BACKGROUND: The distribution of time across physical activity, sedentary behaviors, and sleep appears to be essential for the management of obesity. However, the impact of reallocating time among these behaviors, collectively known as 24-h movement behaviors, remains underexplored. OBJECTIVE: This study examines the theoretical effects of reallocating time between 24-h movement behaviors on obesity indicators across different age groups. METHODS: We performed a pooled data meta-analysis of 9818 participants from 11 observational and experimental studies. To estimate the time spent in movement behaviors, we reprocessed and harmonized individual-level raw accelerometer-derived data. Isotemporal substitution models estimated theoretical changes in body mass index (BMI) and waist circumference (WC) associated with time reallocation between movement behaviors. We performed the analysis separately for children, adolescents, adults, and older adults. RESULTS: Even minor reallocations of 10 min led to significant changes in obesity indicators, with pronounced effects observed when 30 min were reallocated. The most substantial adverse effects on BMI and WC occurred when moderate-to-vigorous physical activity (MVPA) was reallocated to other movement behaviors. For 30-min reallocations, the largest increase in BMI (or BMI z-score for children) occurred when MVPA was reallocated to light-intensity physical activity (LPA) in children (0.26 units, 95% confidence interval [CI] 0.15, 0.37) and to sedentary behavior (SB) in adults (0.72 kg/m2, 95% CI 0.47, 0.96) and older adults (0.73 kg/m2, 95% CI 0.59, 0.87). The largest increase in WC was observed when MVPA was substituted with LPA in adults (2.66 cm, 95% CI 1.42, 3.90) and with SB in older adults (2.43 cm, 95% CI 2.07, 2.79). Conversely, the highest magnitude of the decrease in obesity indicators was observed when SB was substituted with MVPA. Specifically, substituting 30 min of SB with MVPA was associated with a decrease in BMI z-score by - 0.15 units (95% CI - 0.21, - 0.10) in children and lower BMI by - 0.56 kg/m2 (95% CI - 0.74, - 0.39) in adults and by - 0.52 kg/m2 (95% CI - 0.61, - 0.43) in older adults. Reallocating time away from sleep and LPA showed several significant changes but lacked a consistent pattern. While the predicted changes in obesity indicators were generally consistent across age groups, inconsistent findings were observed in adolescents, particularly for reallocations between MVPA and other behaviors. CONCLUSIONS: This investigation emphasizes the crucial role of MVPA in mitigating obesity risk across the lifespan, and the benefit of substituting SB with low-intensity movement behaviors. The distinct patterns observed in adolescents suggest a need for age-specific lifestyle interventions to effectively address obesity. Emphasizing manageable shifts, such as 10-min reallocations, could have significant public health implications, promoting sustainable lifestyle changes that accommodate individuals with diverse needs, including those with severe obesity.
- MeSH
- Accelerometry MeSH
- Time Factors MeSH
- Exercise * MeSH
- Child MeSH
- Adult MeSH
- Body Mass Index MeSH
- Obesity Management * methods MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Obesity * MeSH
- Waist Circumference MeSH
- Sedentary Behavior * MeSH
- Aged MeSH
- Sleep MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Meta-Analysis MeSH
The aim of this study was to compare selected ankle and knee kinematic and kinetic parameters before and a fter a prolonged exhaustive treadmill run between two groups of non-rearfoot footstrike pattern (NRFP) runners with different training volumes. Twenty-eight habitual NRFP runners were assigned to two groups based on their weekly training volume (Highly-trained (HT)/Moderately-trained (MT)). Participants underwent the VO2max test, and the exhaustive treadmill ran with biomechanical analysis at the beginning and the end. The two-way RMANOVA was used to assess differences between the groups and the phase of the run. A paired t-test was used for post-hoc analysis in case of significant interaction effect. Kinetic results showed significant group effect for ankle plantarflexion moment and hip external rotation moment (end-phase: both greater in MT group). Kinematic results showed significant group×phase interaction for ankle dorsiflexion angle (end-phase: greater in MT group) at initial contact (IC), peak knee flexion angle (end-phase: greater in MT group), and peak ankle eversion angle during the stance phase (end-phase: greater in HT group). Additionally, a group effect was found for knee flexion angle at IC (end-phase: greater in HT group). This study suggests that HT healthy NRFP runners may have less potential for increased biomechanical risk of AT overload during an exhaustive run.
- MeSH
- Running * physiology MeSH
- Biomechanical Phenomena MeSH
- Adult MeSH
- Ankle Joint * physiology MeSH
- Kinetics MeSH
- Knee Joint * physiology MeSH
- Knee * physiology MeSH
- Physical Conditioning, Human * methods MeSH
- Ankle * physiology MeSH
- Humans MeSH
- Young Adult MeSH
- Oxygen Consumption MeSH
- Exercise Test MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
BACKGROUND: The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear. OBJECTIVE: To identify how to improve surveillance of movement behaviours, from the perspective of experts. METHODS: This Delphi Study involved 62 experts from the SUNRISE International Study of Movement Behaviours in the Early Years and Active Healthy Kids Global Alliance (AHKGA). Two survey rounds were used, with items categorised under: (1) funding, (2) capacity building, (3) methods, and (4) other issues (e.g., policymaker awareness of relevant WHO Guidelines and Strategies). Expert participants ranked 40 items on a five-point Likert scale from 'extremely' to 'not at all' important. Consensus was defined as > 70% rating of 'extremely' or 'very' important. RESULTS: We received 62 responses to round 1 of the survey and 59 to round 2. There was consensus for most items. The two highest rated round 2 items in each category were the following; for funding (1) it was greater funding for surveillance and public funding of surveillance; for capacity building (2) it was increased human capacity for surveillance (e.g. knowledge, skills) and regional or global partnerships to support national surveillance; for methods (3) it was standard protocols for surveillance measures and improved measurement method for screen time; and for other issues (4) it was greater awareness of physical activity guidelines and strategies from WHO and greater awareness of the importance of surveillance for NCD prevention. We generally found no significant differences in priorities between low-middle-income (n = 29) and high-income countries (n = 30) or between SUNRISE (n = 20), AHKGA (n = 26) or both (n = 13) initiatives. There was a lack of agreement on using private funding for surveillance or surveillance research. CONCLUSIONS: This study provides a prioritised and international consensus list of actions required to improve surveillance of movement behaviours in children and adolescents globally.
- MeSH
- Capacity Building MeSH
- Screen Time * MeSH
- Global Health MeSH
- Exercise * MeSH
- Delphi Technique * MeSH
- Child MeSH
- Consensus MeSH
- Humans MeSH
- Adolescent MeSH
- Sedentary Behavior * MeSH
- Sleep MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
PURPOSE: The International Study of Movement Behaviors in the Early Years (SUNRISE) was conducted in Tunisia to assess the proportion of preschoolers who met the World Health Organization guidelines for physical activity, sedentary behavior, and sleep. The study also evaluated the feasibility of the methods for the SUNRISE study. METHODS: Five kindergartens were recruited from urban and rural areas in Tunisia. Physical activity and sleep duration were assessed using a waist-worn ActiGraph. Screen time and sleep quality were assessed via an interview-administered parent questionnaire. The NIH Toolbox was used. RESULTS: A total of 112 preschoolers were assessed (50 boys, age = 4.1 [0.58]). Only 18% of children met all recommendations of the World Health Organization guidelines, while 53% met the sedentary screen time (in minutes per day), and 41% met physical activity recommendation (in minutes per day). Eighty-one percent of children met the sleep duration recommendation (in minutes per day). There was good compliance with the ActiGraph protocol. CONCLUSIONS: This pilot study provided important insights into the feasibility of the study and the movement behaviors of Tunisian preschool children. The results suggest there is a need to promote healthy levels of physical activity and sedentary screen time in children, which should be a priority in public health initiatives, including preschool curricula, in Tunisia.
- MeSH
- Actigraphy MeSH
- Screen Time MeSH
- Exercise * MeSH
- Humans MeSH
- Pilot Projects MeSH
- Child, Preschool MeSH
- Surveys and Questionnaires MeSH
- Sedentary Behavior * MeSH
- Sleep * MeSH
- Feasibility Studies MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Tunisia MeSH
BACKGROUND: Ice hockey is a dynamic game. We can observe collisions between the players that bring a risk of injury. There are many hockey clubs in the Czech Republic. These clubs raise great hockey players and many competing players in various levels of national leagues. The aim of this study was to map injuries in Czech hockey players and outline the situation of injury prevention and body care in ice hockey players. METHODS: We used a questionnaire survey method to obtain data. We received answers from 100 male active Czech ice hockey players, playing in the top three highest men's competitions (Extraleague - 2nd league). Individual injuries were analyzed according to specific body parts, injury type, playing position, level of competition using basic statistical characteristics and relative frequency analyses, including the recovery time, injury reason and the injury statistics per 1000 sporting performances in ice hockey. RESULTS: We found that 81% of participants suffered injuries with the overall incidence of injuries was 17.1 per 1000 sports performances and mainly happened during the match compared to training. The most common injuries were in the head and neck area (25%), often caused by a collision with another player, a stick or puck hit, or a collision with a board. Other frequently injured parts were the knees (21%), where internal ligament injuries predominate, and the shoulders (20%), where we recorded mainly ligament injuries. CONCLUSIONS: There is a high risk of various injury types of ice hockey players, that are developed accidentally in all body parts mostly in the match (mostly upper part of the body and knee) or by overloading (hip/groin area). We recommend strategies to avoid or minimize the injury risk of players. The hockey clubs, coaches, and players should extensively and regularly cooperate with physiotherapists, starting from the younger age of hockey groups, to prevent injuries and use regular strengthening of crucial muscle parts, regeneration, and compensatory exercises. We endorse adequately evaluating dangerous foul actions for referees and disciplinary officials also in minor competitions.
- MeSH
- Adult MeSH
- Hockey * injuries MeSH
- Incidence MeSH
- Humans MeSH
- Young Adult MeSH
- Surveys and Questionnaires MeSH
- Athletic Injuries * epidemiology prevention & control MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
OBJECTIVES: This study quantified blood bicarbonate (HCO3-) kinetics and gastrointestinal upset to determine the gender-related ergogenic potential of sodium bicarbonate (0.15-, 0.25- and 0.35 gSB·kgFat-free mass (FFM)-1) in high intensity functional training. DESIGN: Double-blind randomized placebo-controlled crossover. METHODS: Thirty female and male athletes performed two bouts of the Wingate Anaerobic Test (WAnTPRE-HIFT and WAnTPOST-HIFT) interspaced with two 3-min bouts of Wall Balls and Burpees 120 min after ingestion of three sodium bicarbonate doses. Blood HCO3- was determined pre-ingestion, after supplementation and before/post exercise. Gastrointestinal upset was evaluated 120 min post-ingestion. Control (CTRL) measurements were performed. RESULTS: There were significant gender × treatment interactions for: changes in blood HCO3- at 60 min post-ingestion (p = 0.014; η2p = 0.104; at 0.15 gSB·kgFFM-1 males experienced higher increase than females); peak power (p = 0.015; η2p = 0.103) and average power (p = 0.005; η2p = 0.124) during WAnTPOST-HIFT, and changes in peak power between the Wingate Anaerobic Test bouts (p = 0.049; η2p = 0.081). Sodium bicarbonate compared to PLA had no significant impact on Wall Balls and Burpees performance. The dose of 0.35 gSB·kgFFM-1 resulted in higher less severe gastrointestinal symptoms compared to CTRL and 0.15 gSB·kgFFM-1 (p = 0.001; W = 0.178); and higher total gastrointestinal upset compared to CTRL, PLA and 0.15 gSB·kgFFM-1 (p < 0.001; W = 0.323). CONCLUSIONS: There were dose- and gender-related differences in extracellular buffering capacity and ergogenic potential of sodium bicarbonate. The study suggested a detrimental impact of gastrointestinal upset on performance.
- MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Sodium Bicarbonate * administration & dosage pharmacology blood MeSH
- Cross-Over Studies * MeSH
- Performance-Enhancing Substances administration & dosage pharmacology MeSH
- Humans MeSH
- Young Adult MeSH
- Sex Factors MeSH
- Exercise Test MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
OBJECTIVES: The efficacy and safety of macitentan, an endothelin receptor antagonist, were assessed in a 52-week, prospective, multicenter, double-blind, randomized, placebo-controlled, parallel-group study assessing the efficacy and safety of macitentan in Fontan-palliated adult and adolescent patients (RUBATO-DB) and an open-label extension trial (RUBATO-OL). METHODS: Patients aged 12 years and older with New York Heart Association functional class II or III underwent total cavopulmonary connection more than 1 year before screening and showed no signs of Fontan failure/clinical deterioration. In RUBATO-DB, the primary efficacy end point was change in peak oxygen consumption from baseline to week 16; secondary end points were change from baseline over 52 weeks in peak oxygen consumption and change in mean count/minute of daily physical activity via accelerometer from baseline to week 16. Safety was assessed throughout both studies. RESULTS: In RUBATO-DB, 137 patients were randomized to macitentan 10 mg (n = 68) or placebo (n = 69); 92.7% completed 52-week double-blind treatment. At week 16, mean ± SD change in peak oxygen consumption was -0.16 ± 2.86 versus -0.67 ± 2.66 mL/kg/minute with macitentan versus placebo (median unbiased treatment difference estimate, 0.62 mL/kg/minute [99% repeated CI, -0.62 to 1.85]; P = .19). No treatment effect was observed in either of the secondary end points. During RUBATO-DB, most common adverse events with macitentan were headache, nasopharyngitis, and pyrexia. Across RUBATO-DB and RUBATO-OL, most common adverse events were COVID-19, headache, and fatigue. RUBATO-OL was prematurely discontinued because RUBATO-DB did not meet its primary or secondary end point. CONCLUSIONS: The primary end point of RUBATO-DB was not met; macitentan did not improve exercise capacity versus placebo in patients with Fontan palliation. Macitentan was generally well tolerated over long-term treatment.
- MeSH
- Endothelin Receptor Antagonists therapeutic use adverse effects MeSH
- Time Factors MeSH
- Child MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Fontan Procedure * adverse effects MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Palliative Care MeSH
- Prospective Studies MeSH
- Pyrimidines * therapeutic use adverse effects MeSH
- Oxygen Consumption drug effects MeSH
- Sulfonamides * therapeutic use adverse effects MeSH
- Exercise Tolerance drug effects MeSH
- Heart Defects, Congenital surgery physiopathology MeSH
- Treatment Outcome MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase III MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
Syndrom vyhoření je v oblasti zdravotnictví významným problémem, který ovlivňuje nejen duševní, ale fyzickou pohodu zdravotníků, dokonce i kvalitu poskytované péče. Zvláště ohroženou skupinou profesionálů jsou všeobecné sestry pracující na jednotkách intenzivní péče, které jsou vystaveny denně vysokým pracovním nárokům, stresu a emočně náročným situacím. Jeden z faktorů, který prokazatelně přispívá k rozvoji syndromu vyhoření, je omezení profesní autonomie, tedy míra, do jaké mají všeobecné sestry možnost rozhodovat o své práci a vykonávat ji v rozsahu stanovených kompetencí dle vlastního úsudku. Cílem provedeného literárního review bylo analyzovat existující publikace vydané v letech 2020–2025 týkající se přímo všeobecných sester pracujících v intenzivní péči. Analýza již sama ukázala, že tato problematika je není doposud dostatečně prozkoumána a zaslouží si pozornost dalších výzkumníků. Porozumění těchto souvislostem může přispět k hledání strategií pro prevenci vyhoření a zlepšení pracovních podmínek a postavení všeobecných sester v intenzivní péči.
Jirkovská V, Dolák F. The impact of misunderstanding and limited professional autonomy of general nurses working in intensive care on the development of burnout syndrome Burnout is a significant problem in healthcare, affecting not only the mental but also the physical well-being of healthcare professionals and the quality of care provided. A particularly vulnerable group of professionals are general nurses working in intensive care units, who are exposed to high daily work demands, stress and emotionally demanding situations. One of the factors that has been shown to contribute to the development of burnout syndrome is the limitation of professional autonomy, i.e. the extent to which general nurses are able to make decisions about their work and exercise their own judgement within their defined competencies. The aim of the literature review was to analyse existing publications published between 2020 and 2025 that relate specifically to general nurses working in critical care. The analysis itself has already shown that this topic has not been sufficiently explored and deserves the attention of further researchers. Understanding these contexts can contribute to the search for strategies to prevent burnout and improve the working conditions and status of general nurses in critical care.
BACKGROUND: Adolescents' movement behaviours (MB) vary between schooldays and weekends, potentially impacting health-related quality of life (HRQoL) and well-being. This study aimed to identify transitions between 24-h MB profiles on schooldays and weekends and examine their associations with HRQoL and well-being. METHODS: This is a cross-sectional study of 1070 Czech adolescents (average age: 13.8 years and standard deviation: 2.2 years; 56% girls). Participants wore accelerometers for 7 consecutive days to assess physical activity (PA) of different intensities, sedentary behaviour (SB) and sleep. A subsample of 451 participants provided data on HRQoL, which was measured using the Paediatric Quality of Life Inventory, and 484 provided valid well-being data measured with the 5-item World Health Organisation Well-Being Index. Latent transition analysis was used on the MB variables to identify transitions across MB profiles, and linear regression was used to examine associations between transitions and HRQoL or well-being. RESULTS: Four MB profiles were identified: Excellent (high PA, low SB and high sleep duration), Good (average MB values), Fair (below-average PA and sleep, above-average SB) and Poor (low PA and sleep, high SB). Most adolescents transitioned to less favourable profiles on weekends. Those remaining in the Excellent profile had higher HRQoL than those transitioning to less favourable profiles. Transitions to the Poor profile were associated with the lowest HRQoL and well-being scores. CONCLUSION: This study underscores the dynamic nature of adolescents' MB and the importance of consistent, healthy routines. Interventions optimizing 24-h MB throughout the week and especially on weekends may enhance adolescent HRQoL and well-being, but further evidence from longitudinal and intervention studies is needed. SUMMARY: We observed a contrast in 24-h MB between schooldays and weekends: 29.7% of adolescents were in the Excellent on schooldays, but only 5.8% did so on weekends, while the prevalence of the Poor profile rose from 1.6% on schooldays to 27.7% on weekends. Adolescents who maintained the Excellent profile across the whole week recorded the highest scores for HRQoL and well-being. Moving into the Poor profile on weekend was associated with about 9 points poorer HRQoL and 14 points lower well-being, compared with peers who remained in the Excellent profile. Behaviour change strategies should target the entire week to preserve PA, reduce SB and protect sleep.
- MeSH
- Accelerometry MeSH
- Time Factors MeSH
- Adolescent Behavior * psychology physiology MeSH
- Exercise * psychology physiology MeSH
- Quality of Life * psychology MeSH
- Humans MeSH
- Adolescent MeSH
- Cross-Sectional Studies MeSH
- Sedentary Behavior MeSH
- Sleep physiology MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: Preservation of mobility independence is a primary goal in older adults with physical frailty and sarcopenia (PF&S). Interventions based on the combination of physical activity (PA) and nutritional counselling have been indicated as strategies for the management of this condition, although their effectiveness is not confirmed in all investigations. A possible explanation for this uncertain scenario relies in the impact of the adherence to PA interventions. Hence, the present study investigated the impact of the adherence to PA sessions on the incidence of mobility disability in older adults with PF&S. METHODS: This is a secondary analysis of an evaluator blinded, randomised controlled trial, developed in 16 clinical sites across 11 European countries, from January 2016 to 31 October 2019. Participants were community-dwelling older adults (70+ years) with PF&S enrolled in the SPRINTT trial (NCT02582138). PF&S was operationalised as having a total score from 3 to 9 on the short physical performance battery (SPPB), low appendicular lean mass and ability to complete the 400-m walk test in < 15 min. Data from participants allocated to a multicomponent intervention (PA with technological support plus nutritional counselling) and a healthy ageing lifestyle education programme (control group) were analysed. Adherence to PA was assessed based on the number of weekly sessions attended. According to recommendations of the American College of Sports Medicine, adherence was categorised as below recommendations (< 2 sessions/week, BR), meeting recommendations (2-3 sessions/week, MR), and above recommendations (> 3 sessions/week, AR). The primary outcome was incident mobility disability, operationalised as incident inability to complete the 400-m walk test in < 15 min during up to 36 months of follow-up. RESULTS: Data of 1444 participants (mean age 79.3 years, 72.6% women) were analysed. In those with SPPB scores of 3-7, MR and AR groups had lower risk of mobility disability compared with controls [MR HR (95% CI): 0.57 (0.41-0.78), p = 0.001; AR HR (95% CI): 0.33 (0.23-0.46), p < 0.001] and BR groups [MR: HR (95% CI): 0.48 (0.34-0.69), p < 0.001; AR: HR (95% CI): 0.27 (0.18-0.38), p < 0.001] in a dose-dependent manner. In those with SPPB scores of 8 or 9, the BR group had a higher risk of mobility disability than controls. MR and AR groups had a lower risk of mobility disability than the BR group. CONCLUSIONS: In older adults with PF&S, adherence to PA recommendations is associated with lower incidence of mobility disability. This benefit depends on the degree of adherence as well as baseline physical performance. TRIAL REGISTRATION: ClinicalTrials.gov NCT02582138.
- MeSH
- Exercise * physiology MeSH
- Humans MeSH
- Mobility Limitation * MeSH
- Persons with Disabilities MeSH
- Sarcopenia * physiopathology therapy MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH