musculoskeletal Disorders in Beekeepers: A Descriptive Study

Purpose: Beekeepers are at risk of musculoskeletal disorders while working, though research is scarce in this field. This study assessed beekeepers' physical and environmental occupational exposure and the prevalence of musculoskeletal disorders. Material and Methods: The study was conducted with 123 male individuals who had been actively beekeeping for a minimum of one year. Beekeepers were administered a survey that included demographic and occupational questions. Beekeepers responded to the Nordic Musculoskeletal Questionnaire and questions related to beekeeping activity from the Quick Exposure Check. Results: The mean age of the beekeepers was 45.4±12.3 years. The present study revealed that migratory beekeepers encountered a greater number of demanding circumstances in comparison to stationary beekeepers (p

The association between sleep duration and cardiometabolic risk among children and adolescents in the United States (US): A NHANES study.

This work aims to assess the association of sleep duration with cardiometabolic risk (adiposity, blood pressure, lipids, albuminuria and A1C) and to investigate lifestyle factors (physical activity, light exposure, caffeine consumption and sugar consumption) associated with sleep duration in children. A nationally representative sample of 3907 children ages 6-17 years enrolled in NHANES from 2011 to 2014 was included in this cross-sectional study. Sleep duration was defined as the daily average time spent sleeping over 7days as measured by a physical activity monitor (PAM). Participants without valid sleep data for ≥95% of the study were excluded. Regression models were adjusted for age, sex, race, body mass index (BMI) Z score, physical activity and light exposure. In adjusted regression models, longer sleep duration was associated with lower systolic blood pressure index (β = -3.63*10-5, 95% CI -6.99*10-5, -2.78*10-6, p = 0.035) and BMI Z score (β = -0.001, 95% CI -0.001, 0.000, p = 0.002). In logistic regression models, longer sleep duration was associated with lower odds of obesity (OR = 0.998, 95% CI 0.997, 0.999, p < 0.001) and overweight status (OR = 0.998, 95% CI 0.997, 0.999, p = 0.004). Greater light exposure (β = 6.64*10-5, 95% CI 3.50*10-5, 9.69*10-5, p < 0.001) and physical activity (β = 0.005, 95% CI 0.004, 0.006, p < 0.001) were associated with longer sleep. Longer sleep duration was associated with lower blood pressure and adiposity measures in children. Improving sleep quality by increasing physical activity and light exposure in childhood may decrease the lifetime risk of cardiometabolic disease.

UPRIGHT BIPEDAL EXERCISE TRAINING IMPROVES INTERVERTEBRAL DISC HEALTH: A SYSTEMATIC REVIEW AND META-ANALYSIS

INTRODUCTION &amp; AIMS The structure and function of human tissue, such as bone, muscle and tendon, can be improved with targeted exercise training. However, the effects of exercise training on intervertebral disc tissue has received comparably less attention. With a scope to identify types of exercise training that improve intervertebral disc health, this study examined the impact of historical exercise, sport and/or physical activity on quantitative intervertebral disc outcomes. METHODS The protocol was prospectively registered with PROSPERO (CRD42022366391). Five databases (inception to 30th September 2022), 17 trial registries and reference lists and forwards/backwards citations were searched. Inclusion criteria followed the Participants (human), Exposure (exercise, sport or physical activity for greater than one week), Comparators (non-exercise, sport or physical activity control group), Outcomes (magnetic resonance imaging measures of lumbar intervertebral disc health on a continuous scale [e.g. T2, signal intensity, intervertebral disc height]) and Study design (any) framework. Pairwise random-effects restricted maximum likelihood meta-analysis estimated standardised mean difference (Hedges g). RESULTS From the search yield of 2,150 records, 12 reports representing 10 studies (participants: 874) were deemed eligible. When compared to any comparator, upright bipedal exposures (g [95%CI]: 0.31 [0.06, 0.55]; P=0.014; studies: 6; participants: 346; I2: 87%), were associated with greater intervertebral disc health. However, no physical loading exposure (g [95%CI]: 0.29 [-0.23, 0.82]; P=0.275; studies: 10; participants: 874), non-upright/non-contact exposures (g [95%CI]: 0.70 [1.25, 2.64]; P=0.336; studies: 5; participants: 260), extreme trunk range of motion exposures (g [95%CI]: -0.28 [-1.60, 1.04]; P=0.456; studies: 3; participants: 230) and aerobic-based exposures (g [95%CI]: 0.48 [0.08, 1.04]; P=0.094) were associated. Sensitivity analyses supported the robustness of primary and secondary effect estimates. CONCLUSION Greater intervertebral disc health associated with a prior history of upright bipedal physical loading indicates prospective interventions examining upright bipedal exercise effects on intervertebral disc health are warranted.

Lifestyle Modulators of Neuroplasticity in Parkinson's Disease: Evidence in Human Neuroimaging Studies.

Parkinson's disease (PD) is a neurodegenerative disease characterized by both motor and non-motor symptoms. A progressive neuronal loss and the consequent clinical impairment lead to deleterious effects on daily living and quality of life. Despite effective symptomatic therapeutic approaches, no disease-modifying therapies are currently available. Emerging evidence suggests that adopting a healthy lifestyle can improve the quality of life of PD patients. In addition, modulating lifestyle factors can positively affect the microstructural and macrostructural brain levels, corresponding to clinical improvement. Neuroimaging studies may help to identify the mechanisms through which physical exercise, dietary changes, cognitive enrichment, and exposure to substances modulate neuroprotection. All these factors have been associated with a modified risk of developing PD, with attenuation or exacerbation of motor and non-motor symptomatology, and possibly with structural and molecular changes. In the present work, we review the current knowledge on how lifestyle factors influence PD development and progression and the neuroimaging evidence for the brain structural, functional, and molecular changes induced by the adoption of positive or negative lifestyle behaviours.

An assembly organization's approach to conducting ergonomics assessments of nutrunners in the absence of standards

Repetitive use of handheld nutrunners contributes to the development of musculoskeletal disorders (MSDs) among assembly operators. Tool-using organizations control the physical exposures resulting from nutrunners through their own, company-specific methods and recommendations. The aim of this study was to explore an automotive organization's current practice when conducting ergonomics assessments of nutrunner use. Fourteen employees representing different professional roles within the automotive manufacturing organization were interviewed about their involvement in, and approaches to, ergonomics evaluations of nutrunners. Findings show that the objective criteria tightening torque and tool type are combined with the operators' subjective assessments of the load to identify MSD risks associated with nutrunner use. This way, the effects of factors such as working posture could be integrated into the assessment. Further, it was found that information and knowledge availability could influence the resulting exposures estimates, where for example information about how to appropriately select tool settings is not readily available. In addition, there are negotiating criteria such as quality considerations which need to be balanced with health and safety management, influencing the physical demands associated with power tools. Relevance to industryBy providing insight into an automotive manufacturer's approach to managing and assessing handheld tightening tools, policy-makers can form recommended limits and methods for standardized assessments of reaction load exposure from nutrunners.

Hydrogen Sulfide and Irisin, Potential Allies in Ensuring Cardiovascular Health.

Irisin is a myokine secreted under the influence of physical activity and exposure to low temperatures and through different exogenous stimuli by the cleavage of its precursor, fibronectin type III domain-containing protein 5 (FNDC5). It is mainly known for maintaining of metabolic homeostasis, promoting the browning of white adipose tissue, the thermogenesis process, and glucose homeostasis. Growing experimental evidence suggests the possible central role of irisin in the regulation of cardiometabolic pathophysiological processes. On the other side, hydrogen sulfide (H2S) is well recognized as a pleiotropic gasotransmitter that regulates several homeostatic balances and physiological functions and takes part in the pathogenesis of cardiometabolic diseases. Through the S-persulfidation of cysteine protein residues, H2S is capable of interacting with crucial signaling pathways, exerting beneficial effects in regulating glucose and lipid homeostasis as well. H2S and irisin seem to be intertwined; indeed, recently, H2S was found to regulate irisin secretion by activating the peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α)/FNDC5/irisin signaling pathway, and they share several mechanisms of action. Their involvement in metabolic diseases is confirmed by the detection of their lower circulating levels in obese and diabetic subjects. Along with the importance of metabolic disorders, these modulators exert favorable effects against cardiovascular diseases, preventing incidents of hypertension, atherosclerosis, heart failure, myocardial infarction, and ischemia-reperfusion injury. This review, for the first time, aims to explore the role of H2S and irisin and their possible crosstalk in cardiovascular diseases, pointing out the main effects exerted through the common molecular pathways involved.

Exploring the Causal Relationship Between Modifiable Exposures and Diabetes Mellitus: A Two-Sample Mendelian Randomization Analysis.

Background Observational studies link lifestyle factors to diabetes, but confounding limits causal inference. This study employed Mendelian randomization (MR) to investigate the potential causal effects of major dietary, obesity, smoking, and physical activity exposures on diabetes risk. Methods A two-sample MR framework integrated FinnGen and United Kingdom Biobank (UKB) data. Genetic instruments for diet (fruits, vegetables, cheese), smoking (initiation, intensity, maternal), body mass index (BMI), and physical activity came from various consortia (n=64, 949-632, 802). Associations with diabetes odds were assessed using inverse-variance weighted analysis. Results Fruit and cheese intake and physical activity per standard deviation increase causally reduced diabetes risk in both cohorts. Conversely, smoking initiation, maternal smoking around birth, and BMI per standard deviation increase causally increased diabetes risk in both cohorts. Coffee increased diabetes risk only in FinnGen, whereas smoking intensity increased diabetes risk only in UKB. Conclusion This study provides robust evidence that modifiable lifestyle factors may have causal effects on diabetes risk. Fruit, cheese, and physical activity may protect against diabetes, whereas smoking, maternal smoking, and higher BMI appear to increase risk. Findings support public health interventions targeting diet, physical activity, smoking cessation, and healthy weight to combat the global diabetes epidemic.

Effectiveness of multi-modal home-based videoconference interventions on sleep in older adults: study protocol for a randomized controlled trial.

Aging is characterized by substantial changes in sleep architecture that negatively impact fitness, quality of life, mood, and cognitive functioning. Older adults often fail to reach the recommended level of physical activity to prevent the age-related decline in sleep function, partly because of geographical barriers. Implementing home-based interventions could surmount these obstacles, thereby encouraging older adults to stay active, with videoconference administration emerging as a promising solution. Increasing the availability of biological rhythms synchronizers, such as physical activity, light exposure, or vestibular stimulation, represents a viable non-pharmacological strategy for entraining circadian rhythms and potentially fortifying the sleep-wake cycle, thereby enhancing sleep in aging. This study aims to (1) assess the impact of remote physical exercise training and its combination with bright light exposure, and (2) investigate the specific contribution of galvanic vestibular stimulation, to sleep quality among healthy older adults with sleep complaints. One hundred healthy older adults aged 60-70 years with sleep complaints will be randomly allocated to one of four groups: a physical exercise training group (n = 25), a physical exercise training combined with bright light exposure group (n = 25), a galvanic vestibular stimulation group (n = 25) or a control group (i.e., health education) (n = 25). While physical exercise training and health education will be supervised via videoconference at home, bright light exposure (for the physical exercise training combined with bright light exposure group) and vestibular stimulation will be self-administered at home. Pre-and post-tests will be conducted to evaluate various parameters, including sleep (polysomnography, subjective questionnaires), circadian rhythms (actigraphy, temperature), fitness (physical: VO2 peak, muscular function; and motor: balance, and functional mobility), cognition (executive function, long-term memory), quality of life and mood (anxiety and depression). The findings will be anticipated to inform the development of recommendations and non-pharmaceutical preventive strategies for enhancing sleep quality in older adults, potentially leading to improvements in fitness, cognition, quality of life, and mood throughout aging.

Physical and psychosocial work-related exposures and the occurrence of disorders of the shoulder: A systematic review update

This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.

Changes in the number and outcome of takeaway food outlet planning applications in response to adoption of management zones around schools in England: A time series analysis

Physical exposure to takeaway food outlets (“takeaways”) is associated with poor diet and excess weight, which are leading causes of excess morbidity and mortality. At the end of 2017, 35 local authorities (LAs) in England had adopted takeaway management zones (or “exclusion zones”), which is an urban planning intervention designed to reduce physical exposure to takeaways around schools. In this nationwide, natural experimental study, we used interrupted time series analyses to estimate the impact of this intervention on changes in the total number of takeaway planning applications received by LAs and the percentage rejected, at both first decision and after any appeal, within management zones, per quarter of calendar year. Changes in these proximal process measures would precede downstream retail and health impacts. We observed an overall decrease in the number of applications received by intervention LAs at 12 months post-intervention (6.3 fewer, 95% CI -0.1, -12.5), and an increase in the percentage of applications that were rejected at first (additional 18.8%, 95% CI 3.7, 33.9) and final (additional 19.6%, 95% CI 4.7, 34.6) decision, the latter taking into account any appeal outcomes. This effect size for the number of planning applications was maintained at 24 months, although it was not statistically significant. We also identified three distinct sub-types of management zone regulations (full, town centre exempt, and time management zones). The changes observed in rejections were most prominent for full management zones (where the regulations are applied irrespective of overlap with town centres), where the percentage of applications rejected was increased by an additional 46.1% at 24 months. Our findings suggest that takeaway management zone policies may have the potential to curb the proliferation of new takeaways near schools and subsequently impact on population health.

A Study to Determine the Prevalence, Risk Factors and Perception of Overweight and Obesity by Parent and Adolescent and Evaluate the Effectiveness of a School-Based Intervention Program on BMI, Body Fat Composition and Selected Health-Related Behaviour Patterns among Adolescents in Kanyakumari District

Adolescents are increasingly susceptible to obesity, and thus at risk of later non-communicable diseases, due to changes in food choices, physical activity levels and exposure to an obese environment. This review aimed to synthesize the literature investigating the effectiveness of health education interventions delivered in school settings to prevent overweight and obesity and/ or reduce BMI in adolescents, and to explore the key features of effectiveness.

Between Floods and Climate Change: Revisiting the Mishing Community of Majuli Island, Northeast India

The transformation of monsoon rainfall patterns in India, largely attributed to climate change, is leading to more frequent and severe floods. These escalating challenges underscore the imperative of prioritising adaptive measures, given the intrinsic link between humans and climate change. This research conducted in Majuli Island, a highly vulnerable region in India’s northeast, aims to understand current adaptive strategies and assess potential risks from impending physical exposures. Empirical evidence was collected using purposive sampling in two flood-prone villages. The objective was to revisit the Mishing community’s experiences with annual flooding and climate challenges. Thematic analysis interpreted the qualitative findings. Implications for community-based adaptation and sustainable practices are discussed for future flood and climate challenges. The study emphasises strengthening ecosystem-based adaptation through multi-sectoral networking in Majuli Island, Northeast India.

Natural carotenoids as a potential chemopreventive agent for prostate cancer: A literature review

Prostate cancer (PCa) is the most commonly diagnosed cancer in men and the second leading cause of cancer death among men worldwide. While the exact etiology of PCa remains unclear, various factors contribute to the onset of the disease. These factors include modifiable risk factors such as physical activity, diet, obesity, smoking, alcohol consumption, and exposure to environmental agents. In addition, unmodifiable risk factors such as age and ethnicity play a role, with men of African ancestry being more susceptible to the disease. Despite the availability of potential treatment options, prevention is of utmost importance in reducing the incidence of PCa. Researchers have turned their attention to carotenoids, which are natural compounds derived from fruit and vegetables such as citrus, tomato, and green leafy vegetables, due to their potential chemopreventive effects. Multiple phase II clinical trials have indicated a reduced incidence and progression of diagnosed PCa in patients. Laboratory studies on PCa cell lines have demonstrated that carotenoids induce apoptosis and reduce cellular accumulation and adhesion of PCa cells in a dose-dependent manner. In this literature review, we assess the chemopreventive potential of the most common carotenoids: &amp;alpha;-carotene, &amp;beta;-carotene, lycopene, lutein, and &amp;beta;-cryptoxanthin, which are often found in a heterogeneous mixture. We also discuss their potential clinical use as well as challenges related to their safety and bioavailability. Overall, a better understanding of the etiology and pathophysiology of PCa will lead to the development of improved preventative strategies and treatments for the disease.

Патогенетическое обоснование остеопатических методов при лечении термических ожогов кожи

The novelty of the present studylies in the application of manual (osteopathic) approach to the treatment of thermal skin burns in patients in the acute period (1-3 days) of a burn injury. Clinical, osteopathic, and analytical methods were used. The study result is thatthe involvement of the underlying tissues in burn process in the projection of the burn wound zone determines thecourse and the forecast of a thermalskin burn of the II-III degree in patients. Osteopathic treatment can stop the course of typical pathological processes and change the pathogenesis of the wound process. It is advisablethat the method of early physical rehabilitation and exposure to osteopathic treatmentaimed at improvingthe course of the wound process in burn wounds already in the diseaseacute periodshould be introduced in clinical practice.

Tip of the iceberg: unveiling the impact on back disorders from cumulative physical job exposure and evaluating bias from the healthy worker effect using a nationwide longitudinal cohort study

PurposeLongitudinal studies across various sectors with physically demanding jobs are notably absent in back disorder risk research. This study aimed to investigate the relationship between cumulative physical job exposure (PJE) and hospital-diagnosed back disorders among individuals in Denmark. To assess the healthy worker effect, we compared the cumulative risk estimate with results from a naive cross-sectional model ignoring PJE history.MethodsA nationwide longitudinal cohort study was conducted using Danish registers, encompassing individuals born between 1975 and 1978 and working in 1996. Cumulative PJE was measured with a 10-year look-back period for each year 2006–2017. PJE consisted of lower-body occupational exposures, including the total weight lifted, stand/sit ratio, and the frequency of lifting more than 20 kg per day from a job exposure matrix. Odds ratio for back disorders was estimated for each year and all years combined.ResultsThe results unveiled a significant 31% increase in the risk of hospital-diagnosed back disorders after 4 years of cumulative PJE. The lowest risk (7%) was observed for incident back disorders with 1 year of exposure, suggesting a healthy worker effect. Nevertheless, this risk is still significantly elevated. This cumulative estimate is fourfold the estimate from the 2006 naive cross section model.ConclusionOur study clearly demonstrates an 31% increase in the risk of hospital-diagnosed back disorders with just 4 years of PJE over a 10-year period. Further, we find that cross-sectional studies strongly underestimate the risk of back disorders due to the healthy worker effect.

The effect of breaking sitting time with physical activity breaks on cognitive performance in young people with cerebral palsy: an exposure response cross-over feasibility design

Abstract Objectives To assess the feasibility of methods and estimate the potential effect of interrupting sedentary behaviour, with intermittent or continuous physical activity breaks, on cognitive performance in young people with Cerebral Palsy. Methods A randomised three-arm exposure response cross-over design with process evaluation. Participants were recruited throughout the Thames Valley, UK between 01/11/2018 to 31/03/2020. The three 2 h activity exposure visits included: (i) sitting only (controls), (ii) sitting plus 20 min of moderate-to-vigorous activity burst, or (iii) 4×5 min of moderate-to-vigorous activity bursts, during a 2.5 h sedentary session. Measures of feasibility were sought. Cognitive performance outcomes (using the Eriksen Flanker task and Forward and Backward Digit Span) were delivered before and after the 2 h testing period. Results 36 participants were randomised (age 13.2±2.7, Gross-Motor Functional Classification System 1–3). Study retention was 83 % across all three interventions and overall missing data for measures was 4 %. A small intervention effect was found in reaction time in the 4×5 min physical activity exposure session compared to the sedentary control condition (0.42; 95 % CI 0.40 to 0.79). There were two research-related minor adverse effects, an allergic reaction to the FreeStyle Libre and feeling faint and vomiting after consumption of glucose solution. Both events were resolved and participants continued with the study. Conclusions The study design and intervention implementing short bursts of physical activity was feasible and indicated a potential effect on reaction time as a measure of cognitive performance in young people with cerebral palsy.

Child Abuse Exposure, Internalizing and Externalizing Trauma Sequelae, and Partner Violence Perpetration Among Young Adult Men

ABSTRACT Partner violence is a major public health concern. Theory and research connect exposure to abuse in childhood to partner violence in adulthood. The present study examined internalizing and externalizing trauma sequelae as mediators in the association between child abuse exposure and adult partner violence perpetration. Young U.S. adult men (N = 423) completed background measures assessing exposure to psychological, physical, and sexual child abuse, internalizing (symptoms of anxiety and depression) and externalizing (problems with anger and alcohol use) sequelae, psychological and physical partner violence perpetration, and follow‐up assessments regarding sexual violence perpetration over the course of 3 months. Negative binomial regression showed that problems with anger mediated the associations between child psychological abuse exposure and adult psychological violence perpetration and between child physical abuse exposure and adult psychological violence perpetration. Problems from alcohol use mediated the associations between child psychological abuse exposure and adult psychological, physical, and sexual violence perpetration. Although child abuse exposure was associated with internalizing sequelae, none of the indirect effects from child abuse exposure to adult violence perpetration via internalizing sequelae were statistically significant. These findings add to the extant literature supporting an intergenerational transmission of violence and underscore that men who experience trauma early in life may attempt to cope with such experiences via maladaptive acting out behaviors. Partner violence interventions may benefit from incorporating strategies that address trauma and provide healthy alternatives for coping with distress.