The beneficial effect of physical activity for the prevention of a range of chronic diseases is widely acknowledged. These chronic conditions are most pronounced in economically disadvantaged groups ...where physical activity levels are consistently lower, yet this group is particularly difficult to recruit and retain in physical activity programmes. This study examined the perceptions of participants, non-participants, and exercise leaders in a low-income area regarding barriers, motives, and enabling factors for organised physical activity with a view to improving recruitment and retention.
A mixed methods research approach was adopted to guide data collection and analysis. A survey, incorporating the Motivation for Physical Activity Measure - Revised (MPAM-R), was used to assess the motivations of 152 physical activity session participants in a highly deprived suburban neighbourhood. The MPAM-R data were analysed using t tests, analyses of variance to estimate age, body mass index, and activity mode differences and Pearson's correlation coefficient to address associations. Semi-structured interviews were also conducted with 33 local residents who did not participate in activity sessions and with 14 activity session leaders. All interviews were audio-taped, transcribed verbatim and analyzed using an inductive thematic approach.
Participants reported cost, childcare, lack of time and low awareness as barriers to joining activity classes. The need for support, confidence and competence in order to take up activity was widely expressed, particularly among women. Once people are active, high levels of social interaction, interest and enjoyment are associated with improved levels of retention, with different types of physical activity scoring differently on these factors.
This study suggests that some factors such as cost, the fear of 'walking in alone', accessibility of facilities, and appropriate communication strategies may be of particular importance to increasing recruitment of low income groups. Interventions targeting this group should consider low cost sessions and childcare; activities popular with the target group and associated with good recruitment and retention; sessions held at accessible times; a focus on fun and socialising; well-researched and designed communications strategies; targeting of friendship groups; clearly branded beginners' sessions, and the potential of social marketing as strategies. The evidence presented here suggests that the current UK government approach designed to 'enable and guide people's choices' may not be sufficient if low-income groups are to be effectively supported in changing their health behaviours.
Physical activity has many positive effects on children's health while TV viewing has been associated with adverse health outcomes. Many children do not meet physical activity recommendations and ...exceed TV viewing guidelines. Parents are likely to be an important influence on their children's behaviour. There is an absence of information about the associations between parents' and children's physical activity and TV viewing.
Year 6 children and their parent were recruited from 40 primary schools. Results are presented for the 340 parent-child dyads with accelerometer data that met a > or = 3 day inclusion criteria and the 431 parent-child dyads with complete self-reported TV viewing. Over 80% of the dyads with valid TV viewing data included mothers and their child. Mean minutes of moderate to vigorous physical activity (MVPA), minutes of sedentary time per day and counts per minute were assessed by accelerometer. Self-reported hours of TV viewing were coded into 3 groups (< 2 hours per day, 2-4 hours per day and >4 hours per day. Linear and multi-nominal regression models were run by child gender to examine parent-child associations.
In linear regression models there was an association for the overall sedentary time of girls and their parents (t = 2.04. p = .020) but there was no association between girls' and parents' physical activity. There were no associations between parents' and boys' sedentary or physical activity time. For girls, the risk of watching more than 4 hours of TV per day, (reference = 2 hours of TV per day), was 3.67 times higher if the girl's parent watched 2-4 hours of TV per day (p = 0.037). For boys, the risk of watching more than 4 hours of TV per day, was 10.47 times higher if the boy's parent watched more than 4 hours of TV per day (p = 0.038).
There are associations in the sedentary time of parents and daughters. Higher parental TV viewing was associated with an increased risk of high levels of TV viewing for both boys and girls. There were no associations between the time that parents and children spend engaged in physical activity.
This study aimed to assess the independent and prospective associations of aspects of self-reported leisure-time physical activity (LTPA) and leisure-time sedentary behaviors (LTSB) with subjective ...well-being (SWB). Data from the 1999, 2003, and 2007 phases of the Survey of Health and Living Status of the Elderly conducted by the Taiwan Ministry of Health and Welfare on a nationally representative sample of older Taiwanese were used. A fixed cohort of 1268 participants aged 70 years or older in 1999 with 8 years of follow-up was analyzed. Subjective well-being was assessed using the Life Satisfaction Index A. Frequencies per week of different types of LTSB and LTPA were self-reported. Generalized estimating equation models with multivariate adjustment for socio-demographic variables, lifestyle behaviors, and health status were developed. Participants who had higher frequencies of LTPA and LTSB, especially engaging in walking, yard/gardening, group exercise, TV watching, social chatting and reading, recorded higher levels of well-being. This was supported by a sensitivity analysis after excluding participants with potential cognitive decline. This study indicated that both LTPA and aspects of LTSB in later life may provide beneficial effects for subsequent SWB.
Physical activity has important benefits for children's physical health and mental wellbeing, but many children do not meet recommended levels. Research suggests that active play has the potential to ...make a valuable contribution to children's overall physical activity, whilst providing additional cognitive, social and emotional benefits. However, relatively little is known about the determinants of UK children's active play. Understanding these factors provides the critical first step in developing interventions to increase children's active play, and therefore overall physical activity.
Eleven focus groups were conducted with 77, 10-11 year old children from four primary schools in Bristol, UK. Focus groups examined: (i) factors which motivate children to take part in active play; (ii) factors which limit children's active play and (iii) factors which facilitate children's active play. All focus groups were audio-taped and transcribed verbatim. Data were analysed using a thematic approach.
Children were motivated to engage in active play because they perceived it to be enjoyable, to prevent boredom, to have physical and mental health benefits and to provide freedom from adult control, rules and structure. However, children's active play was constrained by a number of factors, including rainy weather and fear of groups of teenagers in their play spaces. Some features of the physical environment facilitated children's active play, including the presence of green spaces and cul-de-sacs in the neighbourhood. Additionally, children's use of mobile phones when playing away from home was reported to help to alleviate parents' safety fears, and therefore assist children's active play.
Children express a range of motivational and environmental factors that constrain and facilitate their active play. Consideration of these factors should improve effectiveness of interventions designed to increase active play.
Our understanding of the relationship between physical activity and health is constantly evolving. Therefore, the British Association of Sport and Exercise Sciences convened a panel of experts to ...review the literature and produce guidelines that health professionals might use. In the ABC of Physical Activity for Health, A is for All healthy adults, B is for Beginners, and C is for Conditioned individuals. All healthy adults aged 18-65 years should aim to take part in at least 150 min of moderate-intensity aerobic activity each week, or at least 75 min of vigorous-intensity aerobic activity per week, or equivalent combinations of moderate- and vigorous-intensity activities. Moderate-intensity activities are those in which heart rate and breathing are raised, but it is possible to speak comfortably. Vigorous-intensity activities are those in which heart rate is higher, breathing is heavier, and conversation is harder. Aerobic activities should be undertaken in bouts of at least 10 min and, ideally, should be performed on five or more days a week. All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence. Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults. Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends. Conditioned individuals who have met the physical activity levels recommended for all healthy adults for at least 6 months may obtain additional health benefits by engaging in 300 min or more of moderate-intensity aerobic activity per week, or 150 min or more of vigorous-intensity aerobic activity each week, or equivalent combinations of moderate- and vigorous-intensity aerobic activities. Adults who find it difficult to maintain a normal weight and adults with increased risk of cardiovascular disease or type 2 diabetes may in particular benefit from going beyond the levels of activity recommended for all healthy adults and gradually progressing towards meeting the recommendations for conditioned individuals. Physical activity is beneficial to health with or without weight loss, but adults who find it difficult to maintain a normal weight should probably be encouraged to reduce energy intake and minimize time spent in sedentary behaviours to prevent further weight gain. Children and young people aged 5-16 years should accumulate at least 60 min of moderate-to-vigorous-intensity aerobic activity per day, including vigorous-intensity aerobic activities that improve bone density and muscle strength.
IDH1 gene mutations identify gliomas with a distinct molecular evolutionary origin. We sought to determine the impact of surgical resection on survival after controlling for IDH1 status in malignant ...astrocytomas-World Health Organization grade III anaplastic astrocytomas and grade IV glioblastoma.
Clinical parameters including volumetric assessment of preoperative and postoperative MRI were recorded prospectively on 335 malignant astrocytoma patients: n = 128 anaplastic astrocytomas and n = 207 glioblastoma. IDH1 status was assessed by sequencing and immunohistochemistry.
IDH1 mutation was independently associated with complete resection of enhancing disease (93% complete resections among mutants vs 67% among wild-type, P < .001), indicating IDH1 mutant gliomas were more amenable to resection. The impact of residual tumor on survival differed between IDH1 wild-type and mutant tumors. Complete resection of enhancing disease among IDH1 wild-type tumors was associated with a median survival of 19.6 months versus 10.7 months for incomplete resection; however, no survival benefit was observed in association with further resection of nonenhancing disease (minimization of total tumor volume). In contrast, IDH1 mutants displayed an additional survival benefit associated with maximal resection of total tumor volume (median survival 9.75 y for >5 cc residual vs not reached for <5 cc, P = .025).
The survival benefit associated with surgical resection differs based on IDH1 genotype in malignant astrocytic gliomas. Therapeutic benefit from maximal surgical resection, including both enhancing and nonenhancing tumor, may contribute to the better prognosis observed in the IDH1 mutant subgroup. Thus, individualized surgical strategies for malignant astrocytoma may be considered based on IDH1 status.
There are many health and social benefits of physical activity (PA) for older adults, but little is known about their activity patterns.
The purpose of this study was to objectively assess the PA ...patterns of older adults and the lifestyle and demographic factors associated with PA.
Participants (N = 230, aged 78.1 yr) recruited from medical practices (between 2007 and 2008) completed journey logs and wore accelerometers for 7 d. Mean daily steps, counts per minute (CPM), minutes of sedentary, light, or moderate-to-vigorous PA (MVPA), and frequency of journeys were analyzed (in 2009).
Younger participants (age = 70-74.9 yr) were significantly (P < 0.001) more active (5660.8 steps per day) than older participants aged 80+ yr (3409.6 steps per day). Men performed significantly (P = 0.035) more minutes MVPA than women (23.1 vs 13.8 min MVPA per day). Normal weight participants were significantly (P < 0.05) more active (5368.9 steps per day) than overweight (4532.7 steps per day) and obese (3251.4 steps per day) groups. Those performing many journeys (>11.6 journeys per week) were significantly (P < 0.001) more active (5838.2 steps per day) than those performing few (<7 journeys per week) (3094.2 steps per day). PA was significantly (P < 0.001) greater in mornings (259.3 CPM) than afternoons (181.8 CPM) and evenings (102.5 CPM). Sundays were significantly (P < 0.001) less active (3331.7 steps per day) than Saturdays (4193.1 steps per day) and weekdays (4623.5 steps per day). Light activity was significantly (P = 0.005) higher in spring (3.4 h·d(-1)) than that in winter (2.7 h·d(-1)).
Older adults' PA patterns differ by age, gender, and weight status. Daily journeys are associated with more activity for all groups. Variability in volume of activity is high for all age groups. Temporal patterns of PA indicate that journeys out of the house for shopping and personal business are important in their contribution to PA levels.
Research into daily physical activity (PA) patterns of older adults (>or=70 years) has primarily relied on self-report. This study used accelerometry, an objective measure of minute-by-minute ...movement, to assess PA volume and intensity performed by older adults recruited to the Better Ageing project. Results were used to estimate the degree to which current health recommendations for PA were met. Participants 91 older females (OF) aged 76.0 +/- 4.0 years (mean +/- SD), 70 older males (OM) 76.3 +/- 3.9 years, 23 young females (YF) 26.8 +/- 4.1 years and 22 young males (YM) 27.0 +/- 4.2 years wore an MTI actigraph model 7164 recording activity in 1-min epochs for 7 days. Only those with at least 5 days, and 10 h of actigraph data per day, were included in the analysis, using Caloric.Bas (CSA Inc. 1999) software and a tailored Microsoft Access 2000 macro. Mean counts min(-1) day(-1) were 37% lower for older adults than for young adults OF 236.1 +/- 84.4 vs. YF 370.0 +/- 81.1 counts min(-1) day(-1) t(114) = -6.86, P < 0.001; OM 255.1 +/- 103.0 vs. YM 404.3 +/- 134.0 ct min(-1) day(-1), t(91) = -5.55, P < 0.001. Older adults were more restricted in activity intensity range performing significantly fewer minutes of moderate to vigorous (MV) PA day(-1) than young adults OF 16.7 +/- 12.2 vs. YF 38.4 +/- 18.4 MVPA min day(-1), t(114) = -6.90, P < 0.001; OM 23.8 +/- 20.0 vs. YM 40.4 +/- 19.2 MVPA min day(-1), t(91) = -3.47, P = 0.001. Nearly half of older adults did not perform any sustained 10-min MVPA bouts (OF 48.4% vs. YF 13.0%, chi2 = 8.10, P = 0.004; OM 44.3% vs. YM 4.5%, chi2 = 9.97, P = 0.002), and none met current PA recommendations for health. This study is the first to provide objective data on a large sample of adults aged 70 years and over and indicates low levels of daily movement that are likely to be inadequate for optimal health benefit.
Understanding children's physical activity motivation, its antecedents and associations with behavior is important and can be advanced by using self-determination theory. However, research among ...youth is largely restricted to adolescents and studies of motivation within certain contexts (e.g., physical education). There are no measures of self-determination theory constructs (physical activity motivation or psychological need satisfaction) for use among children and no previous studies have tested a self-determination theory-based model of children's physical activity motivation. The purpose of this study was to test the reliability and validity of scores derived from scales adapted to measure self-determination theory constructs among children and test a motivational model predicting accelerometer-derived physical activity.
Cross-sectional data from 462 children aged 7 to 11 years from 20 primary schools in Bristol, UK were analysed. Confirmatory factor analysis was used to examine the construct validity of adapted behavioral regulation and psychological need satisfaction scales. Structural equation modelling was used to test cross-sectional associations between psychological need satisfaction, motivation types and physical activity assessed by accelerometer.
The construct validity and reliability of the motivation and psychological need satisfaction measures were supported. Structural equation modelling provided evidence for a motivational model in which psychological need satisfaction was positively associated with intrinsic and identified motivation types and intrinsic motivation was positively associated with children's minutes in moderate-to-vigorous physical activity.
The study provides evidence for the psychometric properties of measures of motivation aligned with self-determination theory among children. Children's motivation that is based on enjoyment and inherent satisfaction of physical activity is associated with their objectively-assessed physical activity and such motivation is positively associated with perceptions of psychological need satisfaction. These psychological factors represent potential malleable targets for interventions to increase children's physical activity.
The case for exercise and health has primarily been made on its impact on diseases such coronary heart disease, obesity and diabetes. However, there is a very high cost attributed to mental disorders ...and illness and in the last 15 years there has been increasing research into the role of exercise a) in the treatment of mental health, and b) in improving mental well-being in the general population. There are now several hundred studies and over 30 narrative or meta-analytic reviews of research in this field. These have summarised the potential for exercise as a therapy for clinical or subclinical depression or anxiety, and the use of physical activity as a means of upgrading life quality through enhanced self-esteem, improved mood states, reduced state and trait anxiety, resilience to stress, or improved sleep. The purpose of this paper is to a) provide an updated view of this literature within the context of public health promotion and b) investigate evidence for physical activity and dietary interactions affecting mental well-being.
Narrative review and summary.
Sufficient evidence now exists for the effectiveness of exercise in the treatment of clinical depression. Additionally, exercise has a moderate reducing effect on state and trait anxiety and can improve physical self-perceptions and in some cases global self-esteem. Also there is now good evidence that aerobic and resistance exercise enhances mood states, and weaker evidence that exercise can improve cognitive function (primarily assessed by reaction time) in older adults. Conversely, there is little evidence to suggest that exercise addiction is identifiable in no more than a very small percentage of exercisers. Together, this body of research suggests that moderate regular exercise should be considered as a viable means of treating depression and anxiety and improving mental well-being in the general public.
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