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Aims The aim of this study was to examine the impact of vigorous intensity, high dose exercise (DEI) on cannabis use among stimulant users compared to a health education intervention (HEI) using data from the Stimulant Reduction Intervention using Dosed Exercise, National Institute of Drug Abuse National Drug Treatment Clinical Trials Network Protocol Number 0037 (STRIDE). Methods Adults (N = 302) enrolled in the STRIDE randomized clinical trial were randomized to either the DEI or the HEI. Interventions included supervised sessions three times a week during the Acute phase (12 weeks) and once a week during the Follow-up phase (6 months). Cannabis use was measured at each assessment via Timeline Follow Back and urine drug screens. Cannabis use was compared between the groups during the Acute and Follow-up phases using both the intent-to-treat sample and a complier average causal effects (CACE) analysis. Findings Approximately 43% of the sample reported cannabis use at baseline. The difference in cannabis use between the DEI and HEI groups during the Acute phase was not significant. During the Follow-up phase, the days of cannabis use was significantly lower among those in the DEI group (1.20 days) compared to the HEI group (2.15 days; p = 0.04). Conclusions For those who adhered to the exercise intervention, vigorous intensity, high dose exercise resulted in less cannabis use. Results suggest that there were no significant short-term differences in cannabis use between the groups. Further study on the long-term impact of exercise as a treatment to reduce cannabis use should be considered.

The new World Health Organization (WHO) 2020 guidelines on physical activity (PA) and sedentary behavior include recommendations for adults with chronic conditions. The guidelines provide adaptable and general recommendations for people living with chronic medical conditions. This article summarizes the content and provides suggestions for the application of the guidelines for patients with essential hypertension in primary care. The WHO 2020 PA guidelines recommend broad advice for adults and older adults with chronic conditions. The key recommendations are consistent with other hypertension guidelines. A systemic approach to promote PA in primary care (i.e., PA assessment, safety considerations, PA prescription, behavioral counseling, and referral) along with applying the WHO guidelines is required. Health risk assessment and safety issues related to hypertension (e.g., current PA levels, level of blood pressure, treatment plans, comorbidities) should be concerned. The FITT Pro (frequency, intensity, time, type, and progression) can be adopted as a framework to break down the guidelines into specific PA prescription. The WHO 2020 PA guidelines address the importance of PA in clinical populations. The guidelines can be adapted for patients with hypertension in primary care settings.

Exercise is a promising treatment for stimulant use disorder. However, efficacy has not been clearly demonstrated in a general stimulant using population where response to exercise is expected to be heterogeneous. Thus, examination of response heterogeneity to identify subgroups for whom exercise is either clearly indicated or not indicated is of considerable interest as findings will support more effective tailoring of patient treatments in practice and guide future research in stimulant use disorder. A secondary analysis of the Stimulant Reduction Intervention using Dosed Exercise (STRIDE) randomized controlled trial of 302 stimulant using or dependent participants was conducted to identify baseline clinical and demographic characteristics associated with differential response between participants in the exercise and health education control groups. Characteristics (i.e., moderators of treatment response) were identified using an established Best Approximating Modeling (BAM) method. Six moderators of treatment response were identified: Quick Inventory of Depressive Symptomatology-Clinician (QIDS-C) rated total score, exercise test maximum systolic blood pressure, number of lifetime drug treatments, Stimulant Craving Questionnaire (STCQ) total score, Addiction Severity Index (ASI) Family subscale score, and Cognitive and Physical Functioning Questionnaire (CPFQ) total score. For all moderators, the odds ratio of response to exercise vs. health education ranged from 0.32 to 2.52 or more depending on the level of the moderator. These results demonstrate that it is possible to identify pre-treatment patient characteristics that predict statistically and clinically meaningful differential treatment response to exercise.

Young children's lifestyle behaviors are largely shaped by their parents. There are socioeconomic risk factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents' food choices and feeding practices. The objective of this qualitative study is to identify the behavioral, environmental, and cognitive factors that influence the parental food choices and feeding behaviors of Hispanic mothers of children ages 0–5 years. Snowball sampling was used to recruit participants from the community (n = 30) who were 1) female; 2) Hispanic; 3) over the age of 18; and 4) a mother to child(ren) between the ages zero and five. Each interview consisted of a brief demographic survey and a set of open-ended questions based on Social Cognitive Theory constructs. A thematic analysis using a combined deductive and inductive approach was used to analyze transcriptions. Results indicated that mothers' attitudes around breastfeeding were connected with their challenges, while their attitudes around solid foods were expressed in their feeding strategies. Mothers used strategies of modeling, repeated exposure, and practices of “sneaking” in healthy foods and bribing to promote healthy eating. Mothers were most likely to seek out information from (1) pediatricians, (2) female family members, and (3) the internet. Hispanic mothers actively seek out information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity.

Objectives To evaluate the current level of physical activity (PA) training provided to Australian medical students. Design Individual interviews were completed via phone interview or online survey from June–October 2015. Methods Program leaders from Australian medical schools, who were knowledgeable about their curriculum content, were invited to participate in the study. The number of programs, hours of PA training instruction, institutional attitude towards offering PA, barriers experienced, and content areas in which PA training was offered, were explored. Results Seventeen of the 19 (89%) Australian medical schools participated in the study. Among the responding schools, 15 (88.2%) reported providing specific PA training to medical students. Thirteen of these 15 schools (86.7%) taught the national aerobic guidelines while only seven (46.7%) taught the national strength training recommendations. Four, five, and six year programs reported providing an average of 6.6, 5.0, and 12.3 h of PA training, respectively, across their entire curriculum. Only 42.9% of the schools that had PA training reported that it was sufficient for their medical students. Nearly half (41.2%) of the respondents reported no barriers to implementing PA training into their medical curricula. Conclusions Most Australian medical schools reported including some PA training in their medical curriculum. Key topics, such as the national strength recommendations, however, were not taught by most schools. Given the importance of PA for the prevention and treatment of numerous mental and physical health outcomes, it is unlikely that the attention it currently receives adequately prepares medical students to treat patients.

Background A growing body of evidence suggests that exercise training may have multiple beneficial effects in individuals with mental health or substance use disorders. Yet, relatively little knowledge exists regarding the benefits of exercise training to augment treatment for alcohol use disorders (AUDs). Purpose The purpose of this narrative review is to present a summary of the growing body of published literature supporting exercise training as a treatment strategy for individuals with AUDs. We will provide evidence on the myriad of ways in which exercise may exert a positive effect on AUD outcomes including stress, anxiety, impulsivity, and depression. Further, we will explore how these mechanisms share common neurobiological pathways. The role of exercise in enhancing the social environment and increasing individual self-efficacy to reduce excess and/or inappropriate alcohol consumption will also be discussed. Discussion We will conclude with a description of completed investigations involving exercise training and provide suggestions for next steps in this innovative field of study.

Excessive sedentary behavior is associated with negative health outcomes independent of physical activity. Objective estimates of time spent in sedentary behaviors are lacking among adults from diverse Hispanic/Latino backgrounds. The objective of this study was to describe accelerometer-assessed sedentary time in a large, representative sample of Hispanic/Latino adults living in the United States, and compare sedentary estimates by Hispanic/Latino background, sociodemographic characteristics and weight categories. This study utilized baseline data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) that included adults aged 18–74 years from four metropolitan areas (N = 16,415). Measured with the Actical accelerometer over 6 days, 76.9% (n = 12,631) of participants had > 10 h/day and > 3 days of data. Participants spent 11.9 h/day (SD 3.0), or 74% of their monitored time in sedentary behaviors. Adjusting for differences in wear time, adults of Mexican background were the least (11.6 h/day), whereas adults of Dominican background were the most (12.3 h/day), sedentary. Women were more sedentary than men, and older adults were more sedentary than younger adults. Household income was positively associated, whereas employment was negatively associated, with sedentary time. There were no differences in sedentary time by weight categories, marital status, or proxies of acculturation. To reduce sedentariness among these populations, future research should examine how the accumulation of various sedentary behaviors differs by background and region, and which sedentary behaviors are amenable to intervention., Graphical abstract, Highlights • We present accelerometer-assessed sedentary time in a representative sample of Hispanic/Latino adults living in the U.S. • We compare sedentary estimates by heritage and other socio-demographic variables such as education. • Adults of Mexican background were the least whereas adults of Dominican background were the most sedentary.

Background There are socioeconomic factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents’ food choices and feeding practices. Objective To identify the behavioral, environmental, and cognitive factors that influence food choices and feeding behaviors of Hispanic mothers of children ages 0-5 years. Study Design, Settings, Participants Snowball sampling was used to recruit participants. Participants (n = 30) were included in the study if they were over 18, and self-identified as Hispanic/Latina and a mother of a child between the ages of 0-5 years. Semi-structured interviews were conducted in either English or Spanish and were audio recorded and transcribed verbatim. Measurable Outcome/Analysis Each interview consisted of a brief survey and open-ended questions based on Social Cognitive Theory (SCT) constructs. The questions centered on pediatric guidelines for healthy eating. A thematic analysis using a combined deductive and inductive approach is currently being used to analyze transcriptions. Results Emerging themes include challenges, attitudes, and strategies for both breastfeeding and introducing solid foods. Mothers had especially strong attitudes towards breastfeeding and expressed the importance of it but conversely described the multitudes of problems they experienced. Mothers described issues feeding their older children due to taste preferences and the methods they used to encourage eating, including bribing or tricking the child by hiding nutritious foods in recipes. Participants also described numerous sources of influence that shaped their feeding choices, the most common being other moms, healthcare providers, their culture, and the internet. Conclusion Hispanic mothers are actively seeking information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity. Funding None.

The purpose of the present study was to verify the correlation between static balance and functional autonomy in elderly women. The sample was a random selection of 32 sedentary elderly women (mean age = 67.47 � 7.37 years, body mass index = BMI = 27.30 � 5.07 kg/m 2 ), who live in the city of Teresina in the state of Piaui´, Brazil. Static balance was analyzed by stabilometric assessment using an electronic baropodometer which measured the average of the amplitude of postural oscillations in the right (RLD) and left (LLD) lateral displacements, anterior (AD) and posterior (PD) displacements, and in the elliptical area (EA) formed by the body's center of gravity. Functional autonomy was evaluated by a battery of tests from the LADEG protocol which is composed of: a 10 m walk (10 mW), getting up from a seated position (GSP), getting up from the prone position (GPP), getting up from a chair and movement around the house (GCMH), and putting on and taking off a shirt (PTS). The Spearman's correlation coefficient (r) indicated a positive and significant correlation between GPP and LLD (r = 0.382; p = 0.031), GPP and PD (r = 0.398; p = 0.024) and GPP and EA (r = 0.368; p = 0.038). These results show that sedentary elderly women who spent the greatest amount of time performing the GPP test achieved the largest mean amplitude of displacement leading to greater levels of instability.