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We developed age- and sex-specific smoothed percentiles for vertical and long jump, as well as vertical jump power, in healthy 10-18 year olds (n = 529, 47.1% female). Jump height and distance were measured and vertical jump power was assessed via mechanography. LMS regression was used to create smoothed age-specific reference curves, separated by sex. Pearson correlations between the jumps ranged from r = 0.22 to 0.64, varying by age and sex. Comparing medians, younger males had slightly higher values for vertical and long jump compared to females. Vertical jump power was more comparable between the sexes. For all measures, differences between the sexes become more pronounced at ages associated with the transition into adolescence. Growth model coefficients are reported for calculation of Z-scores. The growth curves can be used to compare samples, track lower body power, and link tests of fitness to athletic performance or health-related outcomes.

Using a sample of healthy youth (n = 466, 10 to 18 yr), we report the predictive utility of vertical jump power (VJ Power, W) for predicting bone strength. We measured VJ Power using mechanography and an indicator of bone strength, i.e., height-adjusted total bone mineral content less head (TBLH BMC, g), using DXA. Growth curve models were used to convert VJ Power to age- and sex-specific percentiles/Z-scores. Associations were examined using receiver operator characteristic curve analysis, i.e., area-under-the-curve (AUC), as well as sensitivity (Se) and specificity (Sp) for Desirable, Marginal, and Low groups based on VJ Power percentiles. The AUC was 0.84 for TBLH BMC [less than or equal to] -2.0 Z-score from VJ Power percentiles. Se for Marginal and Low groups were 71.4% and 42.9%, respectively. Sp for Marginal and Low groups were 85.2% and 95.1%, respectively. The results suggest the utility of using VJ Power percentiles for assessing bone strength.

This study summarized protocols in the "Lisbon Study for the Development and Evaluation of Musculoskeletal Fitness Standards in Youth" and assessed associations between fitness assessments and health outcomes. The sample was 529 children and adolescents (10 to 18 yr). The fitness assessments included handgrip, vertical jump, long jump, plank, and lower body power. The health outcomes were total body and hip bone mineral content, hip bone mineral density, and total body lean tissue mass. Correlation analyses examined associations unadjusted and adjusted for size and maturity. After adjustment, in females, vertical jump, long jump, and lower body power were associated with all health outcomes (r = 0.22 to 0.55, p < 0.05). In males, all fitness assessments were associated with all health outcomes (r = 0.17 to 0.64, p < 0.05). Musculoskeletal fitness assessments including non-invasive and easy-to-measure field assessments are associated with important muscle and bone health outcomes in youth.

Author(s): Nathan C. Nickel 1,*, Wanda Phillips-Beck 2,*, Jennifer E. Enns 1, Okechukwu Ekuma 1, Carole Taylor 1, Sarah Fileatreault 1, Nkiru Eze 1, Leona Star 2, Josée Lavoie 3, [...], Background Differential access to healthcare has contributed to a higher burden of illness and mortality among First Nations compared to other people in Canada. Throughout the Coronavirus Disease 2019 (COVID-19) pandemic, First Nations organizations in Manitoba partnered with public health and Manitoba government officials to ensure First Nations had early, equitable and culturally safe access to COVID-19 diagnostic testing and vaccination. In this study, we examined whether prioritizing First Nations for vaccination was associated with faster uptake of COVID-19 vaccines among First Nations versus All Other Manitobans (AOM). Methods and findings In this retrospective cohort study, we used linked, whole-population administrative data from the Manitoba healthcare system (February 2020 to December 2021) to determine rates of COVID-19 diagnostic testing, infection, and vaccination, and used adjusted restricted mean survival time (RMST) models to test whether First Nations received their first and second vaccine doses more quickly than other Manitobans. The cohort comprised 114,816 First Nations (50.6% female) and 1,262,760 AOM (50.1% female). First Nations were younger (72.3% were age 0 to 39 years) compared to AOM (51% were age 0 to 39 years) and were overrepresented in the lowest 2 income quintiles (81.6% versus 35.6% for AOM). The 2 groups had a similar burden of comorbidities (65.8% of First Nations had none and 6.3% had 3 or more; 65.9% of AOM had none and 6.0% had 3 or more) and existing mental disorders (36.9% of First Nations were diagnosed with a mood/anxiety disorder, psychosis, personality disorder, or substance use disorder versus 35.2% of AOM). First Nations had crude infection rates of up to 17.20 (95% CI 17.15 to 17.24) COVID-19 infections/1,000 person-months compared with up to 6.24 (95% CI 6.16 to 6.32) infections/1,000 person-months among AOM. First Nations had crude diagnostic testing rates of up to 103.19 (95% CI 103.06 to 103.32) diagnostic COVID-19 tests/1,000 person-months compared with up to 61.52 (95% CI 61.47 to 61.57) tests/1,000 person-months among AOM. Prioritizing First Nations to receive vaccines was associated with faster vaccine uptake among First Nations versus other Manitobans. After adjusting for age, sex, income, region of residence, mental health conditions, and comorbidities, we found that First Nations residents received their first vaccine dose an average of 15.5 (95% CI 14.9 to 16.0) days sooner and their second dose 13.9 (95% CI 13.3 to 14.5) days sooner than other Manitobans in the same age group. The study was limited by the discontinuation of population-based COVID-19 testing and data collection in December 2021. As well, it would have been valuable to have contextual data on potential barriers to COVID-19 testing or vaccination, including, for example, information on social and structural barriers faced by Indigenous and other racialized people, or the distrust Indigenous people may have in governments due to historical harms. Conclusion In this study, we observed that the partnered COVID-19 response between First Nations and the Manitoba government, which oversaw creation and enactment of policies prioritizing First Nations for vaccines, was associated with vaccine acceptance and quick uptake among First Nations. This approach may serve as a useful framework for future public health efforts in Manitoba and other jurisdictions across Canada.

Background: Evidence of the positive effects of school physical activity (PA) interventions, including classroom-based PA (CBPA), is rapidly growing. However, few studies examine how variations in scheduled PA opportunities and teacher-implemented CBPA affect students' PA outcomes. Methods: Teachers at five elementary schools attended training on how to implement CBPA. Data on school day PA opportunities (physical education [PE], recess, CBPA) were obtained via calendar and teacher-recorded CBPA logs. Daily step counts were measured via accelerometry in 1,346 students across 65 classrooms in first through fifth grades. Results: PE, recess, and CBPA contributed significantly to students' daily steps. Males accrued more steps than females over the school day, during PE, and during recess. No gender disparity was seen in the amount of additional steps accrued during CBPA. Overall step counts were lower among fifth grade students versus first grade students, but CBPA attenuated this difference such that grade level differences were not significant in fifth grade students who received CBPA. Conclusions: Gender disparities in step totals were present on PE and recess days, but not on CBPA days. CBPA appears to provide equal PA benefits for both genders, and to potentially minimize the decline in PA among older students.

Low-income and middle-income countries are struggling with a growing epidemic of non-communicable diseases. To achieve the Sustainable Development Goals, their healthcare systems need to be strengthened and redesigned. The Starfield 4Cs of primary care-first-contact access, care coordination, comprehensiveness and continuity-offer practical, high-quality design options for non-communicable disease care in low-income and middle-income countries. We describe an integrated non-communicable disease intervention in rural Nepal using the 4C principles. We present 18 months of retrospective assessment of implementation for patients with type II diabetes, hypertension and chronic obstructive pulmonary disease. We assessed feasibility using facility and community follow-up as proxy measures, and assessed effectiveness using singular 'at-goal' metrics for each condition. The median follow-up for diabetes, hypertension and chronic obstructive pulmonary disease was 6, 6 and 7 facility visits, and 10, 10 and 11 community visits, respectively (0.9 monthly patient touch-points). Loss-to-follow-up rates were 16%, 19% and 22%, respectively. The median time between visits was approximately 2 months for facility visits and 1 month for community visits. 'At-goal' status for patients with chronic obstructive pulmonary disease improved from baseline to endline (p=0.01), but not for diabetes or hypertension. This is the first integrated non-communicable disease intervention, based on the 4C principles, in Nepal. Our experience demonstrates high rates of facility and community follow-up, with comparatively low lost-to-follow-up rates. The mixed effectiveness results suggest that while this intervention may be valuable, it may not be sufficient to impact outcomes. To achieve the Sustainable Development Goals, further implementation research is urgently needed to determine how to optimise non-communicable disease interventions.