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Roundtable on Preseason Heat Safety in Secondary School Athletics: Heat Acclimatization.
Adams, WM, Hosokawa, Y, Casa, DJ, Périard, JD, Racinais, S, Wingo, JE, Yeargin, SW, Scarneo-Miller, SE, Kerr, ZY, Belval, LN, et al
Journal of athletic training. 2021;(4):352-361
Abstract
OBJECTIVE To provide best-practice recommendations for developing and implementing heat-acclimatization strategies in secondary school athletics. DATA SOURCES An extensive literature review on topics related to heat acclimatization and heat acclimation was conducted by a group of content experts. Using the Delphi method, action-oriented recommendations were developed. CONCLUSIONS A period of heat acclimatization consisting of ≥14 consecutive days should be implemented at the start of fall preseason training or practices for all secondary school athletes to mitigate the risk of exertional heat illness. The heat-acclimatization guidelines should outline specific actions for secondary school athletics personnel to use, including the duration of training, the number of training sessions permitted per day, and adequate rest periods in a cool environment. Further, these guidelines should include sport-specific and athlete-specific recommendations, such as phasing in protective equipment and reintroducing heat acclimatization after periods of inactivity. Heat-acclimatization guidelines should be clearly detailed in the secondary school's policy and procedures manual and disseminated to all stakeholders. Heat-acclimatization guidelines, when used in conjunction with current best practices surrounding the prevention, management, and care of secondary school student-athletes with exertional heat stroke, will optimize their health and safety.
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Advocating for Children During the COVID-19 School Closures.
Masonbrink, AR, Hurley, E
Pediatrics. 2020;(3)
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ADHD symptoms across adolescence: the role of the family and school climate and the DRD4 and 5-HTTLPR genotype.
Brinksma, DM, Dietrich, A, de Bildt, A, Buitelaar, JK, van den Hoofdakker, BJ, Hoekstra, PJ, Hartman, CA
European child & adolescent psychiatry. 2020;(8):1049-1061
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Abstract
We examined bidirectional relations between attention-deficit/hyperactivity disorder (ADHD) symptoms and family and school climate, and the possible role of DRD4 and/or 5-HTTLPR genotypes herein. Three-wave longitudinal data of 1860 adolescents (mean ages 11, 13.5, and 16 years) from the general population and clinic-referred cohort of TRacking Adolescents' Individual Lives Survey were used. Using a multigroup Random Intercept Cross-Lagged Panel Model, we tested between-person (i.e., stable trait levels) and within-person (i.e., causal processes) associations across ADHD symptoms, family and school climate, and the extent to which these depended on genotype. Findings indicated no influence of genotype. Results did show significant between-person differences (ADHD symptoms with family climate r = .38; and school climate r = .23, p values < .001), indicating that higher stable levels of ADHD symptoms were associated with a less favorable family and school climate. Regarding within-person causal processes, ADHD symptoms predicted a less favorable family climate in early adolescence (β = .16, p < .01), while ADHD symptoms predicted a more favorable family climate in the later phase of adolescence (β = - .11, p < .01), a finding which we explain by normative developmental changes during adolescence. Overall, this study showed that negative associations between ADHD symptoms and both family and school climate are largely explained by stable between-person differences. We recommend applying the Random Intercept Cross-Lagged Path Model to developmental data to tease stable associations and change processes apart.
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Food environment near schools and body weight-A systematic review of associations by race/ethnicity, gender, grade, and socio-economic factors.
Matsuzaki, M, Sánchez, BN, Acosta, ME, Botkin, J, Sanchez-Vaznaugh, EV
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2020;(4):e12997
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Abstract
Previous research reported modest associations between food environments near schools and adiposity among children overall. The associations within sociodemographic subgroups have not been synthesized. This review assessed the evidence on the associations between food environments near schools and childhood obesity within different demographic and socio-economic subgroups. PubMed and Scopus databases were searched to identify studies published in English between January 1, 1980, and April 25, 2019, examining the presence of fast food outlets, convenience stores, supermarkets, and grocery stores near schools and measures of overweight/obesity by race/ethnicity, gender, grade, and income level. Twelve cross-sectional and two ecological studies were included. Fast food outlets were most commonly examined (n = 12). The associations between fast food outlets near schools and obesity were generally positive among Latino, white, and African American students and across grade levels, although the strengths of evidence varied. The directions of association were mixed among Asian children. Three studies reported generally positive associations between convenience stores and obesity among Latino and African American children and mixed associations among white and Asian children. Longitudinal studies are needed in addition to studies examining underlying mechanisms of the differential influence of food environments near schools within each subgroup.
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Effects of school-based physical activity and multi-micronutrient supplementation intervention on growth, health and well-being of schoolchildren in three African countries: the KaziAfya cluster randomised controlled trial protocol with a 2 × 2 factorial design.
Gerber, M, Ayekoé, SA, Beckmann, J, Bonfoh, B, Coulibaly, JT, Daouda, D, du Randt, R, Finda, L, Gall, S, Mollel, GJ, et al
Trials. 2020;(1):22
Abstract
BACKGROUND In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d'Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. METHODS Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1-4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. DISCUSSION The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. TRIAL REGISTRATION The study was registered on August 9, 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081.
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School education and childhood obesity: A systemic review.
Nga, VT, Dung, VNT, Chu, DT, Tien, NLB, Van Thanh, V, Ngoc, VTN, Hoan, LN, Phuong, NT, Pham, VH, Tao, Y, et al
Diabetes & metabolic syndrome. 2019;(4):2495-2501
Abstract
Childhood obesity prevalence is shooting up at a phenomenal rate worldwide, leading to long-term devastating consequences. A great number of studies have investigated factors contributing to the increase in BMI of children and adolescents. School-based, home-based and clinic-based solutions have been suggested as possible viable strategies, among which school-based interventions is believed to produce a noticeable effect on a massive scale. However, the question of whether school interventions, especially school education exert significant impact on childhood obesity or not, is left with mixing results. This article aims to holistically review the relationship between school education and childhood obesity. Various factors are covered, including health education, nutrition education, school nutrition, physical education, teachers' awareness, teaching practice and school stress, In all, school education is not the answer to childhood obesity but just part of it. More attempts from other stakeholders (parents, community, policy makers, researchers, etc.) should be made in order to solve this complicated puzzle.
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The Moderating Role of the School Context on the Effects of the Healthy Primary School of the Future.
Bartelink, N, van Assema, P, Jansen, M, Savelberg, H, Kremers, S
International journal of environmental research and public health. 2019;(13)
Abstract
Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children's health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics of the school population, teacher's health-promoting (HP) practices, implementers' perceived barriers, school's HP elements, and dominating organizational issues. Outcomes included objectively assessed BMI z-scores and physical activity (PA), and parent and child-reported dietary intake. Analyses included linear mixed models (four intervention schools versus four control schools), and qualitative comparisons between intervention schools with similar HP changes. Results: Effects on outcomes varied considerably across schools (e.g., range in effect size on light PA of 0.01-0.26). Potentially moderating contextual aspects were the child's socioeconomic background and baseline health behaviors; practices and perceived barriers of employees; and organizational issues at a school level. Conclusions: Similar HP changes lead to different outcomes across schools due to differences in the school context. The adoption of a complex adaptive systems perspective contributes to a better understanding of the variation in effects and it can provide insight on which contextual aspects to focus on or intervene in to optimize the effects of HP initiatives.
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Participation in school sports among children and adolescents with juvenile idiopathic arthritis in the German National Paediatric Rheumatologic Database, 2000-2015: results from a prospective observational cohort study.
Milatz, F, Klotsche, J, Niewerth, M, Geisemeyer, N, Trauzeddel, R, Weißbarth-Riedel, E, Kallinich, T, Peitz, J, Hartmann, M, Minden, K
Pediatric rheumatology online journal. 2019;(1):6
Abstract
BACKGROUND Regular school sports can help adolescents achieve the recommended amount of daily physical activity and provide knowledge, attitudes and behavioral skills that are needed in order to adopt and maintain a physically active lifestyle. Furthermore, it reaches all children including those that are at risk for engaging in more sedentary types of behavior. Since adolescents with juvenile idiopathic arthritis (JIA) are less involved in physical and social activities than their healthy peers, the objectives were to (1) estimate the prevalence of participation in school sports among patients with JIA; (2) determine the correlates associated with school sports absenteeism; and (3) investigate whether attendance in school sports has changed in the era of biologics. METHODS Data from schoolchildren with JIA recorded in the German National Paediatric Rheumatologic Database (NPRD) in the years 2000 to 2015 were considered for the analyses. Data from the year 2015 were inspected to analyze correlates of school sports absenteeism. Whether school sports participation had changed between 2000 and 2015 was determined using linear mixed models. RESULTS During the 15-year period, the participation rates in school sports were determined in 23,016 patients. The proportion of patients who participated in school sports almost always steadily increased from 31% in 2000 to 64% in 2015 (β = 0.017, 95% confidence interval (CI) 0.015, 0.020), whereas the exemption rate simultaneously decreased from 44% in 2000 to 16% in 2015 [β = - 0.009, 95% CI -0.011, - 0.007]. In 2015, the data from 5879 patients (mean age 13.1 ± 3.3 years, female 65%, disease duration 5.9 ± 4.0 years, persistent oligoarthritis 37%) were available for evaluation. Full exemption from school sports (in 16.1% of cases) was associated with functional limitations, disease activity and any use of DMARDs, intra-articular glucocorticoid injections or physiotherapy. CONCLUSIONS School sports attendance among children and adolescents with JIA has increased significantly over the past 15 years. Possible explanations include improved functional ability probably due to better treatment options. The integration of patients with child acceptable symptom states who have previously been fully exempted from school sports needs to be addressed in the future.
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Partnerships for Active Children in Elementary Schools: Outcomes of a 2-Year Pilot Study to Increase Physical Activity During the School Day.
Weaver, RG, Webster, CA, Egan, C, Campos, CMC, Michael, RD, Vazou, S
American journal of health promotion : AJHP. 2018;(3):621-630
Abstract
PURPOSE To evaluate the impact of the pilot study Partnerships for Active Children in Elementary Schools on the percentage of children achieving the Institute of Medicine guideline of 30 minutes of moderate-to-vigorous physical activity (MVPA) during the school day. DESIGN Pre/multiple post-quasi-experimental. SETTING Four elementary schools. PARTICIPANTS Physical education (n = 3) and classroom teachers (n = 12) and students (n = 229). INTERVENTION Partnerships for Active Children in Elementary Schools was a multicomponent, theory-driven intervention facilitated through school-university partnerships. Intervention approaches included communities of practice, community-based participatory research, and service learning. MEASURES Accelerometer-derived percentage of children accumulating 30 minutes of MVPA during the school day. ANALYSIS Multilevel mixed-effects regression estimated MVPA differences over time. RESULTS Compared to control, a 2.4% (95% confidence interval [CI]: -0.0% to 4.8%) and 8.8% (95% CI: -0.3% to 15.4%) increase in the percentage of time girls and boys engaged in MVPA during the school day was observed. The percentage of boys and girls in the intervention group achieving 30 minutes of MVPA/day increased from 57.5% to 70.7% and 35.4% to 56.9%, respectively. Boys and girls in the control group decreased from 61.5% to 56.4% and 52.6% to 41.9%, respectively. However, these changes did not reach statistical significance. CONCLUSION Partnerships for Active Children in Elementary Schools demonstrated meaningful impact on children's MVPA during the school day by increasing boys' and girls' MVPA. However, additional strategies may be required to help schools achieve the Institute of Medicine guideline.
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The Viennese EDDY Study as a Role Model for Obesity: Prevention by Means of Nutritional and Lifestyle Interventions.
Widhalm, K, Helk, O, Pachinger, O
Obesity facts. 2018;(3):247-256
Abstract
OBJECTIVES Obesity in children and adolescents is a worldwide dramatic health problem, for which treatment is mostly unsuccessful. Therefore, prevention is the most important measure to tackle this problem. The 'EDDY' study as an interventional cohort study with a 1-year lifestyle intervention aimed to affect the lifestyle and nutrition habits of adolescents by intervention with nutritional training and sports programs to prevent obesity. METHODS Four Viennese schools were cluster-randomized into an intervention group and a control group. A total of 141 pupils aged 11-14 years were included. The intervention group received a comprehensive, age-appropriate training on nutrition and lifestyle exercise intervention for 12 months. Before and after intervention and at two follow-ups, subjects were anthropometrically measured. In addition, knowledge of nutritional issues and eating habits were measured with questionnaires. RESULTS The data imply an improvement of nutrition knowledge, a significant reduction in the consumption of junk food (p = 0.01), sweets (p = 0.001) and salty snacks (p < 0.001) as well as a slight improvement of physical performance after intervention. Although there was a trend for a less increase of body fat in the intervention group, no significant changes could have been shown in the anthropometric data. CONCLUSIONS An age-adjusted lifestyle intervention based on dietary training and exercise can improve the nutritional knowledge and eating habits of school children.