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Introduction: Children aged two to five years old are influenced by the behaviors of their guardians and Early Care Education (ECE) teachers. This study aims to determine the relationship between adults' and children's health behaviors in home and ECE settings. This study is novel in examining this correlation between multiple environments. Method: Surveys were conducted across 32 ECE centers. Guardians and teachers reported on their and their children's health behaviors within the home and ECE. Matched child-adult responses (n = 1,140) were analyzed from a representative sample of 32 ECE centers throughout Georgia. Frequency of consumption of fruits, vegetables, and water, as well as frequency of physical activity were measured. Spearman rho correlations were analyzed using SPSS software, with p < 0.05 indicating significance. Results: Spearman rho correlations indicated significant positive correlations between guardian and child behavior (rho = 0.49 to 0.70, p < 0.001) for all data. Teacher and child correlations were inconsistently significant across categories (rho = -0.11 to 0.17, p < 0.001). Discussion: The influence of guardian behavior modeling on child health outcomes is critical for improving ECE programming and child obesity outcomes. This research can be used to inform future health interventions for young children. Significance: Children's behaviors are influenced by the behaviors of guardians in their life. Childhood obesity rates are increasing in the United States, and increased physical activity and improved dietary practices are key methods to prevent obesity. This study assessed the degree to which children's health behaviors model those of their guardians and teachers. Children's health behavior practices were significantly correlated with the practices of their guardians but not with teachers, indicating home-based health promotions can have positive impacts on both adults and children. [ABSTRACT FROM AUTHOR]

Background: Effective physical activity interventions are needed for children because health behaviors track into adulthood, and risk factors for diseases begin early in life. No study has determined whether an intervention designed using a Community-Based Participatory Research approach can improve moderate to vigorous physical activity (MVPA) and the related psychosocial constructs in underserved children. This study determined whether improvements in MVPA and related psychosocial constructs (self-efficacy, knowledge, beliefs, attitudes, and skills) occurred following a Community-Based Participatory Research intervention in underserved, rural children. It was then determined if these constructs were mediators of MVPA. Methods: Two fifth-grade classes at a school (n = 19 and n = 20) were randomly assigned to an intervention or comparison group. The intervention group participated in a 4-week intervention designed to improve MVPA (wGT3X-BT accelerometer; ActiGraph, Pensacola, FL) and the related psychosocial constructs (written survey). Groups were assessed prior to and immediately following the intervention. Results: There were no differences at baseline between groups. MVPA (30.0 [4.4] min), knowledge, and skill scores were significantly higher in the intervention group compared with the comparison group at follow-up (P <.05). Knowledge and skills were mediating variables of MVPA. Conclusions: Priority should be placed on research that determines the sustained impact of similar Community-Based Participatory Research interventions. [ABSTRACT FROM AUTHOR]

Background: A limitation of accelerometer measures of moderate to vigorous physical activity (MVPA) is nonwear time. Nonwear-time data is typically deleted prior to estimating MVPA. In this study, we used an approach that used sociodemographic, health, and time data to guide the imputation of nonwear-time data. We determined whether imputing nonweartime data influences estimates of MVPA and the association between MVPA, body mass index, and blood pressure. Methods: Seven days of accelerometer data were collected on 332 children aged 10-13 years. MVPA was estimated in a "nonimputed dataset," wherein nonwear-time data were deleted prior to estimating MVPA, and in an "imputed dataset," wherein nonwear-time data were imputed using sociodemographic and health characteristics of participants and time characteristics of the nonwear period prior to estimating MVPA. Results: Nonwear time represented 7% of waking hours. Average MVPA estimates did not differ in the nonimputed and imputed datasets (56.8 vs 58.4 min/d). The strength of the relationship between MVPA and the 2 health outcomes did not differ in the nonimputed and imputed datasets. Conclusions: Studies achieving high accelerometer wear-time compliance can obtain MVPA estimates without substantial bias if they use the traditional approach of deleting nonwear-time data. [ABSTRACT FROM AUTHOR]

Background: Identifying periods of the day which are susceptible to varying levels of physical activity (PA) may help identify key times to intervene and potentially change preschool children's PA behaviors. This study assessed variability of objectively measured moderate-to-vigorous physical activity (MVPA) during weekdays and weekend days among preschool children. Methods: One hundred and eighty-eight children (aged 3 to 5 years; 53.2% boys) from a northwest English city wore uni-axial accelerometers for 7 consecutive days. Results: Higher levels of MVPA were recorded in boys, particularly those who attended preschool for a half day. Children who attended preschool for a full day engaged in 11.1 minutes less MVPA than children who attended for a half day. After-school hours were characterized by a decrease in activity for all groups. Patterns of activity during the weekend were smoother with less variability. Conclusion: This study identified discrete segments of the week, specifically afterschool and during the weekend, when preschoolers engage in low levels of PA. Higher levels of MVPA among children who attended preschool for less time each day suggests that the structured preschool environment is related to decreased activity. Consequently, there is a need for interventions in young children to focus on school and home environments. [ABSTRACT FROM AUTHOR]

Background: The YMCA of USA recently adopted Healthy Eating and Physical Activity (HEPA) Standards for their summer-day-camps (SDCs). Standards call for staff to exhibit HEPA promoting behaviors while eliminating HEPA discouraging behaviors. No studies have evaluated training programs to influence policy specified staff behaviors and related changes in child activity in SDCs. Method: Four YMCA SDCs serving approximately 800 children/week participated in this no control group pre/post pilot study. Professional development training founded in the 5 Ms (Mission, Model, Manage, Monitor, Maximize) and LET US Play principles (lines; elimination; team size; uninvolved staff/kids; and space, equipment, and rules) was delivered to staff. Outcomes were staff promotion behaviors and child activity assessed via systematic observation instruments. Results: Twelve of 17 HEPA staff behaviors changed in the appropriate direction from baseline to postassessment with 5 behaviors reaching statistically significant changes. The percentage of girls and boys observed in moderate-to-vigorous physical activity increased from 15.3% to 18.3% (P > .05) and 17.9% to 21.2%, whereas sedentary behavior decreased from 66.8% to 59.8% and 62.3% to 53.6%, respectively. Conclusion: Evidence suggests that the professional development training designed to assist SDCs to meet the HEPA Standards can lead to important changes in staff behaviors and children's physical activity. [ABSTRACT FROM AUTHOR]

Background: The wrist has become a standard location for accelerometry (ACC) data collection, primarily to optimize compliance, yet interpretation of wrist ACC data is limited due to a lack of calibration studies. This study aimed to establish cutpoints for a wrist-mounted Actical accelerometer in 6- to 11-year-old children using 2 methods. Methods: Metabolic and ACC data (15-sec epoch) were collected during 8 activities in 22 children ages 6-11. Linear regression (LR) and Receiver Operator Characteristics (ROC) were used to examine the relationship between METs and ACC counts. Cutpoints were established at < 1.5, 1.5-2.99, 3-5.99, and = 6 METs for sedentary, light, moderate, and vigorous activity, respectively. Cutpoints were applied to a large, multiday sample of children (n = 269) to examine differences in cutpoints on minutes of moderate to vigorous PA (MVPA). Results: LR and ROC yielded moderate cutpoints of 574 and 388, respectively. When applied to the large sample, LR and ROC cutpoints resulted in an estimated 83 and 140 minutes of daily MVPA, respectively. Conclusions: This study established wrist-mounted Actical cutpoints for children using 2 methods. The differences in cutpoints and their effect on estimates of MVPA in an independent sample highlight challenges associated with establishing cutpoints, suggesting that standardized calibration procedures be developed. [ABSTRACT FROM AUTHOR]

Background: Many young people form unhealthy behavioural habits, such as low intake of fruit and vegetables, high intake of energy-dense snack foods, and excessive sedentary screen-based behaviours. However, there is a shortage of parent-and home-focused interventions to change multiple health behaviours in children.Methods: Kids FIRST was a 12-week, home- and school-based pilot randomised controlled trial to reduce screen-time and unhealthy snacking with assessments at pre- (baseline) and post-intervention. Four UK schools were randomised to control or one of three interventions targeting reductions in (1) screen-time and unhealthy snacking (ST + Sn), (2) screen-time (ST only), (3) unhealthy snacking (Sn only), and parents with children aged 9-11 years were recruited via schools. Intervention group parents received four online 'sessions' and four packages of resources tailored to each group. Children received four 30-min lessons during school time. Children and parents reported their own screen-time behaviours, children reported their own snacking behaviours. Descriptive analyses were undertaken using principles of intention to treat.Results: Initial feasibility was shown in that this study successfully recruited schools and families into all four study arms and retained them over a period of 13 weeks (retention rate ≥ 74%). Seventy-five children and 64 parents provided full baseline questionnaire data. Reductions in children's school day and weekend day TV/DVD viewing and computer game use were found in the ST + Sn and ST groups, while self-reported smartphone use increased in these groups. Similar results were found for parents' TV/DVD, computer and smartphone use in these groups. Little to no changes were found in reports of the dietary variables assessed in any intervention group for children or parents.Conclusions: These preliminary findings show some promise for the Kids FIRST intervention. Based on these findings, a future full trial should recruit a more diverse sample of families and optimise the intervention and intervention resources to more fully engage parents with the dietary-based components of the intervention programme, where fewer changes were seen. Although most parents reporting receiving the intervention resources, further development work is required to achieve higher levels of engagement. This might include greater parent and child engagement work early in the development of the project.Trial Registration: Retrospectively registered in June 21st 2019 with ClinicalTrials.gov (number NCT03993652). [ABSTRACT FROM AUTHOR]

Background: We know very little about physical activity in children with long-term illness or disability compared with those children without disabilities. Previous studies indicate low physical activity levels among all adolescents. Methods: The sample consisted of Canadian (n = 2720) and Finnish pupils (n = 3459) approximately 13.5 and 15.5 years of age in general (mainstreamed) education. The study is a part of the Health Behavior in School-aged Children (HBSC) study. Nationally representative data were collected in 2002 using a standardized questionnaire. The moderate-to-vigorous intensity physical activity screening measure was used. Results: Approximately one-fifth of the pupils in both countries had a long-term disability, illness or medical condition. In both countries boys and girls with a long-term illness or disability were equally physically inactive, and adolescents with a long-term illness or disability were as physically active as those without disabilities. Conclusions: There is no difference between young people with and without long-term illness/disability, and between boys and girls, in relation to their physical activity. However, all of them fall short of recommended guidelines. This indicates that promoting a physically active lifestyle should be of high priority in the lives of young people. [ABSTRACT FROM AUTHOR]

Background: Evidence supporting the effectiveness of a developmental-focused youth sport (DYS) program designed exclusively for elementary school aged girls is mounting. The purpose of this study was to evaluate the impact of on the Girls on the Run program on psychological and physical assets among 3rd- to 5th-grade girls. Methods: A longitudinal quasi-experimental study was conducted to evaluate intervention effects among 877 participants categorized into 1 of 3 groups (never, newly, and previously exposed). A 64-item self-report survey measured developmental assets at 3 time-points. Nested random effects ANOVA models were used to compare demographic factors and psychological and physical assets between exposure groups and to compare longitudinal differences in these assets. Results: After adjustment for multiple comparisons, previous program participants had significantly higher physical activity commitment (P = .006) and physical activity levels (P = .047) at preintervention than never exposed. From pre- to postintervention body image improved in newly exposed participants (P = .03). Physical activity increased from preintervention to follow-up among never and newly exposed participants (all P < .05). Conclusions: Although we were unable to fully confirm the study hypotheses, the results of the current study provide new evidence to support future long-term studies examining the effectiveness of an innovative DYS program for 3rd- to 5th-grade girls. [ABSTRACT FROM AUTHOR]

Background: Pedometer step-frequency thresholds (120 steps·min-1, SPM) corresponding to moderate-tovigorous intensity physical activity (MVPA) have been proposed for youth. Pedometers now have internal mechanisms to record time spent at or above a user-specified SPM. If pedometers provide comparable MVPA (P-MVPA) estimates to those from accelerometry, this would have broad application for research and the general public. The purpose of this study was to examine the convergent validity of P-MVPA to accelerometer-MVPA for youth. Methods: Youth (N = 149, average 8.6 years, range 5 to 14 years, 60 girls) wore an accelerometer (5-sec epochs) and a pedometer for an average of 5.7 ± 0.8 hours·day-1. The following accelerometer cutpoints were used to compare P-MVPA: Treuth (TR), Mattocks (MT), Evenson (EV), Puyau (PU), and Freedson (FR) child equation. Comparisons between MVPA estimates were performed using Bland-Altman plots and paired t tests. Results: Overall, P-MVPA was 24.6 min ± 16.7 vs. TR 25.2 min ± 16.2, MT 18.8 min ± 13.3, EV 36.9 min ± 21.0, PU 22.7 min ± 15.1, and FR 50.4 min ± 25.5. Age-specific comparisons indicated for 10 to 14 year-olds MT, PU, and TR were not significantly different from P-MVPA; for the younger children (5-8 year- olds) P-MVPA consistently underestimated MVPA. Conclusions: Pedometer-determined MVPA provided comparable estimates of MVPA for older children (10-14 year-olds). Additional work is required to establish age appropriate SPM thresholds for younger children. [ABSTRACT FROM AUTHOR]

Background: Active recreation sessions taking place within after-school programs (ASP) present an opportunity for attending children to attain part of the recommended 60 minutes of daily moderate-to-vigorous physical activity (MVPA). This cross-sectional study's purpose was to assess relationships between microlevel ASP environmental characteristics and physical activity and sedentary behavior (SED). Methods: During 161 ASP active recreation sessions, 240 children from 7 schools wore Actigraph GT1M accelerometers and were observed up to 6 times per year, over 3 years. To provide microlevel environmental data, trained observers recorded session times, location, duration, organization, equipment, and number of children and staff. Unadjusted bivariate correlations and multivariable regression analyses were used to assess the influence of microlevel environmental variables on MVPA and SED, with regression models controlling for relevant covariates. Results: Across all ASP active recreation sessions, children spent 39 ± 15% in MVPA and 16 ± 11% in SED. Session location, boy-to-girl ratio, and duration were significantly related to MVPA in the regression model. For SED, location and duration were significant influences in the model. Conclusions: Both location and duration appear to be modifiable correlates of group physical activity level, which may serve to inform intervention efforts to promote physical activity in ASP. [ABSTRACT FROM AUTHOR]

Background: To assess from a societal perspective the cost-effectiveness of a school program to increase active transport in 10- to 11-year-old Australian children as an obesity prevention measure. Methods: The TravelSMART Schools Curriculum program was modeled nationally for 2001 in terms of its impact on Body Mass Index (BMI) and Disability-Adjusted Life Years (DALYs) measured against current practice. Cost offsets and DALY benefits were modeled until the eligible cohort reached age 100 or died. The intervention was qualitatively assessed against second stage filter criteria ('equity,' 'strength of evidence,' 'acceptability to stakeholders,' 'feasibility of implementation,' 'sustainability,' and 'side-effects') given their potential impact on funding decisions. Results: The modeled intervention reached 267,700 children and cost $AUD13.3M (95% uncertainty interval [UI] $6.9M; $22.8M) per year. It resulted in an incremental saving of 890 (95%UI -540; 2,900) BMI units, which translated to 95 (95% UI -40; 230) DALYs and a net cost per DALY saved of $AUD117,000 (95% UI dominated; $1.06M). Conclusions: The intervention was not cost-effective as an obesity prevention measure under base-run modeling assumptions. The attribution of some costs to nonobesity objectives would be justified given the program's multiple benefits. Cost-effectiveness would be further improved by considering the wider school community impacts. [ABSTRACT FROM AUTHOR]

Background: Most youth are not meeting physical activity guidelines, and schools are a key venue for providing physical activity. School districts can provide physical activity opportunities through the adoption, implementation, monitoring, and evaluation of policies. This paper reports results of a 2009 survey of California school governance leaders on the barriers and opportunities to providing school-based physical activity and strategies to promote adoption of evidence-based policies. Methods: California school board members (n = 339) completed an 83 item online survey about policy options, perceptions, and barriers to improving physical activity in schools. Results: Board members' highest rated barriers to providing physical activity were budget concerns, limited time in a school day, and competing priorities. The key policy opportunities to increase physical activity were improving the quantity and quality of physical education, integrating physical activity throughout the school day, supporting active transportation to/from school, providing access to physical activity facilities during nonschool hours, and integrating physical activity into before/after school programs. Conclusions: Survey findings were used to develop policy resources and trainings for school governance leaders that provide a comprehensive approach to improving physical activity in schools. [ABSTRACT FROM AUTHOR]

Background: This paper evaluates the impact of a large-scale, community agency-driven initiative to increase physical activity (PA) in after-school programs in Ontario. In 2008, the YMCA and Boys and Girls Club (BGC) introduced CATCH Kids Club (CKC) into 330 after-school program sites. Methods: This study assessed the impact of the intervention on the quality and quantity of PA using a pretest/posttest quasi-experimental research design with a comparison non-CKC group. Data were collected at baseline (September 2008) and postintervention (May/June 2009) using the System for Observing Fitness Instruction Time (SOFIT). Results: Nearly all sites, with the exception of the BGC baseline program (a sports program) achieved greater than 50% of time spent in MVPA. Significant differences were not found between levels of MVPA at CKC and comparison sites (59.3% vs. 64.2%), or at CKC sites at baseline versus postintervention (59.3% vs. 52.1%). BGC sites had significantly higher levels MVPA in CKC programs than in sports programs (70.8% vs. 35.2%). In postimplementation interviews, leaders reported general support but some mixed reactions related to how the program was received by participants. Conclusions: This paper offers support for PA programs that focus on inclusivity and enjoyment and emphasize the important role of staff competency. [ABSTRACT FROM AUTHOR]

Background: Evidence-based physical education (EBPE) programs have increased physical activity (PA) by as much as 18%, yet widespread adoption has not occurred. Understanding school facilitators and barriers to PE should prove useful to EBPE dissemination efforts. Methods: Pairs of principals and PE teachers from 154 schools (75 Adopters and 79 Non-Adopters) from 34 states completed questionnaires. Differences between Adopter and Non-Adopter schools were tested using t tests or Wilcoxon Signed Rank Tests and chi-square analyses. Results: Principals and teachers reported distinct PE curriculum adoption decision making roles, but few viewed themselves as very involved in program evaluation. Teachers in Adopter schools were more satisfied with PE program outcomes and had greater involvement in teacher evaluation and program decision making. Compared with teachers, principals were generally more satisfied with their school's PE program outcomes and did not share the same perceptions of PE barriers. However, principals also demonstrated a general lack of PE program familiarity. Conclusions: To facilitate EBPE adoption, dissemination efforts should target both principals and PE teachers. Increasing principal's knowledge may be instrumental in addressing some teacher perceptions of barriers to PE. Strategic advocacy efforts, including targeting policies that require PE program evaluation, are needed. [ABSTRACT FROM AUTHOR]

There is a dearth of research examining physical activity in children aged 6-10 years with low socioeconomic status, despite the fact there is good reason to suspect this is a critical period when physical activity habits are created. Physical activity and theory of planned behavior variables were measured at three time points, and children (N = 77) randomized to the experimental condition were additionally asked to form an implementation intention. Intention was a potent mediator of the past behavior-future behavior relationship and the implementation intention intervention significantly increased physical activity compared with the control condition. The findings suggest that physical activity can be increased in children aged 6-10 years with low socioeconomic status and that implementation intentions might enhance the effectiveness of children's physical activity programs. [ABSTRACT FROM AUTHOR]

Background: The current study objectively assessed physical activity (PA) levels and patterns in children and adolescents with type 1 diabetes and compared the metabolic and physiologic health profiles of those achieving and those not achieving the current recommendation of 60 minutes a day (minutes·D-1) of at least moderate intensity PA. Method: 37 children and adolescents (20 boys, 17 girls) aged 12.7 ± 2.1 years (mean ± SD), disease duration 5.9 ± 3.0 years participated. PA was assessed using heart rate monitoring. Peak VO2, BMI, sum of 5 skinfolds, HbA1c, and daily insulin dosage were also determined. Results: Mean accumulated time in moderate-to-vigorous intensity PA was 53.6 ± 31.4 minutes·D-1. Levels of vigorous-intensity PA were low, mean 8.3 ± 10.2 minutes·D-1. When controlling for age, no differences in metabolic or physiologic health outcomes were evident between those individuals achieving, and those not achieving, 60 minutes·D-1 of moderate-to-vigorous intensity PA. PA predominantly occurred in short bouts lasting 5 minutes or less. Conclusion: The efficacy of accumulating 60 minutes·D-1 of moderate-to-vigorous intensity PA, in the form of short duration, intermittent bouts of largely unplanned PA, to promote health gains in children and adolescents with type 1 diabetes is questionable. [ABSTRACT FROM AUTHOR]

Background: Few studies have compared physical activity (PA) and sedentary activity (SA) by grade and ethnicity, specifically including elementary school students. A cross-sectional probability-based design was used to provide data by ethnicity (African American, Hispanic, and White/Other), gender, and grade (4th, 8th, and 11th) from 2000 to 2002. Methods: Two validated questionnaires (elementary and secondary) assessed self-reported PA and SA. Point-prevalence estimates and 95% confi- dence intervals were computed. Results: Over 70% of students reported vigorous PA on ≥3 days/week, but <50% participated in daily physical education. A significant percentage (30% to 50%) of students reported ≥3 hours per day in SA. Fourth-grade boys and girls reported equal PA; however, 8th and 11th grade girls reported lowered vigorous PA. African American 8th- and 11th-grade boys reported the highest PA, but African American children also reported the highest prevalence of SA. Conclusions: Findings from this study highlight the disparities in physical and sedentary activities by gender, grade, and race/ethnicity, and the need to address these differences with programs and policy. In general, grade level and gender differences were more striking and consistent than raciallethnic differences. [ABSTRACT FROM AUTHOR]

Accelerometry is frequently used to assess physical activity in children. The number of articles in this area has increased dramatically in the last 10 years. The aim of this article is to provide a contemporary overview of accelerometry research in children. Specifically, the review addresses the choice of monitor, choice of epoch, when and for how long activity should be measured, the lack of consensus over how to define a complete day of activity data, issues of compliance, methods for the calibration of activity output, and the richness of data available from accelerometry. [ABSTRACT FROM AUTHOR]

The study aim was to evaluate the effectiveness of a 2-year health-related physical education intervention in a pretest-posttest design. Sixteen elementary schools (764 pupils, mean age: 11.2 ± 0.7) participated in the study. Schools were randomly assigned to the intervention condition (n = 8) and the control condition (n = 8). Making use of direct observation data gathered according to SOFIT (System for Observing Fitness Instruction Time), the moderate-to-vigorous physical activity engagement during physical education classes was significantly higher in the intervention condition than in the control condition. Children's moderate-to-vigorous physical activity engagement during physical education lessons increased with 14% in the intervention condition (from 42 to 56%). No significant effects were found on the accelerometer data. The health-related physical education intervention was found to be promising in promoting physical activity during physical education classes. [ABSTRACT FROM AUTHOR]

There is limited evidence on how much and on which days accelerometry monitoring should be performed to obtain a representative measurement of physical activity (PA) in young children. We measured 76 children (40 M and 36 F, mean age 5.6 years ([SD ± 0.4]) on 7 days using Actigraph accelerometers. Mean daily PA was expressed in counts per min (cpm). Reliability increased as the number of days and hours of monitoring increased, but only to 10 hr per day. At 7 days of monitoring for 10 hr per day, reliability was 80% (95% CI [70%, 86%]). The number of days was more important to reliability than the number of hours. The inclusion or exclusion of weekend days made relatively little difference. A monitoring period of 7 days for 10 hr per day produced the highest reliability. Surprisingly short monitoring periods may provide adequate reliability in young children. [ABSTRACT FROM AUTHOR]

In the context of rising screen time, only a third of Canadian children are achieving adequate amounts of active play, an important source of physical activity. ParticipACTION, a national not-for-profit organization, created the "Make Room for Play" campaign targeting parents with television advertisements depicting how screen time takes away from active play. The advertisements featured children engaging in active play (e.g., jump rope) while a black screen progressively sequesters the room for them to play. This study's purpose was to evaluate the campaign using the hierarchy of effects model, a framework for conceptualizing the impact of mass media campaigns. It was hypothesized that recall would relate to intermediate (e.g., cognitions, self-efficacy) and distal (e.g., parental support) factors. Twenty-six percent of the general population and caregiver samples surveyed (N = 1576) recalled (unaided) the advertisement and 45.9% recalled when prompted. Parental support was significantly higher in those recalling the campaign, p = .009. Twenty-four percent of parents reporting unaided recall (versus 14.0% of those not) tried to engage in active play with their children and 21.2% (versus 12.0%) tried to create opportunities for children to engage in play. Strengths and limitations of mass media approaches targeting active play and screen time are discussed. [ABSTRACT FROM AUTHOR]

It is clear that physical activity, holistically, is linked with several positive factors through the life course. There exists a large evidence base for physical activity quantity, yet there has been little integration of physical activity qualities, and whilst quality is a nebulous term, recent developments in literature suggest it may be a viable measure in the characterisation of physical activity. The purpose of the study was to comprehensively review the development towards a measure of physical activity quality. A review of literature was conducted using online databases: Web of Science, PubMed and Google Scholar. A narrative review was subsequently prepared on the topic and development of physical activity quality. Quantitative assessment of movement quality shows promise in the evaluation and measurement of physical activity, particularly in relation to motor development, fundamental movement skills and body mass indices. Whilst measures of movement quality display promise, this is a burgeoning field of research contributing to physical activity literature, and as such, these measures must be refined, developed and investigated further. [ABSTRACT FROM AUTHOR]

Nonobese, preadolescent girls self-reported, and their parents provided proxy reports of daughters' daily activities using questionnaires. Responses were evaluated for test-retest reliability, and for validity using one-week diaries. Results indicated all three respondents provided reproducible estimates of time daughters spent watching TV; daughters and mothers, of time daughters spent sleeping; and parents, of time daughters spent in vigorous activities. However, only daughters >10 years of age could provide valid reports for time spent in moderate activities and in sedentary and light activities on school days. Study results suggest that daughters and parents have difficulty providing reliable and valid estimates of activity level. [ABSTRACT FROM AUTHOR]

The article presents a response to the editorial "The Horse Is Dead; Let's Dismount," by T. W. Rowland in the May 1995 issue. The examines how to encourage children to be physically active daily and to continue their physical activity throughout their lifetime. The article also discusses physical fitness testing, getting children to participate in enjoyable physical activities, the negative affects of forcing high-intensity activities on children, and the negative affects of making high-level performance the primary focus of youth sports.

The present study examined the relationship between maximal oxygen uptake (VO2max) and daily physical activity in a group of 7- to 12-year-old boys. VO2max was assessed through the incremental treadmill test using an open circuit system. Physical activity level was obtained from heart rate telemetry outside of school time for 8 hrs during weekdays and during 40 min of physical education classes. The findings indicated that the absolute value of VO2max increased with age, while relative to body weight it remained almost the same across age, with a mean of 48.4 ml · kg-1 · min-1. Moreover, heart rate telemetry showed that the boys spent a limited amount of time on activities that raise the heart rate to a level above 160 bpm (an average of 1.9%). In addition, VO2max was found to be significantly related to the percentage of time spent at activity levels at or above a heart rate of 140 bpm, but not with activity levels at or above a heart rate of 160 bpm. [ABSTRACT FROM AUTHOR]

The article looks at children's enjoyment of and attitude toward physical activity. The article discusses children's motivation for physical activity, health behavior in children, psychological stress in sports, physical fitness testing for children, exercise for children, and pediatric sport psychology literature. According to the article, social support, skill level, self-perception, and positive affect all contribute to children's motivation to start and continue in sports and other physical activities.

Monitoring of physical activity among 3- to 7-year-old children was achieved with an electronic motion sensor, the Caltrac accelerometer, for 1,666 days (of 2,030 scheduled) over a 2-year period. Failure of the monitor averaged once for each 45 days of successful monitoring. The total cost of devices, repairs, and batteries over the 2 years averaged $1.31 per day of successful monitoring. It is concluded that use of the Caltrac accelerometer is a feasible and relatively inexpensive approach for monitoring physical activity in young children in epidemiologic studies. [ABSTRACT FROM AUTHOR]

This study examined the validity of the Caltrac motion sensor for measuring physical activity in young children and described change over time in physical activity among 47 preschool children from obese and nonobese families. Children were videotaped in a controlled setting while wearing Caltrac motion sensors and also wore Caltracs at home. Caltrac readings and an observational measure of physical activity were significantly related in both Year 1 (r =.86) and Year 2 (r =.83), and outside play was associated with higher Caltrac scores (r =.43). In addition, physical activity among young girls with obese parents decreased significantly from Year 1 to Year 2. [ABSTRACT FROM AUTHOR]

The article looks at physical fitness tests for children and youth. According to the article, the main problem with physical fitness testing of children lies in incorrect assumptions that have affected the definition of physical fitness and the selection of test items and test batteries. The article discusses physical education in schools, health behavior in children, physical fitness testing in the U.S., the promotion of physical fitness in schools, and the test battery's components, including aerobic capacity, flexibility, muscular endurance, and body composition.

Objective: To evaluate the effectiveness of a pilot study of a parental school-based intervention to promote healthy eating behaviours in young children.Design: A quasi-experimental longitudinal design with three conditions (complete intervention (CIG), minimal intervention (MIG), control (CG)), with repeated measures at baseline, immediately after the intervention, 6 months and 1 year after intervention.Setting: Fourteen public and state-funded kindergartens near Lisbon, Portugal.Subjects: Parents (n 349) of 3- to 6-year-old children assigned to the three conditions completed the baseline protocol. The 'Red Apple' intervention included four parental group sessions about young children's growth, nutritional guidelines and positive parental feeding strategies, which was combined with adult-child activities at home and in the classroom, and newsletters (CIG). MIG included only a single nutritional counselling session, whereas the CG had no intervention. At the end, thirty-eight, twenty-six and fifty-four parents in the CIG, MIG and CG, respectively, had completed all evaluation components. Data regarding parental perception of children's weight, self-efficacy, nutritional knowledge, feeding strategies, eating behaviours and BMI were collected at the four assessment moments.Results: The CIG showed improvements in children's healthy food intake, compared with the MIG and CG. Parental self-efficacy regarding the regulation of children's eating behaviours decreased in the CG but not in both intervention groups.Conclusions: Considering the low dosage of the intervention, the results obtained were positive. Future studies should offer additional solutions to overcome barriers to parents' participation. [ABSTRACT FROM AUTHOR]

Purpose Parent-focused interventions (PFIs) are a promising method for supporting parents and promoting children’s well-being. Few PFIs in the USA, however, include physical health promotion content and are universal programs. The purpose of this paper is to describe a universal health-promoting PFI for parents of elementary school-aged children and demonstrate proof of concept.Design/methodology/approach The program emphasizes positive parenting practices, stress management skills and physical health promotion strategies and recommendations, and is part of a larger initiative that includes a continuum of universal, developmentally appropriate, health-promoting PFIs for civilian and military parents. The program was implemented at two community sites in rural Pennsylvania with 20 civilian parents completing pretests and posttests. Study measures assessed parenting, stress and stress management and physical health promotion related outcomes.Findings Parents reported decreases in suboptimal discipline and feeding practices, stress and child internalizing behavior. They also reported increases in their sense of control in managing child behavior, coping socialization, child’s outdoor playtime and health recommendations met.Research limitations/implications While these preliminary findings may not be generalizable, they serve as proof of concept, which suggests that more rigorous research on the program is warranted.Practical implications Implementing a universal, health-promoting PFI within the USA is viable and has the potential to impact multiple short-term outcomes.Originality/value Parents are among their child’s earliest and most influential educators, and this study lends further support to their role as health educators. Given the significant public health benefits of holistically promoting child health, the time has come for universal PFIs to begin including physical health promotion content. [ABSTRACT FROM AUTHOR]

Aims: To examine the relationship between child, mother, and environmental factors and increased body mass index in preschool-aged children in China. Background: There are about 120 million children in China are classified as overweight or obese. Understanding the key factors associated with childhood obesity (i.e. child, mother and environment) is the first step in combating the growing obesity epidemic in China, as well as in the global community, where large numbers of Chinese immigrants can be found. Methods: A cross-sectional design was used. Each child's weight and height were measured by trained assistants, whereas mothers were asked to complete several questionnaires including family demographic, family eating and activity habit and child feeding practices. Mothers also reported their own as well as the father's height, weight and waist circumference. Linear regression models were used. Findings: The overweight and obesity prevalence was 22% for children, 7% for mothers and 82% for fathers. Children spent an average of 1.2 h (72 min) engaged in physical activities and 0.76 h (46 min) in sedentary time including TV watching or computer and video games playing per day. Factors associated with a child's higher body mass index included maternal beliefs regarding the child's susceptibility to obesity, their own susceptibility to obesity, a child's more advanced age and more unhealthy food stimulus exposure at home. Conclusion: Because a mother's health behaviours may influence their child's health behaviours and they are a crucial model for the family and children, childhood obesity prevention needs to include mothers and focus on building a healthy home environment for the family. Implications for nursing and health policy: Understanding factors associated with childhood obesity can assist researchers and clinicians to develop culturally sensitive and evidence-based programmes and policy to reduce this global epidemic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Adverse childhood experiences (ACEs) robustly predict future morbidity and mortality. Researchers are just beginning to investigate intergenerational effects. We hypothesize there are intergenerational associations between parent ACE exposure and worse child health, health behaviors, and health care access and use. METHODS: We linked data from 2 population-based cross-sectional telephone surveys in Philadelphia, Pennsylvania, that were used to ask parents about their past exposure to ACEs and their child's health, respectively. Participants were 350 parent-child dyads. Logistic regression models adjusted for parent and child characteristics. Parent ACE score was used to summarize indicators of parents' childhood adversity. Child health outcomes were poor overall health status, asthma diagnosis, obesity, low fruit and vegetable consumption, any soda consumption, inadequate physical activity, excessive television watching, no health insurance, no usual source of health care, and no dental examination in past 12 months. RESULTS: Of adult participants, 80% were female participants and 45% were non-Latino African American. Eighty-five percent of parents had experienced ≥1 ACE and 18% had experienced ≥6 ACEs. In adjusted models, each additional parent ACE was associated with higher odds of poor child overall health status (odds ratio [OR] = 1.19; 95% confidence interval [CI]: 1.07-1.32), asthma (OR = 1.17; 95% CI: 1.05-1.30), and excessive television watching (OR = 1.16; 95% CI: 1.05-1.28). CONCLUSIONS: The full scope of the health effects of ACEs may not be limited to the exposed individual, highlighting the need for a 2-generation approach to addressing the social determinants of child health. [ABSTRACT FROM AUTHOR]

Childhood obesity is a global public health concern. Previous research, mainly conducted in developed countries, suggests that marketing and media exposure is associated with unhealthy eating behaviors. This cross-sectional study was done with 2422 children, mean age 5.5 years, SD = .5, from six low- and middle-income counties (LMICs) (Brazil, China, India, Nigeria, Pakistan, and Russia). The analyses investigated media exposure, logo recognition, and preferences for international foods and beverages, such as globally distributed items like McDonald’s hamburgers and Coca-Cola soft drinks. Overall and in each country, path analysis models showed that media exposure and logo recognition directly and indirectly predicted the selection of international foods and beverages, controlling for child’s sex, age, home location, and parental education. Public health and communication experts must continue to investigate and understand these relationships, so as to inform regulations around food and beverage marketing. [ABSTRACT FROM AUTHOR]

Background: Clinicians in low resource settings in malaria endemic regions face many challenges in diagnosing and treating febrile illnesses in children. Given the change in WHO guidelines in 2010 that recommend malaria testing prior to treatment, clinicians are now required to expand the differential when malaria testing is negative. Prior studies have indicated that resource availability, need for additional training in differentiating non-malarial illnesses, and lack of understanding within the community of when to seek care play a role in effective diagnosis and treatment. The objective of this study was to examine the various factors that influence clinician behavior in diagnosing and managing children presenting with fever to health centres in Kenya. Methods: A total of 20 clinicians (2 paediatricians, 1 medical officer, 2 nurses, and 15 clinical officers) were interviewed, working at 5 different government-sponsored public clinic sites in two areas of Kenya where malaria is prevalent. Clinicians were interviewed one-on-one using a structured interview technique. Interviews were then analysed qualitatively for themes. Results: The following five themes were identified: (1) Strong familiarity with diagnosis of malaria and testing for malaria; (2) Clinician concerns about community understanding of febrile illness, use of traditional medicine, delay in seeking care, and compliance; (3) Reliance on clinical guidelines, history, and physical examination to diagnose febrile illness and recognize danger signs; (4) Clinician discomfort with diagnosis of primary viral illness leading to increased use of empiric antibiotics; and (5) Lack of resources including diagnostic testing, necessary medications, and training modalities contributes to the difficulty clinicians face in assessing and treating febrile illness in children. These themes persisted across all sites, despite variation in levels of medical care. Within these themes, clinicians consistently expressed a need for reliable basic testing, especially haemograms and bacterial cultures. Clinicians discussed the use of counseling and education to improve community understanding of febrile illness in order to decrease preventable deaths in children. Conclusion: Results of this study suggest that since malarial testing has become more widespread, clinicians working in resource-poor environments still face difficulty when evaluating a child with fever, especially when malaria testing is negative. Improving access to additional diagnostics, continuing medical education, and ongoing evaluation and revision of clinical guidelines may lead to more consistent management of febrile illness by providers, and may potentially decrease prescription of unnecessary antibiotics. Additional interventions at the community level may also have an important role in managing febrile illness, however, more studies are needed to identify targets for intervention at both the clinic and community levels. [ABSTRACT FROM AUTHOR]

Background: Although the scientific community has acknowledged modest improvements can be made to weight status and obesogenic behaviors (i.e., physical activity, sedentary/screen time, diet, and sleep) during the school year, studies suggests improvements are erased as elementary-age children are released to summer vacation. Emerging evidence shows children return to school after summer vacation displaying accelerated weight gain compared to the weight gained occurring during the school year. Understanding how summer days differ from when children are in school is, therefore, essential. Discussion: There is limited evidence on the etiology of accelerated weight gain during summer, with few studies comparing obesogenic behaviors on the same children during school and summer. For many children, summer days may be analogous to weekend days throughout the school year. Weekend days are often limited in consistent and formal structure, and thus differ from school days where segmented, pre-planned, restrictive, and compulsory components exist that shape obesogenic behaviors. The authors hypothesize that obesogenic behaviors are beneficially regulated when children are exposed to a structured day (i.e., school weekday) compared to what commonly occurs during summer. This is referred to as the 'Structured Days Hypothesis' (SDH). To illustrate how the SDH operates, this study examines empirical data that compares weekend day (less-structured) versus weekday (structured) obesogenic behaviors in U.S. elementary school-aged children. From 190 studies, 155 (~80%) demonstrate elementary-aged children's obesogenic behaviors are more unfavorable during weekend days compared to weekdays. Conclusion: In light of the SDH, consistent evidence demonstrates the structured environment of weekdays may help to protect children by regulating obesogenic behaviors, most likely through compulsory physical activity opportunities, restricting caloric intake, reducing screen time occasions, and regulating sleep schedules. Summer is emerging as the critical period where childhood obesity prevention efforts need to be focused. The SDH can help researchers understand the drivers of obesogenic behaviors during summer and lead to innovative intervention development. [ABSTRACT FROM AUTHOR]

This field experiment with more than 100 children at a school in the Southeast examined children’s use of an iPad app as a means of improving the measurement of their food consumption. External factors related to children’s food preferences and food consumption were also examined to determine how the iPad app could be further developed to help them become more aware of the foods they ate and how they could become more proactive in their health and well-being. Results indicated that the app enabled children to have more precision in recording the foods that they ate, and children expressed great appeal for the app. The foods that children reported eating via the app were compared to attitudes toward eating and nutritional knowledge; in both cases, more positive attitudes toward eating and stronger nutritional knowledge meant that a child was more likely to report eating healthy foods. Findings from this exploratory study contribute to knowledge in several areas because the findings represent the first of its kind in the discipline. [ABSTRACT FROM PUBLISHER]

Physical activity is beneficial at all stages of life, and has been linked as a protective factor from obesity, and other chronic health conditions. Despite the benefits of physical activity, less than half of US children meet the current recommendations, and activity levels decline with age. When planning physical activity interventions, behavioural theories should be utilised, given the inherent benefits theory-based approaches possess. The purpose of this study was to investigate how constructs of the Integrative Theoretical Model (IM) are associated with physical activity and screen time among children (9 years ±1.2; n = 264). Using structural equation modeling, a final model proved to have a good fit (CFI = 0.989; TLI = 0.975; RMSEA = 0.043), and results indicated intentions and perceived behavioural control (PBC) explained 19.4% of the variance for physical activity, and attitudes, perceived norms, and PBC accounted for 62% of the variance of intentions. Furthermore, attitudes and perceived norms were negatively associated with total screen time, and accounted for 10% of the variance. Results suggest that IM is a useful framework for explaining physical activity and screen time among children. [ABSTRACT FROM AUTHOR]

Background: The family is an important social context where children learn and adopt eating behaviors. Specifically, parents play the role of health promoters, role models, and educators in the lives of children, influencing their food cognitions and choices. This study attempts to systematically review empirical studies examining the influence of parents on child food consumption behavior in two contexts: one promotive in nature (e.g., healthy food), and the other preventive in nature (e.g., unhealthy food). Methods: From a total of 6,448 titles extracted from Web of Science, ERIC, PsycINFO and PubMED, seventy eight studies met the inclusion criteria for a systematic review, while thirty seven articles contained requisite statistical information for meta-analysis. The parental variables extracted include active guidance/education, restrictive guidance/rule-making, availability, accessibility, modeling, pressure to eat, rewarding food consumption, rewarding with verbal praise, and using food as reward. The food consumption behaviors examined include fruits and vegetables consumption, sugar-sweetened beverages, and snack consumption. Results: Results indicate that availability (Healthy: r = .24, p < .001; Unhealthy: r = .34, p < .001) and parental modeling effects (Healthy: r = .32, p < .001; Unhealthy: r = .35, p < .001) show the strongest associations with both healthy and unhealthy food consumption. In addition, the efficacy of some parenting practices might be dependent on the food consumption context and the age of the child. For healthy foods, active guidance/ education might be more effective (r = .15, p < .001). For unhealthy foods, restrictive guidance/rule-making might be more effective (r = -.11, p < .01). For children 7 and older, restrictive guidance/rule-making could be more effective in preventing unhealthy eating (r = -.20, p < .05). For children 6 and younger, rewarding with verbal praise can be more effective in promoting healthy eating (r = .26, p < .001) and in preventing unhealthy eating (r = -.08, p < .01). Conclusions: This study illustrates that a number of parental behaviors are strong correlates of child food consumption behavior. More importantly, this study highlights 3 main areas in parental influence of child food consumption that are understudied: (1) active guidance/education, (2) psychosocial mediators, and (3) moderating influence of general parenting styles. [ABSTRACT FROM AUTHOR]

Childhood obesity is a significant public health concern, and scholars and academicians have proposed the use of successful marketing and advertising tactics as a means of influencing healthy behaviors. This research investigates product placement to assess its potential effects on attitudes and behavior when utilized in an animated children’s television show. Results from an experiment suggest that multiple product placements may affect children’s attitudes toward certain drinks, but also suggest that a child’s existing favorite drink is a stronger predictor of actual beverage choice. Implications are provided. [ABSTRACT FROM PUBLISHER]

Objectives Children differ from adults in the expression of dizziness symptoms and the causes of dizziness. In several studies, benign paroxysmal vertigo of childhood (BPVC) and vestibular migraine (VM) were seen exclusively in children with vertigo, but the age threshold used to define ‘children’ varies, and there are few reported studies about adolescents with dizziness. In this study, we investigated the prevalence of vestibular and balance disorders according to age category in a multi-center study (otolaryngology departments of 11 hospitals) of children and adolescents. Methods Children and adolescents aged under 18 who visited the otolaryngology departments of 11 hospitals for dizziness were included. We classified the patients into three categories: preschool (up to and including 6-year-olds), school age (7- to 12-year-olds), and adolescents (13- to 18-year-olds). These patients were reviewed retrospectively based on their clinical charts. Results In the preschool age group, BPVC was most common, followed by VM. In the school-age group, BPVC and VMs were most common, followed by psychogenic vertigo and benign paroxysmal positional vertigo (BPPV). In adolescents, VM was the most common, and Ménière's disease, cardiogenic vertigo, and BPVC, which are seen primarily in adults, were also seen in some adolescents. Conclusion In children and adolescents with dizziness, VM and BPVC were the most common diseases, and prevalence of disease by age showed differing distributions. These findings will help in diagnosing and managing children and adolescents with vertigo. [ABSTRACT FROM AUTHOR]

Pediatric obesity is a worldwide health epidemic affecting both developed and developing countries. Mexico ranks second to the United States in rates of pediatric obesity. Obesity among youth has immediate and long-term consequences on physical and psychosocial development, including cardiovascular, respiratory, and health-related quality of life. Eventual amelioration of this epidemic will require change at the level of the family and community, along with policy initiatives to support healthier eating and activity habits. Evidence-based interventions for overweight/ obese youth include family-based lifestyle programs that incorporate attention to diet quantity and quality, physical activity, sedentary behavior, and behavioral strategies to support change. While much of this research has been conducted in the United States, several recent studies suggest the efficacy of similar approaches for youth in Mexico. [ABSTRACT FROM AUTHOR]

The study aimed to establish whether family characteristics and the health behaviour and illnesses of parents and children are associated with public health nurses' (PHNs') concerns about children's physical health and psychosocial development in the context of health examinations. Factors affecting children's health and well-being should be identified as early as possible to provide children and families appropriate support. In 2007-2009, a cross-sectional study in Finland collected information about PHNs' concerns, children's health and well-being as well as the background factors affecting them during health examinations of preschool-age children and school-aged children ( n = 4795). Associations between family characteristics, parents' and children's behaviour and diseases, and PHNs' concerns were assessed using logistic regression analysis. Overweight in children, the long-term illnesses of both children and parents, and parental smoking were the factors most strongly associated with PHNs' concerns about a child's physical health whereas non-nuclear family types, the father's low educational level and unemployment, the child's lack of sleep, and bullying were associated with concerns about the child's psychosocial development. The connections found demonstrate that health examinations should address factors that affect the whole family's well-being so as to comprehensively promote children's health, growth and development. [ABSTRACT FROM AUTHOR]

The article presents abstracts of pediatric exercise studies from various sports medicine and pediatric journals. A study by C. Maffeis and colleagues looked at the energy expenditure and intake in obese children. A study by J. C. Ozmun and colleagues studied neuromuscular responses to strength training. Other studies researched how health behaviors of parents affect their children's health behaviors, home exercise training in cystic fibrosis patients, and aerobic and anaerobic characteristics of prepubertal swimmers.

Background: Increasing social inequalities in health across Europe are widening the gap between low and high socio-economic groups, notably in the prevalence of obesity. Public health interventions may result in differential effects across population groups. Therefore, the EPHE (EPODE for the Promotion of Health Equity) project analysed the added value of community-based programmes, based on the EPODE (Ensemble Prévenons l'Obésité Des Enfants-Together Let's Prevent Obesity) model, to reduce socio-economic inequalities in energy balance-related behaviours of children and their family-environmental related determinants in seven European communities. This study presents the changes between baseline and follow-up after the one-year interventions and their sustainability one year after. Methods: This is a prospective study with a one school-year intervention, followed by one year of follow-up. In all, 1266 children (age 6-8 years) and their families from different socio-economic backgrounds were recruited at baseline. For 1062 children, information was available after one year (T1) and for 921 children after two years (T2). A self-reported questionnaire was completed by the parents to examine the children's energy balance-related behaviours and family- environmental determinants. Socio-economic status was defined by the educational level of the mother. The Wilcoxon signed-rank test for paired data was used to test the differences between baseline and intermediate, and between intermediate and final, measurements for each of the socio-economic status groups. Results: Post-intervention effects in energy-balance related behaviours showed the following improvements among the low socio-economic status groups: increased fruit consumption (Netherlands), decreased fruit juices amount consumed (Romania) and decreased TV time on weekdays (Belgium). Whereas in only the latter case the behavioural change was accompanied with an improvement in a family-environmental determinant (monitoring the time the child watches TV), other improvements in parental rules and practices related to soft drinks/fruit juices and TV exposure were observed. A few of those effects were sustainable, notably in the case of Belgium. Conclusions: Inequalities in obesity-related behaviours could be potentially reduced when implementing community-based interventions, tailored to inequality gaps and using the EPODE methodology. Within-group changes varied widely, whereas monitoring of interventions and process evaluation are crucial to understand the observed results. [ABSTRACT FROM AUTHOR]

OBJECTIVE. In this study, we explored the impact of an occupational therapy wellness program on daily habits and routines through the perspectives of youth and their parents. METHOD. Data were collected through semistructured interviews with children and their parents, the Pizzi Healthy Weight Management Assessment©, and program activities. RESULTS. Three themes emerged from the interviews: Program Impact, Lessons Learned, and Time as a Barrier to Health. The most common areas that both youth and parents wanted to change were time spent watching television and play, fun, and leisure time. Analysis of activity pie charts indicated that the youth considerably increased active time in their daily routines from Week 1 to Week 6 of the program. CONCLUSION. An occupational therapy program focused on health and wellness may help youth and their parents be more mindful of their daily activities and make health behavior changes. [ABSTRACT FROM AUTHOR]