Time spent playing outdoors after school and its relationship with independent mobility: a cross-sectional survey of children aged 10–12 years in Sydney, Australia

<p>Abstract</p> <p>Background</p> <p>Time spent outdoors is positively associated with physical activity and has been suggested as a proxy for physical activity of children. The role of children's independence in physical activity and time spent outdoors is less understood. This study aimed to assess how much time children spent playing outdoors after school, and to explore the relationship between outdoor play and independence among children aged 10–12 years.</p> <p>Method</p> <p>Children recorded how much time they spent playing outdoors or watching TV/videos or playing computer games after school using a five-day diary, and also reported whether they were allowed to walk on their own in their neighbourhood as an indicator of their independent mobility. Parents were surveyed on family demographics and perception of neighbourhood safety. The surveys were conducted in late 2006 as part of the Central Sydney Walk to School program which involved 1975 children and their parents from 24 primary schools. Factors associated with time spent playing outdoors were determined by logistic regression modelling.</p> <p>Results</p> <p>Thirty-seven per cent of children spent less than half an hour a day playing outdoors after school, and 43% spent more than 2 hours a day watching TV, videos or playing computer games. Forty-eight per cent of children were allowed to walk on their own near where they lived. Children's independent mobility was significantly associated with outdoor play after adjusting for other confounders. Compared with those who were never allowed to walk on their own near where they lived, students who were allowed to walk on their own were significantly more likely to spend more than half an hour a day playing outdoors after school with an adjusted odds ratio of 2.6, 95% CI 1.84–3.58, P < 0.001.</p> <p>Conclusion</p> <p>The findings that a significant proportion of children spend less than half an hour a day playing outdoors after school and have excessive screen time have important implications for physical activity promotion and obesity prevention. The study also suggests that children's independent mobility should be considered in research and evaluation into children's play and physical activity. Environments that promote greater independent mobility in children may increase their physical activity levels and hence reduce their risk of overweight/obesity.</p

High-velocity power training has similar effects to traditional resistance training for functional performance in older adults: a systematic review

What is the effect of high-velocity power training (HVPT) compared with traditional resistance training (TRT) on functional performance in older adults? What is the quality of intervention reporting for the relevant literature? Systematic review and meta-analysis of randomised controlled trials. Older adults (aged > 60 years), regardless of health status, baseline functional capacity or residential status. High-velocity power training with the intent to perform the concentric phase as quickly as possible compared with traditional moderate-velocity resistance training performed with a concentric phase of ≥ 2 seconds. Short Physical Performance Battery (SPPB), Timed Up and Go test (TUG), five times sit-to-stand test (5-STS), 30-second sit-to-stand test (30-STS), gait speed tests, static or dynamic balance tests, stair climb tests and walking tests for distance. The quality of intervention reporting was assessed with the Consensus on Exercise Reporting Template (CERT) score. Nineteen trials with 1,055 participants were included in the meta-analysis. Compared with TRT, HVPT had a weak-to-moderate effect on change from baseline scores for the SPPB (SMD 0.27, 95% CI 0.02 to 0.53; low-quality evidence) and TUG (SMD 0.35, 95% CI 0.06 to 0.63; low-quality evidence). The effect of HVPT relative to TRT for other outcomes remained very uncertain. The average CERT score across all trials was 53%, with two trials rated high quality and four rated moderate quality. HVPT had similar effects to TRT for functional performance in older adults, but there is considerable uncertainty in most estimates. HVPT had better effects on the SPPB and TUG, but it is unclear whether the benefit is large enough to be clinically worthwhile. [Abstract copyright: Copyright © 2023 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Evaluating Boston Harbor Cleanup: An Ecosystem Valuation Approach

In this study, we develop an economic evaluation of the Boston Harbor Cleanup, a court-mandated action started in 1986, through a comparison of cleanup costs and relevant ecosystem service values. Our results suggest that the ecosystems in the study area provide services to society with a capitalized value ranging from $30 to$100 billion. The $4.7 billion cost of the Boston Harbor Cleanup is about 5–16% of the total asset value of ecosystem services. Although it is not clear what fraction of the ecosystem value is due to the cleanup, our results suggest that the cost of the cleanup may be justified by our high- or midpoint-estimates of the value of ecosystem services

Challenges in the Management of Non-Alcoholic Fatty Liver Disease (NAFLD): Towards a Compassionate Approach

From Crossref journal articles via Jisc Publications RouterHistory: epub 2023-08-25, issued 2023-08-25Article version: VoRPublication status: PublishedRepresenting a growing ‘silent epidemic’, non-alcoholic fatty liver disease (NAFLD) affects around 25–30% of the general population. Alarmingly, NAFLD increases the risk of cardiovascular disease, both independently and through its strong associations with obesity, type 2 diabetes, and metabolic syndrome, whilst posing a substantial burden from an economic and health-related quality of life perspective. Moreover, growing evidence links NAFLD to common mental health disorders including depression, anxiety, and stress. In this context, recent clinical and research attention further focuses on potential additional problems faced by patients with NAFLD, such as perceived stigma, lack of awareness regarding the condition, and possible feelings of loneliness and isolation that might emerge from unmet support needs. To date, despite a wealth of literature on NAFLD, management of the condition remains challenging and not straightforward, with most cases in primary care being treated with lifestyle modification on top of any other comorbidity treatment. However, for many patients with NAFLD, weight loss is hard to accomplish and/or sustain (e.g., patients may lack the skills, confidence, and motivation required to adhere to dietary changes, and/or may have problems limiting opportunities for increased physical activity). Therefore, tailored interventions which are manageable from the perspective of the individual patient with NAFLD could glean greater results. Accordingly, although there is a lack of research exploring the potential benefits of person-centered and compassion-based approaches to the management of NAFLD, in the present review, we draw on evidence from methods utilized in the treatment of other chronic conditions in postulating the view that such approaches might prove beneficial in the future management of NAFLD

Non-invasive Scores and Serum Biomarkers for Fatty Liver in the Era of Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD):A Comprehensive Review From NAFLD to MAFLD and MASLD

Purpose of Review: The prevalence of non-alcoholic fatty liver disease (NAFLD) is rapidly increasing worldwide, making it the leading cause of liver related morbidity and mortality. Currently, liver biopsy is the gold standard for assessing individuals with steatohepatitis and fibrosis. However, its invasiveness, sampling variability, and impracticality for large-scale screening has driven the search for non-invasive methods for early diagnosis and staging. In this review, we comprehensively summarise the evidence on the diagnostic performance and limitations of existing non-invasive serum biomarkers and scores in the diagnosis and evaluation of steatosis, steatohepatitis, and fibrosis.Recent Findings: Several non-invasive serum biomarkers and scores have been developed over the last decade, although none has successfully been able to replace liver biopsy. The introduction of new NAFLD terminology, namely metabolic dysfunction-associated fatty liver disease (MAFLD) and more recently metabolic dysfunction-associated steatotic liver disease (MASLD), has initiated a debate on the interchangeability of these terminologies. Indeed, there is a need for more research on the variability of the performance of non-invasive serum biomarkers and scores across the diagnostic entities of NAFLD, MAFLD and MASLD.Summary: There remains a significant need for finding valid and reliable non-invasive methods for early diagnosis and assessment of steatohepatitis and fibrosis to facilitate prompt risk stratification and management to prevent disease progression and complications. Further exploration of the landscape of MASLD under the newly defined disease subtypes is warranted, with the need for more robust evidence to support the use of commonly used serum scores against the new MASLD criteria and validation of previously developed scores.</p

Capability, opportunity, and motivation—identifying constructs for increasing physical activity behaviours in women with polycystic ovary syndrome (PCOS)

© 2023 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/ijerph20032309Polycystic ovary syndrome (PCOS) is the commonest endocrinopathy in reproductive-aged women. Because increased adiposity is pivotal in the severity of PCOS-related symptoms, treatment usually incorporates increasing energy expenditure through physical activity (PA). This study aimed to understand the reasons why women with PCOS engage in PA/exercise, which could support the development of targeted behavioural interventions in this at-risk population. Validated questionnaires were administered for self-reported PA levels, quality of life, mental health, illness perception, sleep quality, and capability, opportunity, and motivation (COM) for PA. Using categorical PA data, outcomes were compared between groups; ordinal logistic regression (OLR) was used to identify whether COM could explain PA categorisation. A total of 333 participants were eligible; favourable differences were reported for body mass index, depression, mental wellbeing, self-rated health, illness perception, and insomnia severity for those reporting the highest PA levels. COM scores increased according to PA categorisation, whilst OLR identified conscious and automatic motivation as explaining the largest PA variance. The most active participants reported favourable data for most outcomes. However, determining whether health is protected by higher PA or ill health is a barrier to PA was not possible. These findings suggest that future behavioural interventions should be targeted at increasing patient motivation.This research was partly funded by the General Charities of the City of Coventry (6/2020) and ResMed (6/2020).Published onlin

The Influence of Polycystic Ovary Syndrome (PCOS) and Other Related Factors upon Health-Related Quality of Life in Women of Reproductive Age: A Case-Control Study

This study aimed to assess the impact of a polycystic ovary syndrome (PCOS) diagnosis and other factors on health-related quality of life (HRQoL) in women of reproductive age. Online questionnaires were completed and study groups compared. Potential causal relationships were evaluated using path analysis. Analyses revealed that a PCOS diagnosis alongside BMI had the largest effect on HRQoL. Higher levels of physical activity (PA) were not associated with greater HRQoL, and PA was not directly affected by any other outcome. However, reduced self-esteem was identified as a key factor in the promotion of physical and mental health

Age-related degeneration of the lumbar paravertebral muscles: Systematic review and three-level meta-regression

This is an author's accepted manuscript of an article published by Elsevier in Experimental Gerontology, available online: https://doi.org/10.1016/j.exger.2020.110856 The accepted manuscript may differ from the final published version.Background: Morphological changes of the lumbar spine muscles are not well characterised with ageing. To further the understanding of age-related degeneration of the lumbar spine musculature, normative morphological changes that occur within the paravertebral muscles must first be established. Methods: A systematic review and meta-regressions were conducted adhering to PRISMA guidelines. Searches for published and unpublished data were completed in June 2019. Results: Searches returned 4781 articles. 34 articles were included in the quantitative analysis. Three-level meta-analyses showed age-related atrophy (r = −0.26; 95% CI: −0.33, −0.17) and fat infiltration (r = 0.39; 95% CI: 0.28, 0.50) in the lumbar paravertebral muscles. Degenerative changes were muscle-specific and men (r = −0.32; 95% CI: −0.61, 0.01) exhibited significantly greater muscle atrophy than women (r = −0.24; 95% CI: −0.47, 0.03). Imaging modality, specifically ultrasound, also influenced age-related muscle atrophy. Measurements taken across all lumbar levels revealed the greatest fat infiltration with ageing (r = 0.58, 95% CI: 0.35, 0.74). Moderators explained a large proportion of between-study variance in true effects for muscle atrophy (72.6%) and fat infiltration (79.8%) models. Conclusions: Lumbar paravertebral muscles undergo age-related degeneration in healthy adults with muscle, lumbar level and sex-specific responses. Future studies should use high-resolution imaging modalities to quantify muscle atrophy and fat infiltration.AD was funded supported Coventry University and University Hospitals Coventry and Warwickshire. This research was carried out with the support of the National Institute of Health Research (NIHR) Coventry and Warwickshire Clinical Research Facility.Published versio

Uncertainty, anxiety and isolation: Experiencing the COVID-19 pandemic and lockdown as a woman with polycystic ovary syndrome (PCOS)

© 2021 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/jpm11100952Background: The COVID-19 pandemic and the related lockdown measures presented a significant risk to physical and mental wellbeing in affected populations. Women with polycystic ovary syndrome (PCOS) are predisposed to several cardio-metabolic risk factors which increase the susceptibility to severe COVID-19 and also exhibit increased likelihood of impaired mental health wellbeing. Therefore, these women who usually receive care from multiple primary and specialist healthcare services may be disproportionately impacted by this pandemic and the related restrictions. This study aimed to explore the lived experience of the first UK national lockdown as a woman with PCOS. Methods: As part of a larger cross-sectional study, 12 women with PCOS living in the UK during the first national COVID-19 lockdown were recruited to a qualitative study. Telephone interviews were conducted in June/July of 2020, and data collected were subjected to thematic analysis. Results: Five themes were identified. "My PCOS Journey" describes participants' experiences of diagnosis, treatment and ongoing management of their PCOS. "Living Through Lockdown" describes the overall experience and impact of the lockdown on all aspects of participants' lives. "Self-care and Managing Symptoms" describe multiple challenges to living well with PCOS during the lockdown, including lack of access to supplies and services, and disruption to weight management. "Healthcare on Hold" describes the uncertainty and anxiety associated with delays in accessing specialised healthcare for a range of PCOS aspects, including fertility treatment. "Exacerbating Existing Issues" captures the worsening of pre-existing mental health issues, and an increase in health anxiety and feelings of isolation. Conclusion: For the women with PCOS in this study, the COVID-19 pandemic and the first national lockdown was mostly experienced as adding to the pre-existing challenges of living with their condition. The mental health impact experienced by the study participants was increased due to lack of access to their normal support strategies, limitations on healthcare services and uncertainty about their risk of COVID-19.Published versio