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Korkeakouluopiskelijat istuvat noin 11 tuntia päivittäin, ja iso osa tästä määrästä kertyy nimenomaan opiskelupäivän aikana. Lisäksi vain alle puolet opiskelijoista liikkuu liikkumissuosituksiin nähden tarpeeksi. Istumisen tauottamisella ja opiskelupäivien aktivoimisilla voidaan kuitenkin edistää opiskelijoiden terveyttä, hyvinvointia ja opiskelukykyä – ja tulevaa työkykyä. Nämä teemat ovat keskiössä valtakunnallisen opiskelijoiden liikunnan edistämisen Liikkuva opiskelu -ohjelmassa. Myös Keski-Suomen korkeakoulujen yhteisen Aktiivinen ja hyvinvoiva korkeakoulu -hankkeen yhtenä tavoitteena on tehdä opiskelupäivistä Liikkuva opiskelu -ohjelman mukaisesti liikkuvampia ja yhteisöllisempiä. Hanketta rahoittaa Opetus- ja kulttuuriministeriö Liikunnallisen elämäntavan valtakunnallisista kehittämishankevaroista. Osana hanketta korkeakoulujen opiskelijoille sekä opetushenkilöstölle toteutettiin kysely näihin teemoihin liittyen. Opiskelijoiden kyselyyn vastasi yhteensä 307 opiskelijaa ja opetushenkilöstön kyselyyn 64 henkilöä. Sekä opiskelijoiden että opetushenkilöstön kyselyn tuloksista nousi esille, että istumisen tauottamisessa ja opetuksen aktivoimisessa on korkeakouluissa vielä parannettavaa. Kyselyn perusteella toiminnallisten opetusmenetelmien käyttö ja kannustus istumisen tauottamiseen on melko vähäistä, etenkin etäopetuksessa. Sekä opiskelijoiden että opetushenkilöstön kyselyn tulokset kuitenkin osoittavat, että opetuksen ja opiskelun aikaista aktiivisuutta pidetään tärkeänä ja toivottavana, mutta tämä ei välttämättä vielä näy korkeakoulujen opetuksessa. Opiskelijat toivovat opettajien ottavan vastuuta taukojen pitämisestä ja myös opetushenkilöstö pitää opettajan roolia tärkeänä taukojen pitämisessä. Huolestuttavaa on kuitenkin se, että opetushenkilöstöstä suurimman osan mukaan omassa korkeakoulussa ole sovittu yhteistä toimintaohjetta opetuksen aikaisen istumisen vähentämiseksi. Korkeakouluihin tulisikin luoda selkeät istumisen tauottamisen ja aktiivisemman opiskelun toimintaohjeet. Lisäksi opetushenkilöstöä tulisi kouluttaa systemaattisemmin näihin teemoihin liittyen. Myös korkeakoulujen tiloissa on kyselyn mukaan reilusti parantamisen varaa liikuskelun aktivoinnin kannalta. Niin opiskelijoiden kuin henkilöstön mukaan opiskelutiloista löytyy melko heikosti istumisen vähentämisen ja liikuskelun mahdollistavia välineitä, kuten seisomatyö pöytiä, jumppapalloja tai muita liikuntavälineitä. Liikkumisvälineisiin ja -tiloihin liittyy myös epätietoisuutta opiskelijoiden keskuudessa. Suurin osa opiskelijoista vastasi ”ei” tai ”ei osaa sanoa” kysymyksiin mahdollisuudesta käyttää korkeakoulun liikuntatiloja tai -välineitä, käydä suihkussa tai mahdollistavatko korkeakoulun sisätilat tai piha-alueet liikunnallista toimintaa. Olisikin tärkeää panostaa sekä istumista vähentäviin ja liikuskeluun kannustaviin välineisiin ja ympäristöihin että viestintään niiden käyttömahdollisuuksista. Kyselyn tulokset antavat tärkeää tietoa Aktiivinen ja hyvinvoiva korkeakoulu -hankkeen toiminnan tueksi. Esiin nousseisiin puutteisiin tullaan tarjoamaan ratkaisuja esimerkiksi kouluttamalla opetushenkilöstöä ja muuttamalla korkeakoulujen tiloja aktiivisuutta tukevimmiksi.
Purpose: Emmetropization requires coordinated scaling of the major ocular components, corneal curvature and axial length. This coordination is achieved in part through a shared set of genetic variants that regulate eye size. Poorly coordinated scaling of corneal curvature and axial length results in refractive error. We tested the hypothesis that genetic variants regulating eye size in emmetropic eyes are distinct from those conferring susceptibility to refractive error. Methods: A genome-wide association study (GWAS) for corneal curvature in 22,180 adult emmetropic individuals was performed as a proxy for a GWAS for eye size. A polygenic score created using lead GWAS variants was tested for association with corneal curvature and axial length in an independent sample: 437 classified as emmetropic and 637 as ametropic. The genetic correlation between eye size and refractive error was calculated using linkage disequilibrium score regression for approximately 1 million genetic variants. Results: The GWAS for corneal curvature in emmetropes identified 32 independent genetic variants (P < 5.0e-08). A polygenic score created using these 32 genetic markers explained 3.5% (P < 0.001) and 2.0% (P = 0.001) of the variance in corneal curvature and axial length, respectively, in the independent sample of emmetropic individuals but was not predictive of these traits in ametropic individuals. The genetic correlation between eye size and refractive error was close to zero (rg = 0.00; SE = 0.06; P = 0.95). Conclusions: These results support the hypothesis that genetic variants regulating eye size in emmetropic eyes do not overlap with those conferring susceptibility to myopia. This suggests that distinct biological pathways regulate normal eye growth and myopia development.
Purpose: Physical activity promotes a positive physical self-image, but less is known about whether the positive effect covers the general self-evaluation of adolescent appearance. This study aimed to further explore the associations between physical activity and body-esteem in Finnish adolescents, via a country-representative cross-sectional study design. Methods: The data for the study were drawn from the Finnish component of the Health Behaviour in School-aged Children (HBSC) study (2014), using surveys from 15-year-old adolescents (n=1956, mean age 15.8 years) from 122 schools. Self-evaluations of body or appearance were measured by the Body-Esteem Scale for Adolescents and Adults (BESAA). A mixed effects linear regression analysis for body-esteem was conducted separately for boys and girls. The explanatory variables were (i) self-reported moderate-to-vigorous physical activity (MVPA), (ii) weight status, (iii) self-esteem, and (iv) socioeconomic status. The covariates used in the models were maturation state and ethnic background. Results: The body-esteem score was highest among adolescents who reported engagement in MVPA corresponding to the international recommendation for adolescents’ physical activity. The positive association between MVPA and body-esteem was found even when it was considered in conjunction with other body image-related factors, but only among boys. The variance in MVPA explained 5.0% of the body-esteem variance in the model for boys (Model R2 = 26.3%). Conclusions: The physical activity of young people should be further promoted for a variety of health reasons, including its positive association with higher body-esteem. However, consideration should be given to gender differences and other factors related in this complex association.
Background: Mobile phone apps for monitoring and promoting physical activity (PA) are extremely popular among adults. Devices, such as heart rate monitors or sports watches (HRMs/SWs) that work with these apps are at sufficiently low costs to be available through the commercial markets. Studies have reported an increase in PA levels among adults with devices; however, it is unknown whether the phenomena are similar during early adolescence. At a time when adolescents start to develop their own sense of independence and build friendship, the ease of smartphone availability in developed countries needs to be investigated in important health promoting behaviors such as PA. Objective: The objective of this study was to investigate the ownership and usage of PA trackers (apps and HRM/SW) among adolescents in a national representative sample and to examine the association between use of devices and PA levels. Methods: The Finnish school-aged physical activity (SPA) study consisted of 4575 adolescents, aged 11-, 13-, and 15-years, who took part in a web-based questionnaire during school time about PA behaviors between April and May 2016. Binary logistic regression analyses were used to test the associations between moderate to vigorous physical activity (MVPA) and devices, after controlling for gender, age, disability, and family affluence. Results: PA tracking devices have been categorized into two types, which are accessible to adolescents: (1) apps and (2) HRM/SW. Half the adolescents (2351/4467; 52.63%) own apps for monitoring PA, yet 16.12% (720/4467) report using apps. Fewer adolescents (782/4413; 17.72%) own HRM/SW and 9.25% (408/4413) use HRM/SW. In this study, users of HRM/SW were 2.09 times (95% CI 1.64-2.67), whereas users of apps were 1.4 times (95% CI 1.15-1.74) more likely to meet PA recommendations of daily MVPA for at least 60 min compared with adolescents without HRM/SW or without apps. Conclusions: To our knowledge, this is the first study that describes the situation in Finland with adolescents using PA trackers and its association with PA levels. Implications of the use of apps and HRM/SW by adolescents are discussed.
Introduction In research on disparities, the concept of health literacy (HL) as a set of competencies to promote and sustain health may help in understanding the disparities better and in addressing avoidable and unfair health disparities. The presentation will present some key findings on adolescents’ HL levels in ten European countries, and how HL mediates and moderates between various background factors and health outcomes. Methods Data consisted of cross-sectional data from Health Behaviour in School-aged Children (HBSC) study from year 2017/18 of ten European countries (Austria, Belgium (Fl), Czechia, England, Estonia, Finland, Germany, Macedonia, Poland, and Slovakia). Data (n = 14,590 - 22,291) of 13- and 15-year-old pupils were used. Indicators include background variables (e.g. age, gender), Health literacy, Health indicators (e.g. self-rated health (SRH) and problematic social media use (PSMU)). Analysis include (1) Mediator analysis (with Mplus): pearson correlation coefficients, path models (Mplus 7.3 and Maximum Likelihood estimator) and (2) random effects models and moderator analyses (with R-sofware). Findings HL is an independent factor explaining disparities in health (e.g. SRH), and a mediator as well as a moderator between health outcomes and background factors. Based on the national analyses HL had significant main effects in every country, but group level differences emerged only in some countries. For instance, in Finland and Belgium, among girls HL lowered the likelihood to problematic social media use, but not among boys. Discussion HL is of use in understanding and tackling health disparities among adolescents. Results confirm the need to adopt the principles of proportionate universalism when promoting HL among adolescents to avoid widening the disparities within population groups. Also, country-specific health literacy interventions are needed to secure equity in opportunities of different population groups to benefit from the HL interventions.
Physical inactivity has become one of the leading risk factors for non-communicable diseases (NCDs) and death worldwide. From the future perspective it is alarming that in the group of young people few meet the recommendations. In this respect, physical activity promotion in general and physical education have challenges and new approaches are needed. In this study, the theoretical framework is based on the physical activity relationship (PAR) approach and the barriers were grouped according to the ecological model. The aim of the study was firstly to present both the meanings and barriers of physical activity in a comprehensive Finnish population of 11–15 year old (n = 2728) and secondly to examine how the number of important meanings and mentioned barriers associate with each other with physical activity levels. Data were collected using a questionnaire. To examine how the meanings and barriers associate with each other and with the PA level, chi-squared test (χ2), Pearson correlation and General linear model (ANCOVA) were used. Logistic regression was applied to estimate effect sizes by odds ratios and 95% confidence intervals. According to the results, the associations between physical activity with the meanings and barriers were reverse and linear. The more important the meanings were found to be, the more likely the study participants were physically active, whereas the more barriers participants reported, the less active they were. The approach which utilizes meanings and barriers has a lot of untapped potential for the promotion of physical activity and physical education. With the right actions, some barriers could be removed or dampened, and by opening up and deepening meanings, PAR could be strengthened.
Nuorten fyysiseen aktiivisuuteen vaikuttavien tekijöiden tunteminen on perusteltua paitsi nuoruusiän terveyden ja hyvinvoinnin tukemiseksi niin myös yleisemmin kansanterveydellisistä syistä. Tutkimusten mukaan sekä vanhemmat että kaverit vaikuttavat monin eri tavoin lasten ja nuorten fyysiseen aktiivisuuteen ja liikuntaan sosiaalistumiseen. Monen nuoren kohdalla liikunnan harrastaminen hiipuu murrosiässä, mutta sosiaalinen tuki näyttäisi olevan yksi fyysistä aktiivisuutta ylläpitävistä tekijöistä. Tässä tutkimuksessa selvitettiin, miten vanhempien ja kavereiden tuki ovat yhteydessä nuoren fyysiseen aktiivisuuteen viides-, seitsemäs- ja yhdeksäsluokkalaisilla (n=2764). Tutkimus perustuu kyselyaineistoon, joka on kerätty keväällä 2014 Lasten ja nuorten liikuntakäyttäytymisen LIITU-tutkimusta varten. Aineiston analysointi toteutettiin khiin-neliötestillä, yksisuuntaisella varianssianalyysilla (ANOVA) ja lineaarisella regressioanalyysillä. Tulosten mukaan aktiivisesti liikkuvat nuoret saivat useammin vanhemmiltaan tukea, ja kokivat kavereiden kanssa liikkumisen tärkeämmäksi kuin vähemmän liikkuvat nuoret. Vanhempien tuen mää- rä ja sen yhteys nuorten fyysiseen aktiivisuuteen kävi vähäisemmäksi ylemmillä vuosiluokilla sekä aktiivisesti että vähemmän liikkuvien ryhmässä. Kavereiden merkitys fyysistä aktiivisuutta estävänä tekijänä yleistyi iän myötä erityisesti vähemmän liikkuvien nuorten ja poikien keskuudessa. Sekä vanhemmat että kaverit voivat tarjota merkittävää tukea nuorten liikkumiselle, vaikkakin murrosiässä itseohjautuvuus ja autonomia vapaa-ajan valinnoissa lisääntyvät. Vertaisryhmän merkitys korostuu pyrittäessä edistämään yläkouluikäisten fyysistä aktiivisuutta, sillä kavereiden liikkumattomuus ja vähäinen liikunnan arvostus voivat muodostaa vaikeasti ylitettävän esteen nuoren liikkumiselle.
Sufficient and regular physical activity is considered a protective factor, reducing the onset of secondary disability conditions in adolescents with chronic diseases and functional limitations. The aim of this study was to explore whether participation in organized sport may be associated to higher levels of physical activity in adolescents with functional limitations, based on a national representative sample. Data from the Health Behaviour in School-aged Children (HBSC) study collected in Finland from two data collection rounds (2002 and 2010) were conducted and pooled from adolescents aged between 13 and 15 years old with functional limitations (n = 1041). Differences in self-reported physical activity over the past week and participation in organized sport activity were analysed for each function. Overall, four in ten (n = 413) participated in organized sport and were significantly (p < 0.001) more physically active (mean = 4.92days, SD = 1.81) than their non-participating (mean = 3.29, SD = 1.86) peers with functional limitations. Despite low population prevalence, adolescents with epilepsy or visual impairments were the least active if they were not participating in organized sport, yet were the most active if they were involved in organized sport. Participating in organized sport appears to be an important factor promoting resources for maintaining recommended levels of physical activity in Finnish adolescents with functional limitations.
Purpose The purpose of this study was to analyze changes in the prevalence of weight reduction behaviors (WRBs) among European adolescents from 26 countries between 2001/2002 and 2017/2018. The impact of the perception of body weight on WLB was also analyzed, with particular attention being paid to overestimation. Methods The data of 639,194 European adolescents aged 11, 13, and 15 years who participated in the Health Behaviour in School-aged Children survey were analyzed. Age-standardized prevalence rates of WRB were estimated separately by survey round and gender for each country, using the overall 2017/2018 Health Behaviour in School-aged Children study population as the standard. Multivariate logistic regression analyses were used to assess WRB trends over time, adjusted for survey year, body mass index, body weight misperception, and family affluence and stratified by gender and age. Results In the 26 countries examined, the overall age-adjusted prevalence rates of WRB were 10.2% among boys and 18.0% among girls. The prevalence of WRB was higher for girls, but in the more recent surveys, gender differences in WRB decreased. There was a significant increase in the percentage of WRB among boys in most countries. Among girls, most countries did not experience significant changes. Increases in body mass index and overestimation of body weight were significant factors increasing the risk of WRB in both genders. Conclusions The change in the prevalence of WRB by gender warrants greater attention from researchers and practitioners alike.
Finnish sports organisations, local and federal government, and healthcare organisations have widely adopted the World Health Organization and national recommendations for physical activity for different age groups. However, studies have indicated that only 46 % of 3-year-old preschool children, approximately 50 % of primary school students (7–12 years), 10–17 % of secondary school students (13–15 years) and 16 % of Finnish adults (20–54 years) attain those recommendations. In Finland there are 33,620 built sports facilities and over 9000 sport clubs, meaning there are many possibilities for physical activity, yet people are still rather inactive. In this paper we argue that availability of facilities, although an important element, is not enough to promote physical activity. It is possible that the current built physical environmental design does not fulfil people’s needs regarding participation in physical activity. More emphasis should be placed on the design and operation of the facilities to develop new affordances for physical activity.
1) Background: The use of social media has become an integral part of adolescents’ daily lives. However, the intensive use of social media can develop into a health-threatening addiction, but unfavourable health consequences can occur even with less use. Social media user groups categorized as no-risk, moderate risk (of developing problematic behaviour), and problematic use were examined with reference to their prevalence, their associations with individual determinants and health, and the increased health risk between groups. (2) Methods: The Finnish nationally representative HBSC data (persons aged 11, 13, and 15, n = 3408) and descriptive and binary logistic regression analysis were applied. (3) Results: Problematic social media use (9.4%) was most common among older age groups, and among persons with moderate/low school achievement, low health literacy, and low parental monitoring. Belonging to a moderate risk group (33.5%) was most frequent among girls, and among adolescents with low/moderate parental monitoring and health literacy. All the negative health indicators systematically increased if the respondent belonged to a moderate risk or problematic use group. (4) Conclusions: The study confirmed the association between problematic social media use and negative health outcomes and highlighted the need to pay close attention to adolescents at moderate risk who exhibited negative health outcomes.
Background Reports of the overall chronic pain prevalence and its associated demographic characteristics among adolescents vary greatly across existing studies. Using internationally comparable data, this study investigates age, sex and country‐level effects in the prevalence of chronic single‐site and multi‐site pain among adolescents during the last six months preceding the survey. Methods Data (n = 214,283) from the 2013/2014 Health Behaviour in School‐aged Children (HBSC) study were used including nationally representative samples of 11‐, 13‐ and 15‐year‐olds from general schools in 42 participating countries. Multilevel logistic regression analyses were used. Results The overall proportion of adolescents reporting chronic weekly pain during the last six months was high (44.2%). On average, in comparison with different specific localized types of single‐site pain, the prevalence of multi‐site pain was more common varying from 13.2% in Armenia to 33.8% in Israel. Adolescent age and sex were strong predictors for reporting pain, but significantly different demographic patterns were found in the cross‐country analyses. The most consistent findings indicate that multi‐site pain was more prevalent among girls across all countries and that the prevalence increased with age. Conclusions Internationally comparable data suggest that self‐reported chronic pain among adolescents is highly prevalent, but different age and sex patterns across countries exist. Adolescents with chronic pain are not a homogenous group. Chronic pain co‐occurrence and differences in chronic pain characteristics should be addressed in both clinical and public health practice for effective adolescent chronic pain management and prevention. Significance Chronic pain co‐occurrence is common during adolescence across countries, the prevalence being among girls and in older age groups. Significant cross‐country variations in the chronic pain prevalence and chronic pain patterns among adolescents exist. Significant country differences emerge for specific chronic pain patterns in association with adolescent demographics.
(1) Background: Internet use has become an integral part of adolescents’ daily lives. It is important to understand how adolescents use the internet, and how this use is associated with demographic factors and health from a person-oriented perspective. (2) Methods: The study applied the Finnish nationally representative HBSC data (persons aged 11, 13, and 15, n = 3408), descriptive observation, latent class analysis, and multinomial logistic regression analysis. (3) Results: Entertainment activities (listening to music) and socially oriented activities (liking posts, talking online) were the most prevalent among adolescents, but gender differences emerged. Five different internet user profiles were identified (encompassing interest-driven, friendship-driven, abstinent, irregular, and excessive users). Interest-driven users participated in interest- and media-oriented activities. Adolescents in the interest-driven user group were more likely to be boys and participants with low academic achievement, high parental monitoring, and high problematic social media use. Friendship-driven users participated in socially oriented activities. Adolescents in the friendship-driven user group were more likely to be girls and participants aged 13 or 15, with high peer and family support. Abstinent users participated only in entertainment, while irregular users showed no particularly high involvement in any internet activity. Adolescents in the abstinent and irregular user groups were likely to be boys and participants aged 11 with high family support. Excessive users had high involvement in internet activities overall. Adolescents in the excessive user group were more likely to be participants with high problematic social media use and were most likely to feel low and tired on school mornings. (4) Conclusion: The study confirmed the prevalence of internet use. It identified five internet user profiles and differences between user profiles regarding individual and social factors and health outcomes.
Aims: Loneliness is an important public health challenge for all ages. This study reports time trends of loneliness among adolescents over a 12-year period and analyses the strength of the associations between loneliness, health complaints, and medicine use. Methods: Data were derived from the cross-sectional Finnish Health Behaviour in School-aged Children study conducted in 2006, 2010, 2014, and 2018. The study population is based on a random sample of schools with 20,444 participants aged 11–15 years. The trends were analysed with a Mantel–Haenszel test, and the strength of the associations was evaluated by mixed-effects logistic and linear regressions. Results: An increasing prevalence in frequent loneliness (2006: 11%; 2018: 15%) was evident over the 12-year study period, especially in girls and 15-year-olds. Among all adolescents, loneliness was associated with a higher risk of recurrent health complaints and medicine use to treat the corresponding health issues, especially nervousness (odds ratio 5.8) and sleeping difficulties (odds ratio 7.6). Conclusions: Adolescence is a period of higher risk of frequent loneliness and associated health complaints. In this study, loneliness was common among adolescence and an increasing trend of loneliness was observed between 2006 and 2018. Also, psychosomatic health complaints and medicine use were strongly associated with loneliness. Persistent loneliness is a significant health risk and failure to resolve loneliness before entering adulthood may imply significant concerns for future well-being.
Background: While gains in reducing smoking rates in Finland have been made, prevalence rates are still substantial. Relapse rates among smokers engaged in quit-smoking programs are high. Physical activity has been proposed as one means to help smokers manage cravings. Software and apps on mobile phone and handheld devices offer an opportunity to communicate messages on how to use physical activity to manage cravings as part of quit-smoking programs. Objective: We aimed to test the feasibility, acceptability, usability, and preliminary efficacy of an mHealth mobile phone app, Physical activity over Smoking (PhoS), to assist smokers in quitting smoking in a randomized controlled trial. The app was designed to prompt smokers to engage in physical activities to manage their smoking cravings. Methods: Regular smokers (n=44) attended a group-based behavioral counselling program aimed at promoting physical activity as an additional aid to quit. After quit day, participants were randomly allocated to an intervention (n=25) or to a comparison (n=19) group. Participants in the intervention group were provided with the PhoS app and training on how to use it to assist with relapse prevention. Participants in the comparison condition were provided with generalized relapse prevention training. Results: Some participants reported that the PhoS app was useful in assisting them to successfully manage their cigarette cravings, although compliance across the sample was modest and participants reported low levels of usability. Participants receiving the PhoS app did not report greater abstinence than those who did not receive the app. However, participants receiving the app were more likely to report greater abstinence if they did not use pharmacological support, while those who did not receive the app reported greater abstinence when using pharmacological support. Participants receiving the app reported greater levels of physical activity than those who did not. Results revealed that the app resulted in better retention. Conclusions: The PhoS app showed some potential to reduce abstinence among participants not using pharmacological therapy and to increase physical activity. However, problems with usability and lack of effects on abstinence raise questions over the app’s long-term effectiveness. Future research should prioritize further development of the app to maximize usability and test effects of the intervention independent of quit-smoking programs.
I den här studien utforskades ifall det förekommer sociodemografiska skillnader i upplevelse av psykiska besvär, socialt stöd och känsla av ensamhet bland finlandssvenska ungdomar. Det undersöktes även ifall ungdomarnas upplevelse av psykiska besvär kan förklaras med familje-, kamrat- och klasskamratstöd samt känsla av ensamhet. Utöver det utforskades ifall samband mellan socialt stöd och psykiska besvär kan förklaras med känsla av ensamhet. Som datamaterial användes WHO:s skolelevstudie (WHO-Koululaistutkimus) från 2018 med ett deltagarantal på 599 svenskspråkiga elever från årskurs 5, 7 och 9 (Målder = 11,9/14,0/15,9; svarsprocent 38 %). Som statistiska analysmetoder användes Pearsons chi2-test, envägs variansanalys, oberoende t-test, Spearmans rangkorrelationsanalys, multipel linjär regressionsanalys och medierande analys. Resultaten visade att flickor upplevde psykiska besvär och känsla av ensamhet i högre grad än pojkar. Elever i årskurs 7 och 9 upplevde nervositet i signifikant högre grad än eleverna i årskurs 5. De med högre upplevd socioekonomiska status upplevde i lägre grad psykiska besvär. Det förekom inte signifikanta skillnader i fråga om psykiska besvär, socialt stöd eller känsla av ensamhet mellan finlandssvenska ungdomar bosatta i stadsort och på landsbygden. Familjestöd och klasskamratstöd förklarade psykiska besvär signifikant och negativt, vilket innebar att lägre grad av familje- och klasskamratstöd associerades med högre grad av psykiska besvär. Känsla av ensamhet förklarade psykiska besvär signifikant och positivt, det vill säga högre grad av ensamhetskänslor associerades med högre grad av psykiska besvär. Kamratstöd förutsade inte psykiska besvär signifikant. Enligt resultaten kunde även samband mellan socialt stöd i form av familje-, kamrat- och klasskamratstöd och psykiska besvär delvis förklaras med känsla av ensamhet. Studien bidrar med ny kunskap om finlandssvenska ungdomars välmående och kan uppmuntra till hälsofrämjande verksamhet. För att få en djupare förståelse om lägre nivåer av socialt stöd och upplevelse av ensamhet i grundskoleålder kan vara riskfaktorer för utveckling av mental ohälsa behövs mer forskning, speciellt i form av longitudinella studier.
Background: National monitoring of school-aged physical activity (PA) behaviours is necessary to inform policy makers. The Finnish School-aged Physical Activity (FSPA – LIITU in Finnish) is a physical activity monitoring study, collecting data from young adolescents aged 11 to 15 years through a nationally representative sample. This study included a single self-reported item question on moderate to vigorous intensity physical activity (MVPA) from the preceding seven days. The question is used widely in the WHO Collaborative Cross-National Health Behaviour in School-aged Children (HBSC) study as a measure of meeting international PA recommendations. This study evaluated the test-retest reliability of the aforementioned MVPA item in two consecutive surveys while observing gender and age categorisation differences. Methods: In this study, Finnish adolescents with mean ages of 11.5y, 13.5y and 15.5y (n = 2752) completed the HBSC and FSPA surveys in two 45 min class periods without a break in 2014. The HBSC survey completion mode was through pen and paper, and the FSPA study through a web-based questionnaire. The same MVPA question appeared in both surveys. Response alternatives (0–7 days per week) were grouped into four, and two categories in the analyses. Cohen’s Kappa and ICC statistics were performed to test the intra-rater test-retest reliability of the measure. Results: According to Cohen’s Kappa, there was moderate agreement through the use of four (0.503) and two (0.599) categories, however, the proportion of adolescents that met the recommended daily 60 min of MVPA was 8% lower in the FSPA study than in the HBSC study (19% vs 27%). In addition, ICC for MVPA, as continuous variable (0–7 days) had good to excellent reliability (range 0.694–0.765) for boys and girls aged 13 to 15 years, but only fair (0.565) for boys aged 11. Conclusions: This study demonstrated that single item MVPA item was considered to have acceptable reliability of the measure for monitoring purposes of 13- and 15-year old boys, and 11y-, 13- and 15y-old girls meeting the international PA recommendations. There were differences in the prevalence in daily MVPA due to survey design.
Purpose Insufficient and poor sleep patterns are common among adolescents worldwide. Up to now, the evidence on adolescent sleep has been mostly informed by country-specific studies that used different measures and age groups, making direct comparisons difficult. Cross-national data on adolescent sleep that could inform nations and international discussions are lacking. We examined the sleep patterns of adolescents across 24 countries and by gender, age, and affluence groups. Methods We obtained sleep data on 165,793 adolescents (mean age 13.5 years; 50.5% girls) in 24 European and North American countries from the recent cross-sectional Health Behaviour in School-aged Children surveys (2013–2014 and 2017–2018). For each country, we calculated the age-standardized mean in sleep duration, timing, and consistency and the proportions meeting sleep recommendations on school and nonschool days from self-reported bedtimes and wake times. We conducted stratified analyses by gender, age, and family affluence group. Results Adolescent sleep patterns varied cross-nationally. The average sleep duration ranged between 7:47 and 9:07 hours on school days and between 9:31 and 10:22 hours on nonschool days, and the proportion of adolescents meeting sleep recommendations ranged between 32% and 86% on school days and between 79% and 92% on nonschool days. Sleep patterns by gender and affluence groups were largely similar, but older adolescents slept less and went to bed later on school days than younger adolescents in all countries. Conclusions The sleep patterns of adolescents vary across countries and sociodemographic groups. Insufficient sleep on school days is common in many countries. Public health and policy efforts to promote healthy adolescent sleep are encouraged.
Both training volume and overall physical activity (PA) play a role in young athletes’ sports performance and athletic development. The purpose of this study was to describe the training volume and PA of young athletes in endurance, aesthetics, ball games, and power sports. Questionnaire data (n = 671) were obtained from 15-year-old Finnish athletes on sports participation, along with accelerometer data (n = 350) assessing the amount and intensity of their PA. The athletes’ mean weekly training volume was 11 h 41 min. Objectively assessed PA amounted to 4 h 31 min daily, out of which 1 h 31 min was at a level of moderate-to-vigorous intensity (MVPA). Among 24% of the athletes, the weekly training volume (in hours) exceeded the recommended level of age-in-years, which might increase their risk of sports injuries. At the same time, one in six athletes (16%) did not—on average—reach the internationally recommended threshold level of at least 60 minutes of MVPA per day. Compared to girls, boys averaged 2.5 more hours of training per week, and had 21 more minutes of MVPA per day. Moreover, boys had a higher goal orientation than girls, with 52% of the boys and only 29% of the girls focused on success at adult level. Although total training volume and PA did not differ among sports types, there were differences in training forms, and in the proportions of MVPA. The young athletes were found to vary greatly in training forms, training volumes, MVPA, and goal orientation; hence, training should be planned individually, both for team sports and individual sports.
Repeated sprint training in hypoxia (RSH) represents an innovative method in the process of development and improvement of physical performance among athletes. However, there is less scientific data on this topic. The purpose of this systematic review was to investigate the effect of RSH method on motor abilities and performance among athletes, obtain new information, and expand the already known conclusions. The data search was performed of 4 electronic databases for the years 2000-2021 May as follows: Google Scholar, PubMed, Web of Science, and ResearchGate. This search with English language restriction was made by using the following terms, individually/combination: "repeated sprint ability", "hypoxia", "effects", "physical performance", "VO2max" 844 studies were indentified, and 14 studies were selected (11 male studies, 1 female study, 2 both sexes). Results of this systematic review, a total sample size of 347 athletes (40 females and 307 males, aged 15.3 ± 0.5 - 35 ± 7 years), showed that RSH was an effective training method in improving all monitored variables (i.e. RSAmax, VO2max). However, it should be noted that major improvements were observed mainly in repeated sprint ability (RSA) tests, and less in aerobic tests (i.e. Wingate and Yo-Yo). In conclusion, based on current scientific studies, RSH is more effective method to improve the physical performance among athletes compared to repeated sprint training in normoxia (RSN). This study suggested that the RSH has a positive effect on the monitored variables in physical performance tests especially related to RSA.
Grounded in the trans-contextual model, the purpose of the present study was to examine the role of self-determined motivation in Physical Education (PE) on self-determined motivation in Physical Activity (PA), PA intention, and accelerometer-measured habitual PA behavior among high-school aged adolescents. A sample of 394 Spanish high-school students (211 males and 183 females; aged 12-16 years) participated in the present study. The outcome measure of PA was established using accelerometry, whereas motiva- tion toward PA and PE as well as PA intention were measured using validated questionnaires. Path analyses supported in part the central propositions of the trans-contextual model. Self-determined motivation in PE predicted the self-determined motivation in PA (β=.45, p<.001, R2=.26). Self-determined motivation in PA predicted PA intention (β=.51, p<.001, R2=.41). The predictive strength from PA intention to behavior was weak (β=.11, p=.011, R2=.21) with a statistically non-significant mediational model from self-determined motivation in PA via PA intention to PA behavior (β=.28, p=.231). This weak-to-non-significant relationship does not fully support the previous findings that have shown the feasibility of the trans-contextual model in charting the pathways from self-determined motivation in an educational context to behaviors in an out- of-school context.
Abstract The novel coronavirus disease 2019 (COVID-19) pandemic is a truly global public health crisis with substantive human, social, and economic costs. The pandemic and the associated preventive ‘lockdown’ measures have also given rise to a parallel mental health crisis, with elevated levels of chronic stress observed in the general population. Stress levels are also likely to be higher among at-risk groups such as those who have become employed or are on furlough, those in essential services with higher risk of exposure, and those from underserved communities. Development of efficacious means to assist individuals in effectively managing their during the pandemic and beyond is an imperative. We outline how stress reappraisal interventions offer a potentially efficacious, cost effective strategy to manage pandemic-related stress and minimize deleterious health consequences. Specifically, we advocate two stress management strategies: stress reappraisal, which involves prompting individuals to appraise stress as challenging and to be approached rather than threatening and to be avoided, and stress mindsets, which involves highlighting the enhancing nature of stress. We outline how these strategies may be implemented during the pandemic as part of interventions aimed at promoting stress management and better mental health during the pandemic and as communities emerge from lockdown. This article is protected by copyright. All rights reserved.
Introduction: The majority of young women use oral contraceptives (OCs). Use of OCs has been associated with lower myofibrillar protein and tendon collagen synthesis rates, but it is unknown whether OCs will limit the adaptive response of myotendinous tissue to resistance training. Design and Methods: Fourteen healthy untrained young regular OC users (24 +/- 1 years, fat% 32 +/- 1, 35 +/- 2 ml.min(-1).kg(-1)) and 14 NOC users (non-OC, controls) (24 +/- 1 years, fat% 32 +/- 2, 34 +/- 2 ml.min(-1).kg(-1)) performed a 10-week supervised lower extremity progressive resistance training program. Before and after the intervention biopsies from the vastus lateralis muscle and the patellar tendon were obtained. Muscle (quadriceps) and tendon cross-sectional area (CSA) was determined by magnetic resonance imaging (MRI) scans, and muscle fiber CSA was determined by histochemistry. Maximal isometric knee extension strength was assessed by dynamometry while 1 repetition maximum (RM) was determined during knee extension. Results: Training enhanced CSA in both muscle (p < 0.001) and tendon (p < 0.01). A trend toward a greater increase in muscle CSA was observed for OC (11%) compared to NOC (8%) (interaction p = 0.06). Analysis of mean muscle fiber type CSA showed a trend toward an increase in type II muscle fiber area in both groups (p = 0.11, interaction p = 0.98), whereas type I muscle fiber CSA increased in the OC group (n = 9, 3821 +/- 197 to 4490 +/- 313 mm(2), p < 0.05), but not in NOC (n = 7, 4020 +/- 348 to 3777 +/- 354 mm(2), p = 0.40) (interaction p < 0.05). Post hoc analyses indicated that the effect of OCs on muscle mass increase was induced by the OC-users (n = 7), who used OCs containing 30 mu g ethinyl estradiol (EE), whereas the response in users taking OCs with 20 mu g EE (n = 7) did not differ from NOC. Both the OC and NOC group experienced an increase in maximal knee strength (p < 0.001) and 1RM leg extension (p < 0.001) after the training period with no difference between groups. Conclusion: Use of OCs during a 10-week supervised progressive resistance training program was associated with a trend toward a greater increase in muscle mass and a significantly greater increase in type I muscle fiber area compared to controls. Yet, use of OCs did not influence the overall increase in muscle strength related to training.
Objective: This study aimed to investigate the effectiveness of brief training in the guideline-oriented biopsychosocial management of low-back pain (LBP) in occupational health services using a cluster-randomized design. A small sample of physiotherapists and physicians from the intervention units (N=12) were given three- to seven-day training focusing on the biopsychosocial management of LBP, while professionals in the control units (N=15) received no such training. Methods: Eligible patients with LBP, with or without radicular pain, aged 18–65, were invited to participate. A web-based questionnaire was sent to all recruited patients at baseline, three months and one year. The primary outcome measure was disability (Oswestry Disability Index, ODI) over one year. Between-group differences were analyzed using linear and generalized linear mixed models adjusted for baseline-response delay as well as variables showing between-group imbalance at baseline. Results: The final study sample comprised 234 and 81 patients in the intervention and control groups, respectively at baseline, and 137 and 47 patients, respectively, at one year. At baseline, the mean duration of pain was longer in the intervention group (P=0.017), and pain-related fear concerning physical activity was lower (P=0.012). We observed no significant difference between the groups’ primary outcome measure (adjusted one-year mean difference in the ODI: 2.3; 95% confidence interval -1.0–5.7; P=0.175) or most secondary outcomes. Conclusions: Brief training in guideline-oriented biopsychosocial management of LBP for occupational health professionals did not appear to be effective in reducing patients’ symptom over one-year follow-up compared to treatment as usual.
Purpose This study aimed to report the uptake of hysterectomy and/or bilateral salpingo-oophorectomy (BSO) to prevent gynaecological cancers (risk-reducing surgery [RRS]) in carriers of pathogenic MMR (path_MMR) variants. Methods The Prospective Lynch Syndrome Database (PLSD) was used to investigate RRS by a cross-sectional study in 2292 female path_MMR carriers aged 30–69 years. Results Overall, 144, 79, and 517 carriers underwent risk-reducing hysterectomy, BSO, or both combined, respectively. Two-thirds of procedures before 50 years of age were combined hysterectomy and BSO, and 81% of all procedures included BSO. Risk-reducing hysterectomy was performed before age 50 years in 28%, 25%, 15%, and 9%, and BSO in 26%, 25%, 14% and 13% of path_MLH1, path_MSH2, path_MSH6, and path_PMS2 carriers, respectively. Before 50 years of age, 107 of 188 (57%) BSO and 126 of 204 (62%) hysterectomies were performed in women without any prior cancer, and only 5% (20/392) were performed simultaneously with colorectal cancer (CRC) surgery. Conclusion Uptake of RRS before 50 years of age was low, and RRS was rarely undertaken in association with surgical treatment of CRC. Uptake of RRS aligned poorly with gene- and age-associated risk estimates for endometrial or ovarian cancer that were published recently from PLSD and did not correspond well with current clinical guidelines. The reasons should be clarified. Decision-making on opting for or against RRS and its timing should be better aligned with predicted risk and mortality for endometrial and ovarian cancer in Lynch syndrome to improve outcomes.
The Short form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-short) and the STarT Back Tool (SBT) have been developed to screen for risk factors for future low back pain (LBP) -related disability and work loss respectively. The aim of this study was to investigate the accordance of the two questionnaires and to evaluate the accumulation of risk factors in the risk groups of both screening tools in a large population-based sample. The study population consisted of 3079 participants of the Northern Finland Birth Cohort 1966 who had reported LBP over the previous 12 months and had SBT and ÖMPSQ-short data. We evaluated the association of depressive and anxiety symptoms (Hopkins symptom check list-25, Generalized anxiety disorder 7 questionnaire, and Beck’s Depression Inventory 21), psychological features (Fear-Avoidance Beliefs Questionnaire), lifestyle characteristics (BMI, smoking, alcohol abuse, physical inactivity) and social factors (education level) with the SBT and ÖMPSQ-short risk groups. The high-risk groups of both questionnaires were associated (p < 0.001) with depressive and anxiety symptoms and fear-avoidance beliefs. In addition, adverse lifestyle factors accumulated in the higher risk groups, especially from the ÖMPSQ-short. Agreement between the two questionnaires was moderate for men and fair for women.
Purpose Upper-body exercise performed in a cold environment may increase cardiovascular strain, which could be detrimental to patients with coronary artery disease (CAD). This study compared cardiovascular responses of CAD patients during graded upper-body dynamic and static exercise in cold and neutral environments. Methods 20 patients with stable CAD performed 30 min of progressive dynamic (light, moderate, and heavy rating of perceived exertion) and static (10, 15, 20, 25 and 30% of maximal voluntary contraction) upper body exercise in cold (− 15 °C) and neutral (+ 22 °C) environments. Heart rate (HR), blood pressure (BP) and electrocardiographic (ECG) responses were recorded and rate pressure product (RPP) calculated. Results Dynamic-graded upper-body exercise in the cold increased HR by 2.3–4.8% (p = 0.002–0.040), MAP by 3.9–5.9% (p = 0.038–0.454) and RPP by 18.1–24.4% (p = 0.002–0.020) when compared to the neutral environment. Static graded upper-body exercise in the cold resulted in higher MAP (6.3–9.1%; p = 0.000–0.014), lower HR (4.1–7.2%; p = 0.009–0.033), but unaltered RPP compared to a neutral environment. Heavy dynamic exercise resulted in ST depression that was not related to temperature. Otherwise, ECG was largely unaltered during exercise in either thermal condition. Conclusions Dynamic- and static-graded upper-body exercise in the cold involves higher cardiovascular strain compared with a neutral environment among patients with stable CAD. However, no marked changes in electric cardiac function were observed. The results support the use of upper-body exercise in the cold in patients with stable CAD.
Background: There is limited information on whether the orderly display of limb lead ECGs (electrocardiograms) can facilitate students to determine frontal plane QRS complex wave electrical axis. Objectives: The study investigated whether the orderly display of limb lead ECGs can raise Chinese undergraduate intern’s diagnostic accuracy when determining frontal plane axis. Design: A total of 147 fifth-year undergraduate interns aged between 21 and 25 years were randomly arranged into 2 groups: one group was given classically displayed ECGs of limb leads while the other group was given orderly displayed ECGs of limb leads. They were then taught to determine frontal plane axis with one of the above displays. The intern’s diagnostic accuracy and time used were measured. Results: After teaching, the orderly display can more effectively raise diagnostic accuracy when determining axis as compared to the classical display (76.65 ± 23.16% vs. 68.88 ± 23.21%, P < 0.05), although diagnostic accuracy in axis determination was improved in both groups as compared to the axis determination at baseline (all P < 0.05). Conclusions: Orderly display of limb lead ECGs may raise Chinese intern’s diagnostic accuracy when determining frontal plane axis.
Liikunnan ja fyysisen aktiivisuuden terveysvaikutuksista tiedetään laajalti ja lukuisia toimenpiteitä koulupäivän aikaisen fyysisen aktiivisuuden lisäämiseen on toteutettu niin Suomessa kuin useimmissa länsimaissa. Toistaiseksi haasteena on ollut tavoittaa ne nuoret, joiden arkielämään ei kuulu säännöllinen liikunnan harrastaminen. Koulun liikuntatunneille osallistuvat kuitenkin kaikki oppilaat, myös vapaaajallaan vähän liikkuvat. Tutkimuksen tavoitteena oli selvittää, millä sykealueella yläkoulun oppilaat liikkuvat liikuntatunnilla ja kuinka suuren osan tunnista sykkeet ovat terveyttä edistävällä tasolla. Lisäksi tarkasteltiin oppilaan vapaa-ajan fyysisen aktiivisuuden ja sukupuolen yhteyttä liikuntatunnilla mitattuun sykkeeseen. Tutkimukseen osallistui 363 yläkoulun oppilasta ja sykeaineisto kerättiin 14 eri koulusta ja 46 liikuntatunnilta. Liikuntatunnin fyysistä aktiivisuutta mitattiin sykemittarilla ja vapaa-ajan fyysistä aktiivisuutta kyselymittarilla. Nuoret luokiteltiin kolmeen ryhmään vapaa-ajan liikunnanharrastamisen määrän ja intensiteetin perusteella. Sykkeiden analysoinnissa käytettiin seuraavia terveyttä edistävän fyysisen aktiivisuuden raja-arvoja: reipas liikunta, yli 140 lyöntiä minuutissa (bpm); kuormittava liikunta, yli 160 bpm. Kaikkien oppilaiden sykkeen keskiarvo oli 135 bpm, ja oppilaat liikkuivat keskimäärin 42 prosenttiä tunnin kestosta reippaalla tai kuormittavalla sykealueella. Vapaa-ajan fyysisen aktiivisuuden mukaan muodostetut ryhmät erosivat siten, että vapaa-ajallaan vähän liikkuvilla nuorilla oli korkeampi keskisyke ja he liikkuivat suuremman osan tunnista terveyttä edistävällä sykealueella verrattuna vapaa-ajallaan aktiivisesti liikkuviin nuoriin. Lisäksi pojilla oli korkeammat sykkeet kuin tytöillä. Tulokset osoittavat, että liikuntatunneilla sykkeet kohoavat terveyttä edistävälle tasolle erityisesti niillä nuorilla, jotka liikkuvat vähän vapaa-ajallaan.
Elimistö voi saada tukea hyvästä kestävyys- ja lihaskunnosta rakentaessaan puskuria vakavaa COVID-19-tautimuotoa vastaan kaiken ikäisillä. Liikunta auttaa jaksamaan sekä fyysisesti että henkisesti pitkittyneen pandemian oloissa. Yksilöllisesti annosteltuna sillä on tärkeä merkitys myös sairaudesta toipuessa.
Power declines at a greater rate during ageing and is more relevant for functional deterioration than either loss of maximum strength or muscle mass. Human movement typically consists of stretch-shortening cycle action. Therefore, plyometric exercises, using an eccentric phase quickly followed by a concentric phase to optimize power production, should resemble daily function more than traditional resistance training, which primarily builds force production capacity in general. However, it is unclear whether older adults can sustain such high-impact training. This study compared the effects of plyometric exercise (PLYO) on power, force production, jump and functional performance to traditional resistance training (RT) and walking (WALK) in older men. Importantly, feasibility was investigated. Forty men (69.5 ± 3.9 years) were randomized to 12-weeks of PLYO (N = 14), RT (N = 12) or WALK (N = 14). Leg press one-repetition maximum (1-RM), leg-extensor isometric maximum voluntary contraction (MVC) and rate of force development (RFD), jump and functional performance were evaluated pre- and post-intervention. One subject in RT (low back pain) and three in PLYO (2 muscle strains, 1 knee pain) dropped out. Adherence to (91.2 ± 4.4%) and acceptability of (≥ 7/10) PLYO was high. 1-RM improved more in RT (25.0 ± 10.0%) and PLYO (23.0 ± 13.6%) than in WALK (2.9 ± 13.7%) (p < 0.001). PLYO improved more on jump height, jump power, contraction time of jumps and stair climbing performance compared to WALK and/or RT (p < 0.05). MVC improved in RT only (p = 0.028) and RFD did not improve (p > 0.05). To conclude, PLYO is beneficial over RT for improving power, jump and stair climbing performance without compromising gains in strength. This form of training seems feasible, but contains an inherent higher risk for injuries, which should be taken into account when designing programs for older adults.
Background and aims Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder associated with an elevated risk of colorectal cancer (CRC). IBD-associated CRC (IBD-CRC) may represent a distinct pathway of tumorigenesis compared to sporadic CRC (sCRC). Our aim was to comprehensively characterize IBD-associated tumorigenesis integrating multiple high-throughput approaches, and to compare the results with in-house data sets from sCRCs. Methods Whole-genome sequencing, single nucleotide polymorphism arrays, RNA sequencing, genome-wide methylation analysis, and immunohistochemistry were performed using fresh frozen and formalin-fixed tissue samples of tumor and corresponding normal tissues from 31 IBD-CRC patients. Results Transcriptome-based tumor subtyping revealed the complete absence of canonical epithelial tumor subtype associated with WNT signaling in IBD-CRCs, dominated instead by mesenchymal stroma-rich subtype. Negative WNT regulators AXIN2 and RNF43 were strongly downregulated in IBD-CRCs and chromosomal gains at HNF4A, a negative regulator of WNT-induced epithelial-mesenchymal transition (EMT), were less frequent compared to sCRCs. Enrichment of hypomethylation at HNF4α binding sites was detected solely in sCRC genomes. PIGR and OSMR involved in mucosal immunity were dysregulated via epigenetic modifications in IBD-CRCs. Genome-wide analysis showed significant enrichment of noncoding mutations to 5’UTR of TP53 in IBD-CRCs. As previously reported, somatic mutations in APC and KRAS were less frequent in IBD-CRCs compared to sCRCs. Conclusions Distinct mechanisms of WNT pathway dysregulation skew IBD-CRCs towards mesenchymal tumor subtype, which may affect prognosis and treatment options. Increased OSMR signaling may favor the establishment of mesenchymal tumors in IBD patients.
Background Consumer wearables and smartphone devices commonly offer an estimate of energy expenditure (EE) to assist in the objective monitoring of physical activity to the general population. Alongside consumers, healthcare professionals and researchers are seeking to utilise these devices for the monitoring of training and improving human health. However, the methods of validation and reporting of EE estimation in these devices lacks rigour, negatively impacting on the ability to make comparisons between devices and provide transparent accuracy. Objectives The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The network was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables and smartphones in the estimation of EE. Methods The recommendations were developed through (1) a systematic literature review; (2) an unstructured review of the wider literature discussing the potential factors that may introduce bias during validation studies; and (3) evidence-informed expert opinions from members of the INTERLIVE network. Results The systematic literature review process identified 1645 potential articles, of which 62 were deemed eligible for the final dataset. Based on these studies and the wider literature search, a validation framework is proposed encompassing six key domains for validation: the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. Conclusions The INTERLIVE network recommends that the proposed protocol, and checklists provided, are used to standardise the testing and reporting of the validation of any consumer wearable or smartphone device to estimate EE. This in turn will maximise the potential utility of these technologies for clinicians, researchers, consumers, and manufacturers/developers, while ensuring transparency, comparability, and replicability in validation.
This study examined content and intensity of anger prior to, during, and after best ever and worst ever performances in 43 high-level Spanish karate athletes using individualized anger profiling. Optimal and dysfunctional anger intensities were assessed using a modified version of Borg’s Category Ratio (CR-10) scale. Anger profiling was supplemented with positive and negative emotion profiling. As expected, content of anger descriptors was highly idiosyncratic. Moreover, great variability in optimal and dysfunctional anger intensities was found at individual and group levels. In best performances, anger was related to the generation of additional energy, whereas in worst performances, anger resulted from a perceived lack of resources or low readiness to perform. Athletes generated different anger descriptors in performance and in non-sport performance situations (overlap ranged from 0 to .35). The results support the use of an idiographic approach in the study of anger states.
Background: Lynch syndrome is associated with an increased risk of colorectal cancer and with a broader spectrum of cancers, especially endometrial cancer. In 2011, our group reported long-term cancer outcomes (mean follow-up 55·7 months [SD 31·4]) for participants with Lynch syndrome enrolled into a randomised trial of daily aspirin versus placebo. This report completes the planned 10-year follow-up to allow a longer-term assessment of the effect of taking regular aspirin in this high-risk population. Methods: In the double-blind, randomised CAPP2 trial, 861 patients from 43 international centres worldwide (707 [82%] from Europe, 112 [13%] from Australasia, 38 [4%] from Africa, and four [<1%] from The Americas) with Lynch syndrome were randomly assigned to receive 600 mg aspirin daily or placebo. Cancer outcomes were monitored for at least 10 years from recruitment with English, Finnish, and Welsh participants being monitored for up to 20 years. The primary endpoint was development of colorectal cancer. Analysis was by intention to treat and per protocol. The trial is registered with the ISRCTN registry, number ISRCTN59521990. Findings: Between January, 1999, and March, 2005, 937 eligible patients with Lynch syndrome, mean age 45 years, commenced treatment, of whom 861 agreed to be randomly assigned to the aspirin group or placebo; 427 (50%) participants received aspirin and 434 (50%) placebo. Participants were followed for a mean of 10 years approximating 8500 person-years. 40 (9%) of 427 participants who received aspirin developed colorectal cancer compared with 58 (13%) of 434 who received placebo. Intention-to-treat Cox proportional hazards analysis revealed a significantly reduced hazard ratio (HR) of 0·65 (95% CI 0·43–0·97; p=0·035) for aspirin versus placebo. Negative binomial regression to account for multiple primary events gave an incidence rate ratio of 0·58 (0·39–0·87; p=0·0085). Per-protocol analyses restricted to 509 who achieved 2 years' intervention gave an HR of 0·56 (0·34–0·91; p=0·019) and an incidence rate ratio of 0·50 (0·31–0·82; p=0·0057). Non-colorectal Lynch syndrome cancers were reported in 36 participants who received aspirin and 36 participants who received placebo. Intention-to-treat and per-protocol analyses showed no effect. For all Lynch syndrome cancers combined, the intention-to-treat analysis did not reach significance but per-protocol analysis showed significantly reduced overall risk for the aspirin group (HR=0·63, 0·43–0·92; p=0·018). Adverse events during the intervention phase between aspirin and placebo groups were similar, and no significant difference in compliance between intervention groups was observed for participants with complete intervention phase data; details reported previously. Interpretation: The case for prevention of colorectal cancer with aspirin in Lynch syndrome is supported by our results.
Saccular intracranial aneurysm (sIA) rupture leads to a disabling subarachnoid hemorrhage. Chronic inflammation and lipid accumulation in the sIA wall contribute to wall degenerative remodeling that precedes its rupture. A better understanding of the pathobiological process is essential for improved future treatment of patients carrying sIAs. Serum amyloid A (SAA) is an acute-phase protein produced in response to acute and chronic inflammation and tissue damage. Here, we studied the presence and the potential role of SAA in 36 intraoperatively resected sIAs (16 unruptured and 20 ruptured), that had previously been studied by histology and immunohistochemistry. SAA was present in all sIAs, but the extent of immunopositivity varied greatly. SAA immunopositivity correlated with wall degeneration (p = 0.028) and rupture (p = 0.004), with numbers of CD163-positive and CD68-positive macrophages and CD3-positive T lymphocytes (all p < 0.001), and with the expression of myeloperoxidase, matrix metalloproteinase-9, prostaglandin E-2 receptor, and cyclo-oxygenase 2 in the sIA wall. Moreover, SAA positivity correlated with the accumulation of apolipoproteins A-1 and B-100. In conclusion, SAA occurs in the sIA wall and, as an inflammation-related factor, may contribute to the development of a rupture-prone sIA.
Objective: To compare colorectal cancer (CRC) incidences in carriers of pathogenic variants of the MMR genes in the PLSD and IMRC cohorts, of which only the former included mandatory colonoscopy surveillance for all participants. Methods: CRC incidences were calculated in an intervention group comprising a cohort of confirmed carriers of pathogenic or likely pathogenic variants in mismatch repair genes (path_MMR) followed prospectively by the Prospective Lynch Syndrome Database (PLSD). All had colonoscopy surveillance, with polypectomy when polyps were identified. Comparison was made with a retrospective cohort reported by the International Mismatch Repair Consortium (IMRC). This comprised confirmed and inferred path_MMR carriers who were first- or second-degree relatives of Lynch syndrome probands. Results: In the PLSD, 8,153 subjects had follow-up colonoscopy surveillance for a total of 67,604 years and 578 carriers had CRC diagnosed. Average cumulative incidences of CRC in path_MLH1 carriers at 70 years of age were 52% in males and 41% in females; for path_MSH2 50% and 39%; for path_MSH6 13% and 17% and for path_PMS2 11% and 8%. In contrast, in the IMRC cohort, corresponding cumulative incidences were 40% and 27%; 34% and 23%; 16% and 8% and 7% and 6%. Comparing just the European carriers in the two series gave similar findings. Numbers in the PLSD series did not allow comparisons of carriers from other continents separately. Cumulative incidences at 25 years were < 1% in all retrospective groups. Conclusions: Prospectively observed CRC incidences (PLSD) in path_MLH1 and path_MSH2 carriers undergoing colonoscopy surveillance and polypectomy were higher than in the retrospective (IMRC) series, and were not reduced in path_MSH6 carriers. These findings were the opposite to those expected. CRC point incidence before 50 years of age was reduced in path_PMS2 carriers subjected to colonoscopy, but not significantly so.