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Objective: This paper examines the relationship between body mass index (BMI) and cardiorespiratory fitness (CRF) using a multivariate multilevel approach and investigates the links between individual and school-related correlates with children's BMI and CRF., Methods: This cross-sectional sample included 1014 children (6-10 years) from 25 Portuguese primary schools. BMI was calculated, and CRF was assessed with the PACER test. Fundamental movement skills (FMS) included five object control tasks. Moderate-to-vigorous physical activity (MVPA), sleep, and sedentary time were assessed with the ActiGraph wGT3X-BT accelerometer. Socioeconomic status (SES) and school variables were also obtained. A multivariate multilevel model was used, and alpha was set at 5%., Results: BMI and CRF systematically increased with age. Most of the joint variance (94.4%) was explained at the child level, and BMI and CRF were correlated at this level (ρ = -.37). More active children demonstrated higher CRF levels and had lower BMI levels; sedentary and sleep time were not significantly associated with BMI or CRF. FMS were positively associated with CRF but were not significantly associated with BMI. Children at higher SES were more fit and had lower BMI than their peers of lower SES. Finally, school-level variables were not significantly related to BMI and CRF., Conclusion: BMI and CRF had a low but statistically significant negative correlation in this sample of children. Most of the variation in BMI and CRF was explained by child-level characteristics., (© 2024 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.)

Objective: The aim was to (1) estimate the relationship between physical fitness (PF) and object control fundamental movement skills (FMS), (2) identify child characteristics that relate with PF and FMS, and (3) examine associations between the school environment, PF, and FMS., Methods: The sample included 1014 Portuguese children aged 6-10 years from the REACT project. PF was assessed via running speed, shuttle run, standing long jump, handgrip, and the PACER test. Object control FMS were assessed with stationary dribble, kick, catch, overhand throw, and underhand roll. Test performances were transformed into z-scores, and their sum was expressed as overall PF and FMS. Child-level variables included body mass index (BMI) z-scores, accelerometer-measured sedentary time and moderate-to-vigorous physical activity, and socioeconomic status (SES). School size, physical education classes, practice areas, and equipment were also assessed., Results: Approximately, 90% of the variance in object control PF and FMS was at the child level, and 10% at the school level. The correlation between PF and object control FMS was .62, which declined to .43 with the inclusion of covariates. Older, more active, and higher SES children had higher object control PF and FMS, and boys outperformed girls. BMI was negatively associated with PF but not with object control FMS. Sedentary time and number of physical education classes were not significant predictors. Most school predictors did not jointly associate with PF and object control FMS., Conclusion: PF and object control FMS z-scores were moderately related. Not all child characteristics were associated with both PF and object control FMS, and their effect sizes were different. School characteristics only explained 10% of the total variation in PF and object control FMS., (© 2024 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.)

Aims To determine the association between participation in a brief introductory didactic diabetes education programme and change in HbA1c among individuals with newly diagnosed diabetes. Methods We identified a population-based cohort of adults newly diagnosed with diabetes between October 2005 and June 2008 in Calgary, Canada, and conducted a retrospective cohort study by linking administrative and laboratory data with programme attendance data. We matched individuals who attended the programme within the first 6 months after diagnosis with those who did not attend, based on their propensity scores. We measured the change in HbA1c between time of diagnosis and 6-18 months later to determine the association between programme participation and change in HbA1c. Results HbA1c was measured at baseline and follow-up for 7793 individuals, including 803 programme participants. After propensity score matching, programme participation was associated with a significantly greater adjusted mean reduction in HbA1c between baseline and follow-up of 3.3 mmol/mol (95% CI 2.2-4.3) or 0.30% (95% CI 0.20-0.39). There was a significant interaction between baseline HbA1c and programme participation-the difference in adjusted mean reduction in HbA1c associated with programme participation ranged from 2.7 mmol/mol (0.25%) at baseline HbA1c of 53 mmol/mol (7%) to 6.2 mmol/mol (0.56%) at baseline HbA1c of 97 mmol/mol (11%). Conclusion Despite its brevity, participation in a diabetes education programme was associated with an additional reduction in HbA1c in newly diagnosed people that was comparable with that reported in trials of programmes targeted at those with prevalent diabetes. [ABSTRACT FROM AUTHOR]

This report presents the results of a small workgroup convened by the American Association of Dental Schools to examine experiences related to postdoctoral general dentistry programs linked with managed care systems and clinical settings. The workgroup was a component of an Association effort to identify and promote innovative and nontraditional methods by which the number of postdoctoral general dentistry (PGD) positions can be increased to meet current demand for PGD education. The participants identified factors and conditions that they believed to be critical to the planning, development, and conduct of PGD programs with substantial linkages with managed care systems and settings. The information should be helpful to others as they consider opportunities to establish PGD programs or increase their number of PGD training positions. [ABSTRACT FROM AUTHOR]

Mechanically, the brain is characterized by both solid and fluid properties. The resulting unique material behavior fosters proliferation, differentiation, and repair of cellular and vascular networks, and optimally protects them from damaging shear forces. Magnetic resonance elastography (MRE) is a noninvasive imaging technique that maps the mechanical properties of the brain in vivo. MRE studies have shown that abnormal processes such as neuronal degeneration, demyelination, inflammation, and vascular leakage lead to tissue softening. In contrast, neuronal proliferation, cellular network formation, and higher vascular pressure result in brain stiffening. In addition, brain viscosity has been reported to change with normal blood perfusion variability and brain maturation as well as disease conditions such as tumor invasion. In this article, the contributions of the neuronal, glial, extracellular, and vascular networks are discussed to the coarse‐grained parameters determined by MRE. This reductionist multi‐network model of brain mechanics helps to explain many MRE observations in terms of microanatomical changes and suggests that cerebral viscoelasticity is a suitable imaging marker for brain disease. [ABSTRACT FROM AUTHOR]

Objective: This study uses longitudinal data from school children in Dunedin, New Zealand, to evaluate impacts of COVID-19 lockdown measures on changes in body mass (BMI, kg/m 2 ). Impacts are assessed using two non-mutually exclusive hypotheses. The "structured days" hypothesis holds that children tend to alter sleep patterns, reduce activity and increase snacking when not in structured environments. The bidirectional hypothesis proposes that over-weight or obese children are predisposed to further gains in unstructured settings., Methods: Juveniles and adolescents (n = 95, 60% female) were recruited from Dunedin schools. Repeated measures analyses assessed variation in intra-individual change in BMI during four periods: P1 (before summer break), P2 (during summer break), P3 (during the COVID-19 lockdown), and P4 (after the lockdown ended). The model also examined if these changes were influenced by participants' sex or body size early in the first period assessed using log-transformed BMI, log-transformed weight, height, or lower leg length., Results: Repeated measures analyses of per month gains in BMI (kg/m 2 ) during the four periods revealed consistent period (p ≤ .001), period by sex (p ≤ .010), and period by body size (p ≤ .001) interactions across all four body size proxies. Both sexes experienced the greatest gains during the lockdown (P3), but differed in response to their summer break (P2)., Conclusion: Results are mostly consistent with the "structured days" hypothesis, but challenge the bidirectional hypothesis as defined. Further research better characterizing risks of gains in adiposity are needed., (© 2023 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.)

Objectives: Studies have shown that children develop a higher body weight during summer months. This has been demonstrated repeatedly using the body mass index (BMI), but the effect of season on other weight-related anthropometric measurements is still unclear., Methods: Measurements of height, weight, waist circumference (WC), triceps, and subscapular skinfolds (TSF and SSF), collected from September till May in a cross-sectional sample of 4-16-year-old children and adolescents (n = 4525) from the Bergen Growth Study 1 (BGS1). Differences in z-score by season were tested with linear models adjusted for age group and separately for sex. Overall differences were tested with a one-way between-group analysis of variance., Results: The girls had higher BMIz (+0.12, p = .03) and WCz (+0.18, p = .002) in fall compared with spring. TSFz (-0.19, p < .001) and SSFz (-0.18, p < .001) were lower in winter in girls, and in boys both in fall (TSFz -0.10, p = .046; SSFz - 0.16, p < .001), and winter (TSFz -0.15, p = .004; SSFz -0.14, p = .003), when compared with spring., Conclusions: Seasonal variation was detected for all anthropometric measures, but differences in the direction of the effect between measures of global (BMI), central (WC) or subcutaneous (SF) adiposity suggest a more complex mechanism that needs further exploration., (© 2024 The Authors. American Journal of Human Biology published by Wiley Periodicals LLC.)

Using psychological network analysis, this study explored the heterogeneity of the network structure between extracurricular time‐use and delinquency using a nationally representative longitudinal survey of at‐school students in China (N = 10,279, 47.3% female, average age 13.6, 91.2% Han ethnicity). The results are threefold: First, time stimulation of activities occurs on weekdays, while time displacement and stimulation occur on weekends. Second, delinquent behaviors are positively correlated, forming a problem behavior syndrome. Smoking or drinking is the central delinquent behavior. Third, negative consequences of specific time‐use behaviors are more likely to occur on weekends than on weekdays, and time‐use behavior may function differently on weekdays versus weekends. Among them, going to coffeenets or game‐centers serves as the bridge with the highest potential of triggering delinquency. [ABSTRACT FROM AUTHOR]

GATA2 and ZNF148 have both been mapped to chromosome 3q. Pathogenic variants in GATA2 have been associated with immunodeficiency and high risk for myelodysplasia, acute myeloid leukemia, and chronic myelomonocytic leukemia. Gain-of-function variants in ZNF148 have previously been suggested as a mechanism for agenesis of the corpus callosum (ACC). Here, we report a novel 10.4 Mb interstitial deletion on 3q12.33q22.1 including GATA2 and ZNF148 in a child with developmental delay, agenesis of the corpus callosum, and vertebral segmentation defects. With this diagnosis, we were able to suggest preemptive referrals to hematology/oncology and allergy/immunology for close monitoring of early myelodysplasia. We also propose a possible link between ZNF148 loss of function variants and ACC., (© 2024 The Authors. American Journal of Medical Genetics Part A published by Wiley Periodicals LLC.)

The purpose of this descriptive cross-sectional study is to describe the amount and intensity of physical activity (PA) measured by accelerometry among adolescents participating in organized sports (SCP) and age-matched non-participating peers (NP). SCPs (332) and NPs (139) wore an accelerometer on the hip for seven days. PA was reported using the 1-min exponential moving average. The current moderate-to-vigorous physical activity (MVPA) recommendation of at least an average of 60 min of MVPA daily was reached by 85% of SCPs and 45% of NPs (p <.001). During training days, the MVPA times among SCPs ranged from 153 ± 39 min in males and 109 ± 35 min in females participating in basketball to 113 ± 33 min in males participating in floorball and 83 ± 32 min in females participating in gymnastics. Sports participation contributes rather strongly to the accumulation of the recommended amount of MVPA. During training days, SCPs, except for females participating in gymnastics, accumulated more MVPA than NPs. During non-training days, only males participating in cross-country skiing and females participating in track and field accumulated more MVPA than NPs. HIGHLIGHTS PA of Finnish adolescents participating in nine different organized sports and age-matched non-participating peers was measured by accelerometry for one week and the results are reported using the 1-min exponential moving average. Adolescents participating in many organized sports accumulated more PA than non-participants; this was observed in meeting the PA recommendations, total amount of PA at different intensities, and step count. The current PA recommendation of at least an average of 60 min of MVPA per day was reached by 85% of SCPs and 45% of non-participating peers. Vigorous physical activity at least three times per week was incorporated by 96% of SCPs and 81% of NPs. During training days, males participating in soccer, basketball, and cross-country skiing spent more time in MVPA than females participating in the same sports. During non-training days, the time spent in MVPA was similar between males and females participating in sports clubs. [ABSTRACT FROM AUTHOR]

In the United States, the Coronavirus Disease 2019 (COVID‐19) pandemic necessitated nationwide closures of kindergarten through twelfth grade (K‐12) schools. Stay‐at‐home orders and social distancing mandates were also implemented to mitigate the spread of COVID‐19. The purpose of this systematic review was to synthesize the existing literature on how COVID‐19 impacted K‐12 students' eating patterns, physical activity, and sleep in the United States. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, a literature search was conducted between October and December 2021. Inclusion criteria were studies focused on COVID‐19 and eating patterns, physical activity, and sleep in students enrolled in K‐12 schools since March 2020. International studies were excluded. Mixed findings were observed for eating patterns whereby the consumption of unhealthful savory and sweet items and healthful snacks (e.g., fruit and vegetables) increased. Reductions in physical activity and disrupted sleep routines were also observed. Heterogeneity in methodological procedures may limit the generalizability of these findings. In the United States, preliminary data suggest that select health‐promoting behaviors were negatively impacted by the COVID‐19 pandemic. Given that prolonged unhealthful eating patterns, physical inactivity, and poor sleep contribute to chronic disease risk, initiatives that increase health‐promoting behaviors are warranted. Highlights: Some health‐promoting behaviors were negatively impacted by COVID‐19.Unhealthful savory and sweet items and healthful snacks increased.Reductions in physical activity and disrupted sleep routines were observed. [ABSTRACT FROM AUTHOR]

It is worth paying attention to the level of worry and fear of students during the normalization of the epidemic. We conducted the cross‐sectional study that included 182,991 high school students using an online survey to assess worry and fear levels and its influencing factors in three cities in Henan Province, China, from May 21 to May 27, 2021. Worry and fear levels were measured using a five‐item Likert‐type scale. Multinomial logistic regression was used to analyze the risk factors. Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID‐19) epidemic, and about 41.44% of students reported being high fear about the COVID‐19 epidemic. In addition, compared with female, male had lower odds of suffering from a high worry, and compared with senior high school students, junior high school students were more likely to suffer from a high worry. Students lived in rural had highest odds increased likelihood of high worry. Similar results in fear levels. During the normalization period of the COVID‐19 epidemic, many students have high levels of worry and fear. This study has implications for potential influencers of worry and fear levels in follow‐up work. Practitioner Points: Approximately 65.42% of students reported being high worry about the coronavirus disease 2019 (COVID‐19) epidemic, and about 41.44% of students reported being high fear about the COVID‐19 epidemic.Students lived in rural had highest odds increased likelihood of high level of worry and fear.Compared with senior high school students, junior high school students were more likely to suffer from a high worry. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends that children should engage in an average of 60 min of moderate-to-vigorous physical activity (MVPA) per day and should perform activities that strengthen muscle and bone at least 3 days a week. Public health professionals as well as pediatric researchers have identified schools as a strategic place to promote muscular strength development. Thus, the aim of this systematic review and meta-analysis was to investigate the efficacy of school-based exercise interventions for improving muscular fitness (MF) in children. Searches were conducted in three databases. Eligible criteria were randomized and non-randomized controlled trials evaluating the effects of school-based exercise interventions on MF (i.e. muscular strength, muscular power, and local muscular endurance) in children under 13 years of age. Risk of bias by the National Institutes of Health tool was appraised, and pooled effect sizes (Hedges'g) were calculated using random-effects inverse-variance analyses. Seventeen studies enrolling 1653 children (28% girls were analyzed). Exercise interventions, mostly combined interventions targeting selected domains of MF, were associated with significant moderate increases in local muscular endurance (g = 0.65 95% CI, 0.13 to 1.17, p = 0.020; I2 = 85.0%) and muscular strength and muscular power (g = 0.33 95% CI, 0.16 to 0.51, p = 0.001; I2 = 59.3%), with higher effects using interventions with ≥3 sessions per week. Our findings indicate that school-based exercise that includes strength building exercises may improve MF in children and, consequently, prepare modern day youth for the demands of exercise and sport activities. School-based muscle and bone strengthening exercises performed at least 3 days per week may serve to support the development of muscular fitness in girls and boys Integrative interventions that include a variety of strength and conditioning activities seem to be a promising strategy to promote muscular fitness in school environment Future research should standardize assessment methods for use with children in the school context and should include interventions with girls It is of interest to a growing number of health care providers, fitness professionals and physical education teachers to encourage participation in well-designed muscle and bone strengthening exercises. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta‐analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross‐sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit‐transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics. [ABSTRACT FROM AUTHOR]

Summary: The COVID‐19 pandemic had a major impact on people of all ages. Adolescents' exposure to online learning is linked to excessive screen time on digital devices, which leads to poor sleep quality. This study aimed to investigate the association between screen time on different electronic devices and sleep quality among adolescents in the United Arab Emirates. This study was based on a self‐reported questionnaire, which was administered online to school‐aged adolescents (aged 12–19 years). The multicomponent questionnaire collected information on sociodemographic characteristics, sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and screen time (minutes) on TV, TV‐connected devices, laptops, smartphones, and tablets on weekdays, weeknight, and weekends using the Screen Time Questionnaire (STQ). Univariate and multivariate analyses were used to identify factors correlated with poor sleep quality. A total of 1720 adolescents were recruited from private and public schools (mean age 14.6 ± 1.97 years). The mean PSQI score was 8.09 ± 3.37, and 74.3% of participants reported poor sleep (cutoff score >5). Mean scores were highest for the sleep latency (1.85 ± 0.97) and sleep disturbance (1.56 ± 0.62) domains. The highest STQ score was observed for smartphones, with a median screen time of 420 min on weekdays and 300 min on weekends. Screen time related to smartphones on weekends (p = 0.003) and increased screen time in bed (p < 0.001) were significantly associated with poor sleep. Our results confirmed the correlation between sleep and screen time in adolescents. The results may inform educational polices that target screen time and sleep among adolescents during and after the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to explore fathers' adjustment and father–child relationships during the first peak of the coronavirus disease 2019 (COVID‐19) outbreak (April 2020). More particularly, the study analysed paternal perceptions of changes concerning familial economic conditions and children's psychological difficulties (viz., emotional problems and hyperactivity) during the lockdown produced by the current pandemic. Furthermore, we investigated the following correlates of fathers' parenting stress: socio‐demographic condition, paternal individual stress, anxiety, depression and changes in the father–child relationship during the outbreak. Methods: A total of 102 fathers (mean age = 41.60 years; SD = 11.54) with minor children were recruited through an online survey and reported data about their socio‐economic condition, anxiety, and depressive levels, parenting stress, offspring's adjustment, and changes in their relationship with their children. Results: As for the economic conditions, participants were equally distributed between those who did not perceive changes and those who perceived a worsening. With regard to changes in the child's psychological difficulties, results showed that levels of children's emotional problems and inattention/hyperactivity had significantly increased during the lockdown period. A multiple linear regression analysis highlighted that the principal predictor of paternal parenting stress was living in the regions most affected by the COVID‐19 pandemic, followed by high levels of paternal anxiety symptomatology and high levels of worsening of the relationship with the child during the pandemic. Conclusions: Overall, our study suggests to consider the effects of COVID‐19 on fathers as well, as they have been rather overlooked by previous research that has mainly focused on mothers, and to plan specific interventions able to also take them into account. [ABSTRACT FROM AUTHOR]

Background: As the COVID‐19 pandemic emerged in the United States in the spring and summer of 2020, many organizations serving children and youth immediately faced significant operational and healthcare challenges. Centers for Disease Control and Prevention guidance for the safe operation of youth programmes emphasized the importance of non‐pharmaceutical interventions (NPIs), yet few studies have examined NPI usage in summer programmes such as camps. Method: This sequential explanatory mixed‐methods study explored the utilization of NPIs among camp healthcare providers who completed an online questionnaire followed by one‐on‐one interviews. Results: The study findings indicated that camps consistently used a core set of NPIs to maintain and protect the health of camp participants, including screening, cohorting, hand hygiene, sanitizing practices, ventilation and physical distancing. The study findings further identified specific practices of camp healthcare providers that made NPI utilization possible, as exemplified in the emergent themes of wellness promotion; health awareness and modelling; and camp health service mobilization. Conclusion: NPI usage benchmarks from this study, as well as effective practices for NPI utilization, can inform the application of NPIs and other health‐promoting practices across diverse formal and informal youth settings. [ABSTRACT FROM AUTHOR]

School mental health (SMH) practitioners and physical education (PE) teachers have been identified as key stakeholders in supporting the integration of social‐emotional learning (SEL) and physical activity within schools. Authors of this study developed and administered a survey measure to delineate SMH practitioners' (i.e., school psychologists, school counselors; n = 219) and PE teachers' (n = 138) perspectives of social‐emotional learning (SEL) and PA, and aligning these practices within their work. There were two forms of the measure developed, with one for each stakeholder group. The analytic procedure involved Exploratory Factor Analysis (EFA), descriptive statistics, and analysis of mean differences using independent sample T tests at the factor level. The SMH form brought forth three factors (linking practices, need for training, and current practices), and the PE form brought forth two factors (linking practices and need for training). Survey results suggest that both SMH practitioners and PE teachers agree that there is inherent value in youths' engagement in both SEL and PA and would like increased training to incorporate such practices within their unique roles. SMH professionals rate on average that they "neither agree nor disagree" that they integrate PA within their work. Implications are discussed for both research and practice. Practitioner points: School mental health practitioners and physical education teachers agree that there is value in youths' engagement in both social‐emotional learning (SEL) and physical activity (PA).School mental health practitioners and physical education teachers would value increased training to support the integration of SEL and PA.Practitioners and researchers may find benefit in utilizing this measure to assess school mental health practitioners' and physical education teachers' perspectives on SEL and PA. [ABSTRACT FROM AUTHOR]

The relevance between circulating metabolites and vascular events remains controversial and comprehensive studies are lacking. We sought to investigate the prospective associations of plasma metabolomics with risks of incident stroke, ischemic stroke (IS), hemorrhagic stroke (HS), and myocardial infarction (MI). Within the UK Biobank cohort, 249 circulating metabolites were measured in 90 438 participants without baseline vascular diseases. Cox proportional hazards regressions were applied to estimate adjusted hazard ratios (HRs) for per 1 standard deviation increment in metabolites. The least absolute shrinkage and selection operator algorithm was used for selecting metabolite subsets. During a median of 9.0 years of follow‐up, we documented 833 incident stroke and 1256 MI cases. Lipid constituents, comprising cholesterol, cholesteryl esters, free cholesterol, phospholipids, and total lipids, in very low‐ (VLDL), intermediate‐ (IDL), and low‐density lipoprotein (LDL) particles were positively associated with MI risk (HR = 1.12 to 1.36; 95% CI = 1.06 to 1.44), while in high‐density lipoprotein (HDL) particles showed inverse associations (HR = 0.68 to 0.81; 95% CI = 0.63 to 0.87). Similar association pattern with MI was also observed for VLDL, IDL, LDL, and HDL particles themselves. In contrast, triglycerides within all lipoproteins, including most HDL particles, were positively associated with MI risk (HR = 1.14 to 1.28; 95% CI = 1.08 to 1.35) and, to a slightly lesser extent, with stroke and IS. Unsaturation of fatty acids and albumin were inversely associated with risks of stroke, IS, and MI. In contrast, the linear association for HS is absent. When combining multiple metabolites, the metabolite risk score captured a drastically elevated risk of all vascular events, about twice that of any single metabolite. Taken together, circulating metabolites showed remarkably widespread associations with incident MI, but substantially weakened associations with risks of stroke and its subtypes. Exhaustive metabolomics profiling may shed light on vascular risk prediction and, in turn, guide pertinent strategies of intervention and treatment. [ABSTRACT FROM AUTHOR]

To date, few data on how the COVID-19 pandemic and restrictions affected children's physical activity in Europe have been published. This study examined the prevalence and correlates of physical activity and screen time from a large sample of European children during the COVID-19 pandemic to inform strategies and provide adequate mitigation measures. An online survey was conducted using convenience sampling from 15 May to 22 June, 2020. Parents were eligible if they resided in one of the survey countries and their children aged 6–18 years. 8395 children were included (median age [IQR], 13 [10–15] years; 47% boys; 57.6% urban residents; 15.5% in self-isolation). Approximately two-thirds followed structured routines (66.4% [95%CI, 65.4–67.4]), and more than half were active during online P.E. (56.6% [95%CI, 55.5–57.6]). 19.0% (95%CI, 18.2–19.9) met the WHO Global physical activity recommendation. Total screen time in excess of 2 h/day was highly prevalent (weekdays: 69.5% [95%CI, 68.5–70.5]; weekend: 63.8% [95%CI, 62.7–64.8]). Playing outdoors more than 2 h/day, following a daily routine and being active in online P.E. increased the odds of healthy levels of physical activity and screen time, particularly in mildly affected countries. In severely affected countries, online P.E. contributed most to meet screen time recommendation, whereas outdoor play was most important for adequate physical activity. Promoting safe and responsible outdoor activities, safeguarding P.E. lessons during distance learning and setting pre-planned, consistent daily routines are important in helping children maintain healthy active lifestyle in pandemic situation. These factors should be prioritised by policymakers, schools and parents. To our knowledge, our data provide the first multi-national estimates on physical activity and total screen time in European children roughly two months after COVID-19 was declared a global pandemic. Only 1 in 5 children met the WHO Global physical activity recommendations. Under pandemic conditions, parents should set pre-planned, consistent daily routines and integrate at least 2-hours outdoor activities into the daily schedule, preferable on each day. Schools should make P.E. lessons a priority. Decision makers should mandate online P.E. be delivered by schools during distance learning. Closing outdoor facilities for PA should be considered only as the last resort during lockdowns. [ABSTRACT FROM AUTHOR]

Objectives: Further evidence on how the Great Recession was associated with childhood obesity is needed, particularly when the world is facing a new and severe economic downturn caused by the COVID‐19 pandemic. This study explores: (1) the direct association of the 2008's economic crisis with eating patterns and body mass index (BMI), among children, independently of their socioeconomic status (SES), and (2) the indirect association between the crisis and children's BMI, by using eating patterns as mediators. Methods: A sample of children (n = 8472, mean age: 7.17 years old, 50.8% male) was recruited in schools from the cities of Porto, Coimbra and Lisbon, Portugal. Children's height and weight were objectively measured; BMI was calculated. Other data were collected by a parental questionnaire. A structural equation modeling studied the associations between the economic crisis impact, eating patterns, and BMI; model was adjusted for SES. Results: Children in families that reported a greater impact of the economic crisis showed higher consumption of unhealthy food items and lower consumption of healthy foods, regardless of SES. Indirectly, children whose parents scored higher in the economic crisis impact had higher BMI mediated by a higher consumption of cakes/chocolates and lower intake of vegetables/salads. Conclusions: The economic crisis was associated with higher BMI and unhealthy eating patterns. Efforts to promote healthy diets and weight are needed at a population level rather than for specific social classes, particularly in the face of a new economic crisis caused by the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

This study explored how children (9–13 years old) coped with the uncertain situation during the first Covid‐19 confinement period (Spring 2020) and whether media helped them handle the situation. Based on a survey among 667 West‐European (Belgian) children, we concluded that children used various strategies to cope with the situation. Seeking social support via social media and searching for distraction was applied by most children. Creating a comforting atmosphere was used by many, although not evaluated as an effective strategy. Whereas older children searched for Covid‐19‐related information, younger children indicated to avoid news media to regulate their emotions. The Covid‐19 anxiety of parents in the confinement period impacted upon the general level of concerns of their children. The results offer policy recommendations on how to support children in handling the tensive Covid‐19 situation, especially during lockdown periods. [ABSTRACT FROM AUTHOR]

Objectives: Urban–rural comparisons between those who maintain traditional lifestyles such as pastoralist Maasai children, and those who live in cities such as Nairobi, provide implications on how urbanization is associated with children's physical activity (PA) and sedentary behavior (SB) patterns. This study compares PA and SB volumes and patterns across different segments of the week among children in Maasai village and Nairobi city in Kenya. Method: A total of 261 children (11.4 ± 1.3 years) from Maasai (n = 118) and Nairobi (n = 143) participated in this cross‐sectional study. Moderate‐ to vigorous‐intensity PA (MVPA) and SB on weekdays (before, during, and after school) and weekends (morning, afternoon, and evening) were calculated using accelerometers (ActiGraph). Screen time and sleep duration were assessed using questionnaires. Results: Maasai children were more physically active than Nairobi children with MVPA (min/day) of 166.6 and 81.4 for Maasai and Nairobi boys and 116.4 and 77.4 for Maasai and Nairobi girls, respectively. Our week segments analyses suggested that Maasai children were more active both in and out of school than Nairobi children. Additionally, Nairobi children spent more time watching television and playing computer games than Maasai children. There was no significant difference in sleep duration between Maasai and Nairobi children. Conclusion: Our findings suggest that urbanization is negatively associated with activity patterns both in and out of school in Kenyan children. This is concerning given that Kenya is currently undergoing rapid urbanization, which may lead to further reductions in PA among Kenyan children. [ABSTRACT FROM AUTHOR]

Background and Objective: Motor performance during childhood and adolescence is recognized as a relevant determinant of present and future health, but its effects on back pain (BP) remain unclear. In this systematic review, we aimed to identify the association between motor performance and BP in children and adolescents. Databases and Data Treatment: A literature search was performed in the MEDLINE, Scopus, Embase, SPORTDiscus and CINAHL databases. We included cross‐sectional, cohort, case‐control and controlled clinical trials (data from control groups). The inclusion criteria were as follows: (a) participants aged 6–19 years; (b) assessment motor performance components; (c) assessment of BP and (d) reported measures of association. The risk of bias was assessed by the Downs and Black instrument and the quality of evidence by the grading of recommendations, assessment, development and evaluation (GRADE). Results: A total of 2360 articles were identified, 25 of which were included in our systematic review. Of the 25 studies, 19 were evaluated as having a low risk of bias. GRADE indicated that 20 studies presented low or very low quality. Most of the studies evaluated flexibility (n = 16), muscle endurance (n = 18) and muscle strength (n = 9). Aerobic capacity, balance and speed were also examined in some studies (n < 5). Overall, motor performance (flexibility, muscle endurance, muscle strength, aerobic capacity, balance and speed) was not associated with BP. Most of the results were inconsistent because of the lack of studies, risk of bias and low quality of evidence. Only trunk extensor muscle endurance was associated with decreased BP with moderate quality of the supporting evidence. Prospective studies with a low risk of bias are warranted to further clarify this relationship in childhood and adolescence and findings may support more targeted and effective health promotion interventions. Significance: This systematic review shows that motor performance (flexibility, muscle endurance, muscle strength, aerobic capacity, balance and speed) was not associated with BP in children and adolescents. Most of the results were inconsistent because of the lack of studies, risk of bias and low quality of evidence. Only trunk extensor muscle endurance was associated with decreased BP with moderate quality of supporting evidence. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to examine the effects of a mobile web‐based self‐management program on menopausal symptoms, self‐efficacy and quality of life in breast cancer patients with chemotherapy‐induced amenorrhoea. Design: A quasi‐experimental pretest–posttest design with repeated measures. Methods: The study was carried out at a university medical centre between October 2017 and September 2018. The intervention group received a 12‐week mobile web‐based self‐management program including education and coaching/support. Multiple instruments were used to measure menopausal symptoms, self‐efficacy, and quality of life at pre‐test, after the intervention (post‐test), and 3 months post‐intervention (follow‐up test). Repeated measure ANOVA was used to analyse the data. Results: In the intervention group, menopausal symptoms were significantly improved compared to the control group at the follow‐up test. In the follow‐up test, the intervention group's self‐efficacy and quality of life were significantly improved, whereas that of the control group was decreased. [ABSTRACT FROM AUTHOR]

Summary: Consumer "Smartbands" can collect physiological parameters, such as heart rate (HR), continuously across the sleep–wake cycle. Nevertheless, the quality of HR data detected by such devices and their place in the research and clinical field is debatable, as they are rarely rigorously validated. The objective of the present study was to investigate the reliability of pulse photoplethysmographic detection by the Fitbit ChargeHR™ (FBCHR, Fitbit Inc.) in a natural setting of continuous recording across vigilance states. To fulfil this aim, concurrent portable polysomnographic (pPSG) and the Fitbit's photoplethysmographic data were collected from a group of 25 healthy young adults, for ≥12 hr. The pPSG‐derived HR was automatically computed and visually verified for each 1‐min epoch, while the FBCHR HR measurements were downloaded from the application programming interface provided by the manufacturer. The FBCHR was generally accurate in estimating the HR, with a mean (SD) difference of −0.66 (0.04) beats/min (bpm) versus the pPSG‐derived HR reference, and an overall Pearson's correlation coefficient (r) of 0.93 (average per participant r = 0.85 ± 0.11), regardless of vigilance state. The correlation coefficients were larger during all sleep phases (rapid eye movement, r = 0.9662; N1, r = 0.9918; N2, r = 0.9793; N3, r = 0.9849) than in wakefulness (r = 0.8432). Moreover, the correlation coefficient was lower for HRs of >100 bpm (r = 0.374) than for HRs of <100 bpm (r = 0.84). Consistently, Bland–Altman analysis supports the overall higher accuracy in the detection of HR during sleep. The relatively high accuracy of FBCHR pulse rate detection during sleep makes this device suitable for sleep‐related research applications in healthy participants, under free‐living conditions. [ABSTRACT FROM AUTHOR]

Italy was the first Western country affected by the pandemic. The school closures that followed lasted for a full school semester, including final exams. Italy is already known as a country with a high degree of educational inequality, where reproduction of social disadvantages by social origins is prominent. In such a situation, we hypothesise that a prolonged lockdown and the consequent reliance on remote education have played an important role in exacerbating existing inequalities. Families were forced to take on the full responsibility of educating their children, which has reinforced the role of household resources. The analysis presented in this article draws on results from an online survey of the effects of school closures on educational practices, the analysis focused on responses from parents of primary school students. The survey was carried out in Milan in June 2020 and was disseminated through institutional and informal channels after two months of school closure in Italy. Results were re‐balanced to represent different social classes. The survey explored the relationships between economic and social inequalities on the one hand, and school activity experienced at home during the lockdown on the other. It also explored the involvement of pupils and their parents in school activities. We aimed to capture what educational and organisational resources families were able to mobilise in this situation, and to what extent these are unequally distributed. Our results contribute to an understanding of the impact of family resources on educational chances, identifying resources and how they are distributed through the population. Our findings confirm that the pandemic has exacerbated already existing inequalities. [ABSTRACT FROM AUTHOR]

Background: The long‐term closing of schools and home‐quarantine during the COVID‐19 pandemic cause negative effects on the physical and mental health of young people. Studies evaluating the mental health of adolescents during the pandemic are limited in the literature. Aim: In our study, it was aimed to determine the results of home‐quarantine measures taken for adolescents during the pandemic and the affecting factors. Method: This study was conducted as an online cross‐sectional self‐report questionnaire and included children aged between 12 and 18 years. The data were obtained from the children of volunteer families via Facebook family groups, and Google Forms questionnaires sent by the child psychiatry clinic to their smartphones. Sociodemographic form, State‐Trait anxiety scale, and UCLA loneliness survey were used as data collection tools. Results: We examined the data of 745 adolescents. The average age of the study group was 16.83 ± 1.66 years, and 69.5% were females. It was determined that 88.2% of the adolescents followed the developments in the COVID‐19 process and obtained most information from the television. State anxiety was related to "Former psychiatric referral" by 4.39‐fold, "Having a COVID positive patient in the family or your surroundings" by 3.81‐fold, and "The most common medium for obtaining COVID‐related information" by 2.41‐fold. Conclusions: Closure of schools and home‐quarantine during pandemic causes anxiety and loneliness in young people. The identification of risky groups helps to properly support these individuals by various social connections, including healthcare professionals, families, and schools. [ABSTRACT FROM AUTHOR]

When hydrogels are designed for biological applications, the mechanical properties are carefully chosen to match their precise application. However, traditional methodologies of mechanical characterization (simple shear or compression/extension) commonly ignore the multiaxiality of in vivo deformations. A recent study highlights that biopolymers and tissue indeed show a complex response to combined uniaxial and shear strains. In this study a synthetic yet biomimetic fibrous hydrogel is used, which is based on polyisocyanides and forms a self-assembled network of branched semiflexible chains, similar in architecture networks of structural biopolymers like actin, collagen, and fibrin. Its synthetic nature allows to decouple key parameters of these networks and individually understand their impact on the mechanical response under multiaxial deformation. Experimentally, it is found that the persistence length is a key parameter of biological networks, which tunes softening of gels under compression: The stiffer the polymer, the more the network softens in compression. This study provides insights into tissue behavior that likely is only obtainable from synthetic model systems and is able to direct further the design of new synthetic biomimetic soft materials that are in high demand as tunable bio-free extracellular matrix materials. [ABSTRACT FROM AUTHOR]

This paper presents findings on physical education (PE) trainees' and teachers' attempts to design and implement authentic curricular experiences, within the constraints of a neoliberalist context. It involved adopting a principle‐based approach to promoting active lifestyles designed to align PE trainees' and teachers' health‐related philosophies and pedagogies. The promoting active lifestyles (PAL) project was framed by social cognitive theory and the social ecological model and adopted a qualitative explanatory case study approach. Participants were secondary school PE trainees and teachers involved in a University‐based Initial Teacher Education partnership in the East Midlands in England. The 32 participants were involved in professional development which included co‐constructing and implementing PAL principles in the schools in which they were employed or undertaking their placement. All participants viewed the PAL principles positively and were able to implement at least some of them. Participants experienced unanticipated benefits beyond increased physical activity such as improved pupil behaviour. Many participants described transformative and enduring changes to their health‐related philosophies and pedagogies. This low cost, flexible principle‐based approach to pedagogical change addresses calls for evidence‐based PE‐for‐health pedagogies and the development of possibilities that acknowledge the complexity of supporting physical educators to become more effective promoters of physical activity. [ABSTRACT FROM AUTHOR]

Objective: To present the adaptations to treatment protocols made in a child and adolescent eating disorders (ED) unit during the eight‐week confinement period mandated in response to the COVID‐19 pandemic and examine clinical and treatment variables in the outpatient, day hospital, and inpatient care programs. Method: Description of the implementation of a combined teletherapy program for outpatient and day‐hospital patients and the adaptations made to the inpatient protocol. Retrospective review of medical records and analysis of general and specific variables related to the pandemic and confinement. Results: We held 1,329 (73.10%) telehealth consultations and 489 (26.9%) face‐to‐face outpatient visits with 365 patients undergoing treatment in the outpatient clinic or day hospital. Twenty‐eight (7.67%) were initial evaluations. Twenty‐two patients were newly admitted and 68 ED‐related emergencies were attended. Almost half of the children and adolescents studied experienced reactivation of ED symptoms despite treatment, and severe patients (25%) presented self‐harm and suicide risk. Conclusions: The implementation of a combined teletherapy program has enabled continuity of care during confinement for children and adolescents with ED. Delivery of treatment to adolescents in the day hospital program posed the biggest challenge due to their greater degrees of severity and higher hospitalization rates. An adapted inpatient program should be maintained throughout confinement, as the need for hospitalization of children and adolescents with ED does not decrease with lockdown. [ABSTRACT FROM AUTHOR]

This systematic review of the literature aims to identify, analyze, and synthesize studies assessing the effectiveness of interventions stimulating prosocial behavior. It concentrates on helping behavior and covers experimental and quasi‐experimental research concerning interventions carried out in different settings. This review was performed in accordance with the PRISMA guidelines. Of the initial sample of 4,653 publications found in databases, 49 articles met our inclusion criteria and were classified as eligible for data extraction and narrative synthesis. The studies included in the review assessed 63 interventions, most of them targeted at children and adolescents. We distinguished three strategies stimulating prosocial behavior: behavioral, cognitive, and emotional. This review is informative for both researchers and practitioners. It provides researchers with methodological guidelines concerning how to conduct studies on the effectiveness of prosocial interventions, and it provides practitioners with guidelines on empirically tested strategies for stimulating prosocial helping behavior. [ABSTRACT FROM AUTHOR]

An unprecedented strategy for the synthesis of highly fluorescent chromeno[4,3‐b]pyrazolo[3,4‐d]pyridin‐4(3H)‐ones via a 1,3‐dipolar cycloaddition reaction/ring closure in the presence of NH4OAc/air oxidation in a one‐pot procedure is described. The molecular structures were characterized by IR spectrophotometry, mass spectrometry, NMR spectroscopy, and single‐crystal X‐ray analysis. Furthermore, the photophysical properties of synthesized compounds were studied by absorption and fluorescence spectroscopy. All of the compounds exhibited almost similar spectra due to their resembling molecular structures. Therefore, one of the synthesized coumarin‐based pyrazolopyridines was selected to evaluate its application as a live‐cell imaging agent by an inverted phase‐contrast microscope. The result reveals that synthesized chromeno[4,3‐b]pyrazolo[3,4‐d]pyridin‐4(3H)‐one has acceptable photostability, low cytotoxicity, satisfactory fluorescence efficiency (Φf: 0.53), and excellent capability to penetrate into the intracellular space. Accordingly, it can be rendered as a promising dye in fluorescence bioimaging. Chemoselectivity, simple and available starting materials, operational simplicity, and good yields are other outstanding advantages of this reaction. [ABSTRACT FROM AUTHOR]

The Step it UP! Game is an interdependent group reinforcement contingency based on the Good Behavior Game. We evaluated the effects of the Step it UP! Game on the number of steps taken by 3rd‐grade students during physical‐education (PE) classes at a local public elementary school. We divided the class into 2 teams and awarded a "Step it UP! Champ" badge to the members of the team with the highest mean step totals at the end of each game. We used a reversal design to compare the mean number of steps taken while playing the game and during regular PE classes. Overall, participants took more steps while playing the game than they did during class periods without the game. When given the opportunity to choose playing the Step it UP! Game or having regular PE class during a follow‐up session, 16 of 18 participants voted to play the game. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this systematic review of literature include: (a) describe the intervention strategies; (b) examine the outcomes as they pertain to the child (individual level), families (interpersonal level), and community or culture (organizational level); and (c) develop a foundation of interventional approaches that specifically target obesogenic behaviors in Hispanic preschool‐aged children. Design: A systematic review of literature was performed. The theoretical framework was the Socioecological Model. Sample: Twenty‐four total articles were used for this review. Measurements: The method used was the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Results: Of the 24 studies reviewed, 36% focused on the individual, 56% were interpersonal (focused on parents), and 9% focused on the organizational level. Conclusion: Interventions that are culturally competent, directed at families, and include healthy dietary intake along with a physical activity component are most effective at lowering obesity in Hispanic preschool children. [ABSTRACT FROM AUTHOR]

Objective: To describe food and beverage provisions by Faith Communities from one denomination in association with events for children. Design, sample and measures: Foods and beverages provided at 32 child‐focused activities were documented using direct observation methodology and analyzed for contribution to food groups and per serving energy, fat, saturated fat, sugar, and sodium contents. Results: Main dishes were mostly (71%) convenience/casserole‐type foods, and averaged 962 mg sodium and 436 kcal, with 36% of energy from fat and 14% as saturated fat. Cheese was the main source of dairy products. Grain‐based side dishes, provided at 29% of meals, included white rice, pasta, and bread. Non‐starchy vegetables were provided at three (29%) meals. Fruits were served at six events. Desserts, served at 75% of events, contained 41% of energy from fat, with 17% as saturated fat, and 22 g of added sugar. Snack chips, provided at 31% of events, contributed 165 kcal mostly from fat and 243 mg of sodium. Sugar‐sweetened beverages, served at 71% of events, contributed 28 g of added sugar. Conclusions: This pilot investigation identified areas for improvements in the nutritional quality of foods/beverages served at faith community child‐focused events and aligns with expanding public health efforts to improve child nutrition beyond traditional settings. [ABSTRACT FROM AUTHOR]

Physical activity provides a myriad of well‐documented social‐emotional, behavioral, and academic benefits for youth. While research suggests that physical activity should be integrated within the school day to support the well‐being of students, an understanding of related empirical work within school psychology research and practice is unclear. School psychologists are well positioned to systematically incorporate physical activity within their intervention practices, particularly given their role and expertise in implementing and evaluating interventions. Authors engaged in a systematic review of 20 years (1998–2018) of physical activity intervention research within 10 peer‐reviewed school psychology journals and six school psychology‐related journals. Authors analyzed 22 studies to glean a comprehensive understanding of the literature base and highlight the ways in which physical activity can be incorporated to support school and student outcomes. Suggestions for research and practice in school psychology are discussed in light of the examined literature. [ABSTRACT FROM AUTHOR]

We consider the problem of model-based clustering in the presence of many correlated, mixed continuous, and discrete variables, some of which may have missing values. Discrete variables are treated with a latent continuous variable approach, and the Dirichlet process is used to construct a mixture model with an unknown number of components. Variable selection is also performed to identify the variables that are most influential for determining cluster membership. The work is motivated by the need to cluster patients thought to potentially have autism spectrum disorder on the basis of many cognitive and/or behavioral test scores. There are a modest number of patients (486) in the data set along with many (55) test score variables (many of which are discrete valued and/or missing). The goal of the work is to (1) cluster these patients into similar groups to help identify those with similar clinical presentation and (2) identify a sparse subset of tests that inform the clusters in order to eliminate unnecessary testing. The proposed approach compares very favorably with other methods via simulation of problems of this type. The results of the autism spectrum disorder analysis suggested 3 clusters to be most likely, while only 4 test scores had high (>0.5) posterior probability of being informative. This will result in much more efficient and informative testing. The need to cluster observations on the basis of many correlated, continuous/discrete variables with missing values is a common problem in the health sciences as well as in many other disciplines. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if participants in a summer camp met physical activity guidelines and to examine whether physical activity levels differed by gender, race, socio-economic status, or weight status. Height, weight, demographic information, and accelerometer-measured physical activity were obtained from 132 participants aged 6-12 years at 6 day camps. Participants engaged in an average of 57.7 min ( SD = 26.54) of moderate-to-vigorous physical activity during the 8 hr of camp. Almost 40% (39.8%) of the campers met the physical activity guidelines of at least 60 min of moderate-to-vigorous physical activity during the camp day, but there were gender and weight status differences. Results of an ANOVA analysis indicated that boys were more active than girls and normal weight children were more active than obese children. Summer day camp attendance appears to provide many children with an opportunity to attain recommended levels of physical activity, but differs by gender and weight status. [ABSTRACT FROM AUTHOR]

Three intact male dogs with stranguria and haematuria caused by uroliths in the penile urethra underwent urethrotomy using a novel surgical approach directly over the caudal part of the os penis because conservative procedures to resolve the obstructions had failed. Haemorrhage was minimal, and the incisions healed rapidly by second intention. Complications did not occur during the 6-month follow-up period. Urethrotomy directly over the os penis is straightforward, associated with few complications and holds promise for the removal of urinary calculi in the penile urethra. [ABSTRACT FROM AUTHOR]

As part of its 2011 commitment to the Partnership for Healthier America, the YMCA of the USA (Y-USA) pledged that by 2015, 85 percent of its local Y associations with early childhood or afterschool programs would have at least one program site that met 100 percent of the Y-USA's healthy eating and physical activity (HEPA) standards. To inform the measurement and monitoring of HEPA standards, the Y-USA designed a thirty-three-item online survey to assess which HEPA standards were being met in afterschool program sites each year in order to track progress over time. Verification activities including direct observation, key informant interviews, and document review generated overall compliance ratings for each standard. Compliance ratings were then compared to the self-reported survey results to determine the validity of the survey for assessing each HEPA standard. The survey had variable accuracy when compared to the validation methods. This chapter aims to inform the measurement and monitoring of HEPA standards implementation in larger afterschool networks by reporting on learnings from the Y-USA's early efforts in its network. [ABSTRACT FROM AUTHOR]

The YMCA of the USA serves more than nine million youth in its summer day camping programs nationwide. In spring 2011, the YMCA of Columbia, SC, with support from the University of South Carolina, adopted a competency-based staff-level training approach in an attempt to align staff behaviors with the YMCA of the USA new physical activity standards for summer camp programs. This chapter presents findings from a multiyear evaluation of a competency-based training approach using a single group design with preassessments and multiple postassessments. Training consisted of participatory exercises and video demonstrations. Data on staff physical activity promotion behaviors were collected using SOSPAN, an instrument that utilizes momentary time sampling to record instances of staff physical activity promotion behaviors consistent with physical activity standards. This chapter describes how a competency-based professional development training may be effective at increasing physical activity promoting and decreasing physical activity discouraging staff behaviors and related child activity levels. [ABSTRACT FROM AUTHOR]