School Holidays Research Articles

Enhancing Sleep and Reducing Occupational Stress Through Forest Therapy: A Comparative Study Across Job Groups.

The coronavirus disease-2019 (COVID-19) pandemic radically shifted occupational patterns, leading to increased telecommuting and related stressors. Healthcare providers, among the most impacted group, faced heightened risks and workplace changes. Our study examined the efficacy of forest therapy in alleviating work-induced stress across various professions, exploring the need for profession-specific stress-relief strategies in the post-pandemic workplace. To examine the impact of COVID-19 on professionals, 62 participants were recruited, consisting of 20 healthcare providers, 21 information technology (IT) specialists, and 21 teachers. Instruments such as Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale, along with salivary tests for cortisol and melatonin, were used to assess the participants' sleep and stress levels. A specialized forest healing program was implemented among these participants. Data analysis was conducted using SPSS Win Ver. 22.0, utilizing paired t-tests and a repeated measures analysis of variance. Significant improvements were observed in the participants' sleep metrics, depression scales, and stress levels after the forest healing program. Physiological measures indicated an increase in melatonin and a decline in cortisol and dehydroepiandrosterone sulfate levels, with only cortisol changes being statistically significant. Teachers, participating during school vacations, exhibited minimal stress-related physiological changes. Overall, the program demonstrated widespread health benefits regardless of occupation or gender. This study showed that forest therapy reduced stress equally across professions, including healthcare providers, IT specialists, and teachers. Individual physiological responses may play a greater role in stress relief than the specific occupation.

Understanding the interactions that children and young people have with their natural and built environments: A survey to identify targets for active travel behaviour change in Wales.

Active travel offers many societal benefits, including improving people's mental and physical health and minimising our impacts on the environment. Increasing active travel is particularly important amongst children and young people (CYP), who are building habits which they will carry into adulthood. Studies on active travel amongst CYP are limited, however, with most research focusing on adult participants or on adult perceptions of children. This study sought to understand CYP's interactions with the built and natural environment-and therefore their access to active travel-through the Capability, Opportunity, Motivation, Behaviour (COM-B) model. With a stakeholder group representing local government, youth organisations and active travel organisations, we co-created two bilingual questionnaires-one for young people aged 12-16 years living in Wales and the other for parents of young people aged 12-16 years living in Wales. Both questionnaires collected information on behaviour and perceived capability, opportunity and motivation of CYP to engage with their natural and built environments. The questionnaires included a discrete choice experiment (DCE), which proposed a series of binary choice questions indicating preferences based on landscape, journey time and type of travel. A total of 124 questionnaires (38 young people and 86 parents) were returned for analysis. These data indicate that CYP's time spent outdoors is not dependent upon geography (rural/urban/suburban), season, or school holidays. There was a significant difference in capability, opportunity and motivation between parents and CYP, with parents over-estimating the psychological capability of CYP to engage outdoors. The preference data indicate that active travel is the favoured mode of transport, with both CYP and parents stating that they would increase travel time in order to travel actively. While this response is not consistent with respondent's day-to-day travel choices, it suggests that the limitations to active travel may be psychological capability and automatic motivation, rather than a lack of opportunity.

Modeling the population-level impact of a third dose of MMR vaccine on a mumps outbreak at the University of Iowa

Mumps outbreaks among fully vaccinated young adults have raised questions about potential waning of immunity over time and need for a third dose of the measles, mumps, rubella (MMR) vaccine. However, there are currently limited data on real-life effectiveness of the third-dose MMR vaccine in preventing mumps. Here, we used a deterministic compartmental model to infer the effectiveness of the third-dose MMR vaccine in preventing mumps cases by analyzing the mumps outbreak that occurred at the University of Iowa between August 24, 2015, and May 13, 2016. The modeling approach further allowed us to evaluate the population-level impact of vaccination by different timing in relation to the start of the outbreak and varied coverage levels, and to account for potential sources of bias in estimating vaccine effectiveness. We found large uncertainty in vaccine effectiveness estimates; however, our models showed that early introduction of a third dose of MMR vaccine during a mumps outbreak can be effective in preventing transmission. School holidays, such as the winter break, likely played important roles in preventing mumps transmission.

Understanding Parents' Views on Key Factors and Risks in School Holiday Camp Participation

Understanding Parents' Views on Key Factors and Risks in School Holiday Camp Participation

A study of the relation between traffic accidents and election posters

Inattention in traffic is a risk factor for the occurrence of accidents. Elements surrounding traffic could potentially be a safety risk for road users. This study investigates the relation between election posters and traffic accidents using a seasonal autoregressive-moving-average model with exogeneous variables (seasonal ARMAX) correcting for variations in meteorological conditions and general traffic volume indicated through public holidays. Danish traffic accident micro data are used to construct a time series for daily number of accidents in city zones adjusted for probable known accident causes, namely drunk driving, narcotics, drivers deemed unfit to drive, and accidents related to low visibility. Model parameters are determined from Maximum Likelihood estimation on the period from 1 January 1997 to 15 December 2009 with an indicator for general election periods. The presence of general election posters is associated with an increased risk of traffic accidents (p = 0.003), when correcting for meteorological variables and public school holidays. While a causal relation between traffic accidents and the presence of election posters cannot be concluded from the analysis, we find distraction from election posters to be the most likely explanation for the associated increase in traffic accidents. On average, the model indicates that 1.18 additional daily accidents occur for general elections in Denmark. In total, that amounts to 127 additional accidents for the investigated period of time. This study shows that such sudden changes in traffic surroundings are significantly related to increased safety risks which could lead to a better discussion of relevant traffic legislation.

Pediatric Burn Unit Admission is Associated with School Holidays and Lower Home Childhood Opportunity Level.

Burn injury can have profound detrimental effects on quality of life and mental health of children. We collected demographics, burn etiology, burn date, and home zip code for pediatric patients admitted to our burn unit from 2016-2023. Age, burn date, and etiology of burn were used to assess temporal and mechanistic patterns of injury for pre-school-age and school-age children. Home zip code was used to determine each child's home Childhood Opportunity Index score, which is composed of sub-domains for Education, Health & Environment, and Social & Economic. We calculated the odds-ratio for odds of pediatric burn admission for each COI sub-domain quintile, using very high opportunity neighborhoods as the reference. Scald was the prevailing burn etiology (64%). In school-age children, July was the month with the most burn injuries (19%), attributable to firework injuries. School-age children were also more likely to be injured in a week without classroom instruction (p<0.001). There was a dose-response relationship between Childhood Opportunity Index and odds of burn admission, with the greatest odds of burn admission observed for children from very low educational opportunity areas (OR 5.21, 95% CI 3.67-7.39). These findings support interventions for burn prevention such as increased education about the dangers of fireworks, addressing inequities in access to childcare and extracurricular activities, and reducing the default water heater temperatures in multi-unit dwellings.

Weekend warriors: contrasting temporal patterns in the harvest of three species of boreal ungulates

Understanding the drivers that shape hunter behaviour and success can help guide management decisions regarding hunting. Although there has been work on the socioeconomic and environmental drivers of hunter effort, less quantitative analysis of the temporal patterns of wildlife harvest has been available. Yet, knowing when hunters are most active may be useful for distributing the spatiotemporal allotment of hunting opportunities where real or perceived issues of hunt quality (e.g. hunter congestion) or negative impacts to local people or target and non‐target wildlife species are of concern. As a case study, we used generalized linear models to examine the effect of season, day of week (i.e. weekday versus weekends), and holidays on 26–28 years of harvest data for bison Bison bison, thinhorn sheep Ovis dalli, and moose Alces americanus in Yukon, Canada. These species are important in regional socioecological systems and highly prized by local hunters. For all three species, harvest was significantly greater on weekends than weekdays. Most of the harvest for thinhorn sheep occurred early in the season, consistent with an ‘opening day' phenomenon, whereas that for moose and bison started slowly and increased throughout the season. For all three species harvest was not significantly influenced by holidays. Bison harvest, however, was influenced in relation to public school holidays, with harvest decreasing over the winter (Christmas) break and increasing over spring break in March. Differences between these three species are likely due to species‐specific hunting strategies, the behaviour of each species, hunter competition, and seasonal climate. Identifying patterns in hunter effort and harvest can inform wildlife management decisions on permit allocation. However, our data indicate that species‐specific patterns vary substantially, even in the same region, and need to be understood for proposed changes to the timing of hunting opportunities to be effective.

Enhancing Elementary School Students' Soft Skills Through the Parent Teaching Program: Leveraging Local Resources for Optimization

This study employed an explanatory sequential design to investigate the implementation of the parent teaching program and its impact at an elementary school in Yogyakarta, Indonesia. It was conducted in two stages: distributing and analyzing questionnaires to 76 students in the first stage and interviewing teachers and parents in the second stage. Data analysis employed basic statistics for quantitative analysis and thematic analysis for qualitative aspects. The results indicate that the parent teaching program at this school commences with the program's planning stage, during which teachers directly involve parents in meetings. The program is implemented after final exams or a week before the school holidays. It has a positive impact on the development of students' soft skills. Following the program's implementation, students demonstrated increased teamwork, communication, and creativity activities. Additionally, the program boosted students' self-confidence and critical thinking skills, which could benefit them in the future. It can be concluded that this program represents an innovative approach to enhancing students' soft skills by making use of local resources.

미래 예비교사의 AI 리터러시와 교수 효능감 발달을 위한 교육청 캠프 운영 사례 연구

Objective: This study analyzes the effectiveness of the Education Office's high school Winter/Summer School camp during school vacations for enhancing the artificial intelligence (AI) digital competences of high school students aspiring to become future teachers, and students' satisfaction. Methods: To measure the effects and satisfaction, we conducted pre- and post-course surveys using Google Forms to assess students' perception of AI, AI literacy, and teaching efficacy. We supplemented these quantitative data with qualitative data by utilizing participants' learning logs and conducting interviews. Finally, we fostered interaction among the participants during the learning process through Naver Band, and observed the outputs and learning process through activities such as creating teaching and learning content using AI and digital tools. Results: We found high satisfaction levels, and significant positive effects on students' perception of AI, AI literacy, and teaching efficacy. Clearly, the camp courses helped participating students develop AI literacy, enhance teaching efficacy, and build their competencies as future teachers. Conclusions: The "AI and Digital Competency Education Practicum for Future Teachers" conducted in the Winter/Summer School can enhance participants' AI literacy, teaching efficacy, and overall learning satisfaction. This has important educational implications for future teacher training.

Variations in Dispensing Psychotropic Drugs to Adolescents Depending on School Periods: A French Nationwide Retrospective Study.

Seasonality patterns are reported for various psychiatric disorders. Concerning adolescents, there is an increased frequency of general emergency department visits for mental health disorders observed between March and May, as well as in October and November. We conducted a retrospective cohort study using the French health insurance medico-administrative database. We extracted psychotropic drug deliveries occurring between 2015 and 2019 for patients aged between 12 and 18 years old. Each drug delivery was classified as occurring during a school period (Sc), the summer holidays (SumH) or other shorter holidays periods (ShH). We compared the number of distinct patients, as well as the proportion of new consumers, according to week status. Anxiolytics and hypnotics were more frequently dispensed during the school periods and short breaks than during the summer holidays. Conversely, antidepressants were more commonly dispensed during the short breaks rather than school periods and summer holidays. The stressful effects induced by schooling appear to be addressed in the first line by anxiolytics and hypnotics, while antidepressants are more frequently introduced during school holidays.

Forecasting of influenza activity and associated hospital admission burden and estimating the impact of COVID-19 pandemic on 2019/20 winter season in Hong Kong.

Like other tropical and subtropical regions, influenza viruses can circulate year-round in Hong Kong. However, during the COVID-19 pandemic, there was a significant decrease in influenza activity. The objective of this study was to retrospectively forecast influenza activity during the year 2020 and assess the impact of COVID-19 public health social measures (PHSMs) on influenza activity and hospital admissions in Hong Kong. Using weekly surveillance data on influenza virus activity in Hong Kong from 2010 to 2019, we developed a statistical modeling framework to forecast influenza virus activity and associated hospital admissions. We conducted short-term forecasts (1-4 weeks ahead) and medium-term forecasts (1-13 weeks ahead) for the year 2020, assuming no PHSMs were implemented against COVID-19. We estimated the reduction in transmissibility, peak magnitude, attack rates, and influenza-associated hospitalization rate resulting from these PHSMs. For short-term forecasts, mean ambient ozone concentration and school holidays were found to contribute to better prediction performance, while absolute humidity and ozone concentration improved the accuracy of medium-term forecasts. We observed a maximum reduction of 44.6% (95% CI: 38.6% - 51.9%) in transmissibility, 75.5% (95% CI: 73.0% - 77.6%) in attack rate, 41.5% (95% CI: 13.9% - 55.7%) in peak magnitude, and 63.1% (95% CI: 59.3% - 66.3%) in cumulative influenza-associated hospitalizations during the winter-spring period of the 2019/2020 season in Hong Kong. The implementation of PHSMs to control COVID-19 had a substantial impact on influenza transmission and associated burden in Hong Kong. Incorporating information on factors influencing influenza transmission improved the accuracy of our predictions.

Effect of vaccinations and school restrictions on the spread of COVID-19 in different age groups in Germany

With the emergence of SARS-CoV-2, various non-pharmaceutical interventions were adopted to control virus transmission, including school closures. Subsequently, the introduction of vaccines mitigated not only disease severity but also the spread of SARS-CoV-2. This study leveraged an adapted SIR model and non-linear mixed-effects modeling to quantify the impact of remote learning, school holidays, the emergence of Variants of Concern (VOCs), and the role of vaccinations in controlling SARS-CoV-2 spread across 16 German federal states with an age-stratified approach. Findings highlight a significant inverse correlation (Spearman's ρ = −0.92, p < 0.001) between vaccination rates and peak incidence rates across all age groups. Model-parameter estimation using the observed number of cases stratified by federal state and age allowed to assess the effects of school closure and holidays, considering adjustments for vaccinations and spread of VOCs over time. Here, modeling revealed significant (p < 0.001) differences in the virus's spread among pre-school children (0–4), children (5–11), adolescents (12–17), adults (18–59), and the elderly (60+). The transition to remote learning emerged as a critical measure in significantly reducing infection rates among children and adolescents (p < 0.001), whereas an increased infection risk was noted among the elderly during these periods, suggesting a shift in infection networks due to altered caregiving roles. Conversely, during school holiday periods, infection rates among adolescents mirrored those observed when schools were open. Simulation exercises based on the model provided evidence that COVID-19 vaccinations might serve a dual purpose: they protect the vaccinated individuals and contribute to the broader community's safety.

Aubergine time: A day in 1980s Romania

AbstractThis piece of creative nonfiction originates from a desire to salvage characters and situations that are slowly disappearing in Romania, for natural and social reasons, from aging to emigration. For decades, especially as part of the processes of industrialization and urbanization during socialism, children left villages in search of opportunities to study and work in towns and cities around the country. Their own children would return to these villages during their school holidays and would stay with their grandparents, men and women born in the first half of the 20th century. I was one of these grandchildren. Until I was 18 years old, I spent the whole summer break with my grandmother. In this piece, I draw upon my childhood memories and conversations with persons of my age about the days they spent in the countryside when they were children, their relationship to their grandparents and village life in socialist Romania. My aim is to take the readers back in time, to a summer day in the late 1980s that an 11‐year‐old girl spends in her grandmother's company in a southern Romanian village.

PERAMALAN JUMLAH PENUMPANG BUS RAPID TRANSIT (BRT) BANJARBAKULA DENGAN METODE AUTOREGRESSIVE INTEGRATED MOVING AVERAGE WITH EXOGENOUS VARIABLE (ARIMAX) DENGAN EFEK VARIASI KALENDER

Banjarbakula Bus Rapid Transit (BRT) is an inner-city bus-based mass transit system that provides a sense of comfort, safety, speed in mobility, and low cost in serving the citizens of Banjarmasin City and Banjarbaru City. Based on data on the number of passengers on the Banjarbakula BRT for the period April 2020 - February 2023, public interest in using the Banjarbakula BRT as a mode of transportation is quite high. However, the limited units and operational schedules make the Banjarbakula BRT unable to fully meet the needs of the public. Forecasting the number of passengers of BRT Banjarbakula for the next 12 periods is one of the measures to prepare the infrastructure, quality and units of BRT Banjarbakula in order to facilitate the public and create a better transportation system. In the Banjarbakula BRT passenger data, there is an increase in the number of passengers at certain times such as during religious holidays and school holidays, so this increase in passenger numbers is thought to be due to the influence of the calendar variation effect. This research intends to forecast the number of passengers of BRT Banjarbakula using the best ARIMAX model with the effect of calendar variation. The results indicate that the ARIMAX (0, 1, 1) model is the best ARIMAX model to forecast the number of passengers of BRT Banjarbakula for the next 12 periods. The forecast results indicate an increase in the month where the Christmas celebration and also the memorial haul guru sekumpul, so that the variable Christmas celebration and memorial haul guru sekumpul significantly affect the number of passengers of BRT Banjarbakula.Keywords: Forecasting, BRT Banjarbakula, ARIMAX with calendar variation effects

Commentary- Bridging the Gap: The Impact of Bowel Management Programs on Daily Life in Pediatric Colorectal Disease

BackgroundThis commentary discusses the social impact of bowel management programs (BMPs) on children with colorectal diseases, including anorectal malformations (ARM), Hirschsprung disease (HD), functional constipation (FC), and spina bifida. Previous studies focused on functional outcomes, but this study bridges the gap to daily life experiences. MethodsThe study examined children's experiences in BMPs, focusing on school participation, vacation ability, and overall patient experience. Cleanliness, defined as fewer than one stool soiling episode per week, was achieved by 70% of participants. ResultsPositive patient experiences were linked to achieving stool cleanliness, regardless of the management method. Invasive methods like enemas did not negatively affect experiences if cleanliness was maintained. Validated patient-reported experience measures (PREMs) and patient-reported outcomes measures (PROMs) were used, though the median age of 8.9 years posed limitations. ConclusionThe commentary highlights the significance of stool cleanliness in improving patient experiences and supports the effectiveness of various BMP methods. Future research should include longitudinal follow-ups to assess BMP durability and gather data from older children.

Comparing times of self-harm presentations to hospital emergency departments in children, adolescents, young adults and adults: a national registry study 2007–2019

PurposeThe few studies that have explored self-harm presentation times at hospital emergency departments (EDs) – an important factor that can determine if a patient receives a mental health assessment – primarily focus on adult samples. This study examined the times of self-harm presentations to EDs, self-harm methods used, mental health assessments, and admission data across different age-groups.MethodsUsing data from the National Self-Harm Registry Ireland over a 13-year timeframe (2007–2019), this study compared times, days, seasons, methods of self-harm, and admission data for children (8–12 years), adolescents (13–17 years), young adults (18–25 years) and adults (> 25 years).ResultsThe majority of the 152,474 self-harm presentations (78.6%) for all ages occurred out-of-hours (outside the standard working hours or in-hours times of 09:00–17:00, Monday-Friday). The four hours before midnight had the highest proportions of self-harm presentations for adolescents (27.9%) and adults (23.1%), whereas the four hours after midnight had the highest proportion of self-harm presentations for young adults (22.9%). The 16:00-midnight timeframe had highest proportion of self-harm presentations in children (52.3%). Higher proportions of patients received a mental health assessment in-hours compared to out-of-hours among young adults (78.2% vs. 73.3%) and adults (76.1% vs. 72.0%). Self-harm presentations were lowest during summer months in children and adolescents.DiscussionHospitals should ensure that adequate resources are available for individuals presenting with self-harm, especially in the case of overcrowded EDs, and protocols need to be designed for those presenting with self-harm due to intoxication. In line with national policy, protocols for patients presenting during out-of-hours should be designed that can incorporate services from allied health multidisciplinary teams, social work, addiction services and counselling organisations. Given the lower rates of self-harm during school holidays for children and adolescents, the school environment must be considered in the context of mental health and self-harm public health prevention interventions.

Increasing the Concentration of School Holidays in Early Childhood

It is very important for fathers and mothers to train their children to focus from an early age because many fathers and mothers make mistakes when introducing basic learning to their children but forget to teach them how to train their children's focus first. If children are used to practicing focus from an early age, they will easily accept various stimulation and basic learning that parents and mothers give their children at home, and children will get used to good focus. Training children to focus is not easy, and it cannot be done quickly, it needs to be gradual and takes time, so parents need to be patient so that children are able to focus well, which will affect the child's growth and development at home and at home. The research method uses descriptive qualitative so that it can describe the results of the research that has been carried out by the author and the research location at PAUD An-Nur. The data collection technique was direct observation at An-Nur PAUD, after which the author conducted interviews and documentation. It is hoped that the results of this research will serve as a guide for prospective mothers and fathers and those who are already fathers and mothers in educating their children and being able to train their children to focus from an early age because children's focus is related to concentration so that they get used to being at home with their fathers and mothers.

School holidays and respiratory syncytial virus transmission in Sweden: An interrupted time series analysis.

Respiratory syncytial virus (RSV) represents a significant cause of morbidity for children worldwide, especially for newborns. As RSV vaccines are not routinely used for children yet, non-pharmaceutical interventions (NPIs) represent the main strategy for prevention. The objective of this study was to investigate the correlation between school holidays and RSV transmission. Data were collected from the weekly reports on RSV incidence for the 2021/2022 and 2022/2023 seasons in Sweden. The 7-day cumulative incidence of RSV was compared before and after the designated school holidays (Fall, Christmas, and Winter holidays). Our findings reveal an immediate (-1.7%, p < 0.001, 95% CI [-3.1%, -0.4%]) and gradual (-1.4%/week, p < 0.001, 95%CI [-1.8, -1.0]) reduction in RSV incidence following the Fall holiday in 2021, especially among children under 1 year of age, both immediately (-107.6%, p < 0.05, 95% CI [-203.7, -11.5]) and gradually afterwards (-58.5%/week, p < 0.001, 95% CI [-72.7, -44.3]). Mixed results were obtained for the Fall in 2022/2023 and for the Winter and holidays in both the studied years. While the Fall holiday in 2021/2022 was associated with a decrease in RSV incidence in Sweden, our results do not support a universal effect of school holidays on reducing RSV transmission.

Seasonal dynamics of sand flies in Lençóis Maranhenses National Park: a tourist destination and endemic area for leishmaniasis.

Numerous sand fly species have been reported in Lençóis Maranhenses National Park (LMNP) in Northeast Brazil, including important Leishmania vectors, making the park an endemic area for tegumentary and visceral leishmaniasis. We evaluated sand fly abundance monthly over 7 years, correlating it with environmental variables and monthly tourist numbers in LMNP. Sand fly species were observed throughout the year, with Lutzomyia longipalpis Lutz & Neiva and Nyssomyia whitmani Antunes and Coutinho (Diptera: Psychodidae) being the most abundant species, especially from April to June. In addition to seasonal abundance patterns, Lu. longipalpis showed increasing abundance throughout 2013 until April 2014, whereas Ny. whitmani exhibited a consistent increase throughout the study period. Redundancy analysis indicated that monthly sand fly abundances increased with humidity but decreased with mean temperature and wind speed. Ecotourists mainly visit the park from May to September when interdune lagoons are full, coinciding with high-frequency vector activity during the rainy months (May-June). Tourists also visit in January and February during school holidays, when the rains begin and sand fly abundance increases, and in July, when sand fly abundance decreases. To date, no instances of infected tourists have been recorded, likely because visits to LMNP occur during the day when sand flies are inactive. However, there is a potential risk of vector exposure if tourists engage in nighttime cultural visits to villages around the park, where leishmaniasis cases occur annually.

Prevalence and associated factors of non-traumatic knee pain in high school volleyball players: a cross-sectional study

ABSTRACT Objectives This study aimed to determine the prevalence of knee pain among high school volleyball attackers, identify associated factors, and explore the relationship between knee pain and lower back pain (LBP). Methods A cross-sectional study involving 82 high school volleyball attackers (15–17 years) used questionnaires, interviews, and field-based assessments to collect data on demographics, volleyball-specific factors, flexibility, and jumping ability. Logistic regression analysis was used to identify factors associated with knee pain. Results The prevalence of knee pain was 19.5%. Factors significantly associated with knee pain were a history of LBP (OR, 4.64; 95% CI, 1.28 to 16.8; p = 0.019) and flexibility determined by the absolute difference in heel-buttock distance (OR, 1.37; 95% CI, 1.02 to 1.83; p = 0.037). Participants with knee pain had more volleyball experience and a higher proportion of players who competed as starters in the previous year. Both groups reported approximately 18 hours of practice per week during the school year and around 27 hours during school holidays, with no significant difference observed. Conclusion Factors associated with knee pain include a history of LBP and reduced flexibility on the heel-buttock distance test. The study highlights the need for a comprehensive approach, considering the coexistence of LBP and focusing on improving anterior thigh flexibility.