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Smoking is a leading cause of preventable morbidity and mortality globally. During the COVID-19 pandemic, Smoking Cessation (SC) services faced many challenges, including lockdown and social distancing restrictions. Consequently, SC services had to adapt to the challenges in different ways or halt delivery. This research evaluated the impact of COVID-19 on the delivery and outcomes of SC services. This was achieved by comparing service delivery and outcomes pre-COVID-19 and during the pandemic and drawing insights for the delivery of SC services post-pandemic. Secondary analysis was performed on the data of 11,533 participants who attended the One Life Suffolk (OLS) SC services pre- and during the COVID-19 pandemic. A total of 4923 and 6610 participants attended SC services pre-COVID-19 and during COVID-19 respectively. Fifty-four percent of participants achieved quit status at week-4 while attending the SC services during the COVID-19 pandemic, compared with 46% pre-COVID-19, (X2(1) = 38.2, p-value<0.001). Participants who attended the SC services during the COVID-19 period were 1.7 times more likely to achieve quit status at week-4 than pre-COVID-19. However, the proportion of participants lost-to-follow-up (LTF) was significantly higher during the COVID-19 period (11%) compared to pre-COVID-19 (7%), (X2(1) = 51.4, p-value <0.001). There was an increased participation and quit rate during the pandemic for modified, remotely delivered SC services indicating successful delivery of remote services during the pandemic. Although switching from face-to-face to online helped some smokers to access the service at a time of motivational readiness, despite the COVID-19 restrictions, some smokers could not access or use some aspects of the remote delivery due to a lack of internet access, poor digital literacy, no peer support and no commitment to a group during face-to-face sessions, contributing to an increased rate of LTF. Posing a major challenge to SC services delivery, COVID-19 compelled OLS SC services to adapt and be more innovative in their delivery. SC services need to continue to evolve and adapt by applying the lessons learnt during the pandemic in terms of flexibility and person-centered delivery given what did and did not work well for different demographics within the population. [ABSTRACT FROM AUTHOR]

Objective: With growing concerns to establish the value for returns on public health investment, there is a need to identify cost-effective physical activity interventions. This study measured change in moderate physical activity (MPA) in seven community-based intervention types, costs and cost-effectiveness of the interventions, and possible explanations for cost variation. Design: Between 2004 and 2006, pre- and post-intervention assessments identified demographics and MPA levels, and quarterly interviews with intervention managers identified key implementation costs. Setting: Nine sites across the UK. Method: MPA was collected using self-report measures. MPA categories (sedentary, lightly, moderately, highly active) were assigned at pre- and post-intervention. Differences between pre- and post-intervention scores identified MPA change (median metabolic equivalent (MET)-minutes/week) in completers. Cost, attendance and activity data were combined to estimate the average monthly implementation cost, cost per participant attending interventions, and the cost per completer improving MPA category. An economic model was built to estimate the cost per Quality Adjusted Life Year (QALY) gained and potential savings to the National Health Service (NHS). Results: Demographics (n = 984) show that those who engaged with the interventions were predominantly white, British older females. In completers (N = 1,051), 37.9 per cent improved at least one MPA category. The cost per completer improving MPA category ranged from 260 British Pounds to 2,786 British Pounds (N = 1000). The cost per QALY gained from intervention types ranged from 47 British Pounds to 509 British Pounds, which was below the 20,000 British Pounds threshold implicit in National Institute for Health and Clinical Excellence (NICE) decisions. Future cost savings to the NHS per intervention participant ranged from 769 British Pounds to 4,891 British Pounds. In the case of each of the interventions, this saving per participant exceeds the implementation cost per participant, which ranged from 55 British Pounds to 3,420 British Pounds (N = 6940). Conclusions: MPA interventions are cost-effective. (Contains 3 tables.)

Objective: Identifying community physical activity interventions that facilitate increases in moderate physical activity (MPA) is important in meeting targets set in government health policy. This study evaluated community interventions that aimed to increase levels of MPA. Intervention themes included exercise referral, classes and groups, peer mentoring, motivational interviewing, campaigns and directories, outdoor activity and training physical activity leaders. Design: Longitudinal, pre-intervention and intervention assessments occurred between 2004 and 2006. Setting: Recruitment of 10,433 people from ten sites located in areas of high health need across England. Method: Demographic data were collected by questionnaire, with seven-day, population-specific self-reports assessing pre-intervention and intervention MPA. Using guidelines for young people and adults, MPA MET-minutes/week were used to assign participants to four MPA categories (sedentary, lightly, moderately and highly active) at pre-intervention and intervention phases. Cross-tabulation established movement between three change categories (reversal, stability and progression). Results: From nine sites, 5324 people engaged in the evaluation, and a sub-sample of 998 provided demographic and 1022 self-report baseline and intervention data (i.e. completers) for a typical week's physical activity participation. Of completers who were sedentary or lightly active at pre-intervention, 58.5 per cent achieved recommended physical activity guidelines. 80.9 per cent who were sedentary at pre-intervention reported as lightly, moderately or highly active at intervention. Conclusions: Completers increased overall activity levels, including those sedentary and lightly active at pre-intervention who increased levels to recommended guidelines. (Contains 2 tables.)

The purpose of this investigation was to evaluate the postactivation potentiation (PAP) effects of both dynamic and isometric maximum voluntary contractions (MVCs) on sprint and jump performance and establish whether PAP methods could be used effectively in warm up protocols for soccer players. Twelve male soccer players performed 4 warm up protocols in a crossover, randomized, and counterbalanced design. In addition to a control warm up, subjects performed deadlift (5 repetitions at 5 repetitions maximum), tuck jump (5 repetitions), and isometric MVC knee extensions (3 repetitions for 3 s) as PAP treatments in an otherwise identical warm up protocol. After each treatment, the subjects underwent 3 10 m and 20 m sprints 4, 5, and 6 minutes post-warm up and 3 vertical jumps (VJ) at 7, 8, and 9 minutes post-warm up. Repeated measures analysis of variance showed no significant differences in the first 10 m (p = 0.258) and 20 m (p = 0.253) sprint and VJ (p = 0.703) performance and the average 10 m (p = 0.215), 20 m (p = 0.388), and VJ (p = 0.529) performance between conditions. There were also no significant differences in performance responses between the strongest and weakest subjects, but large variations in individual responses were found between the subjects. The findings suggest that there was no significant group PAP effect on sprint and jump performance after dynamic and isometric MVCs compared with a control warm up protocol. However, the large variation in individual responses (-7.1% to +8.2%) suggests PAP should be considered on an individual basis. Factors such as method, volume, load, recovery, and interindividual variability of PAP must be considered in the practical application of PAP and the rigorous research design of future studies to evaluate the potential for performance enhancement. KEY WORDS warm up, power, strength, individual responses

Purpose: To quantify the peak post-pitch-entry physical responses of soccer substitutes while assessing contextual influences. Peak responses may be important performance indicators for substitutes introduced to provide a physical impact. Method: Thirty-three professional substitutes wore Microelectromechanical Systems during 44 matches (4 ± 3 observations·player−1). Post-pitch-entry relative peak values for total and high-speed (> 5.5 m·s−1) distances, average acceleration, and PlayerLoad™ were calculated using rolling averages over 60-s to 600-s. Linear mixed models assessed contextual influences (position, substitution timing, scoreline, and location). Results: Substitutes introduced during the final ~15 min of match-play covered less high-speed distance than first-half substitutes (~2.8–3.1 m·min−1) over 480-s to 600-s epochs, and less than 60:00–74:59 min substitutes (~1.7–1.8 m·min−1) during 540-s and 600-s epochs. Average acceleration during all except 180-s epochs was lower for 75:00+ min substitutes compared with first-half replacements (~0.27–0.43 m·s−2), and lower than 60:00–74:59 min substitutes during 60-s (~0.13 m·s−2). Substitutes introduced when their team was winning recorded greater distances over 120-s to 600-s (~6.2–7.7 m·min−1), and higher PlayerLoad™ values during 120-s, 180-s, 300-s, and 480-s epochs (~2.7–3.6 arbitrary units·min−1), compared with when scores were level at pitch-entry. Irrespective of substitution timing, substitute midfielders exceeded the total distance of substitute attackers (~5.9–16.2 m·min−1) for all except 360-s and 600-s epochs, and defenders (~13.3–26.7 m·min−1) during epochs < 300-s. Conclusions: This study provides benchmark data for practitioners tailoring training and recovery protocols, particularly "top-up" conditioning, to the competitive demands of soccer substitutes. Knowing how contextual factors influence substitutes' peak match-play responses may help managers/coaches assess the efficacy of substitution strategies. [ABSTRACT FROM AUTHOR]

This study examined the relationships between selected kinematic and physiological parameters and their influence on performance during incremental exercise in elite swimmers competing at the international level. Eleven men and ten women (all specialized in 200-m events) performed an incremental 7 x 200-m test in their specialized stroke. Stroke rate (SR), stroke length (SL), velocity (V), and blood lactate concentration (BLa) were measured for each 200 m. In addition to the crosssectional group design, the longitudinal performance of a male swimmer was evaluated by 4 tests during a period of 20 weeks. Stroke rate increased and SL decreased with V, regardless of the age, stroke, or gender of the swimmer. Statistically significant correlations were found between SR and V (p < 0.01; r = 0.66 to 0.99),SR and SL(p < 0.01; r= -0.78 to - 0.99), SL and V (except for women's freestyle and breast-stroke) (p < 0.01; r = -0.67 to -0.98), and BLa and V (p < 0.01; r = 0.7 to 0.96). Changes in SR and SL were not affected by changes in BLa. Similar velocities were produced with different combinations of SR and SL. The fastest times reached in the test were generally slower than expected, and the performance in the test was not associated with competition performance. The case study revealed similar results to those of the group. The test used in this study was informative with respect to identifying the most economical and effective stroke kinematics combination for slow to submaximal velocities. It is possible that the swimming speeds were not maximal in the final 200-m swim because of cumulative fatigue, which is a major limitation for assessing race pace. An additional test that produces velocities similar to those used in competitions would be more useful for the purpose of providing optimal kinematic information specific to racing speeds, which would facilitate performance improvement through regular monitoring in training. KEY WORDS swimming, biomechanics, stroke rate, stroke length, lactate, exercise test

Aerobic and anaerobic performance of the upper body (UB) and lower body (LB) were assessed by arm cranking and treadmill tests respectively in a comparison of national (N) and international (I) male gymnasts. Force velocity and Wingate tests were performed using cycle ergometers for both arms and legs. In spite of a significant difference in training volume (4-12 vs. 27-34 h x [wk.sup.-1] for N and I, respectively), there was no significant difference between N and I in aerobic and anaerobic performance. Upper body and LB maximal oxygen uptake ([Vo.sub.2]max) values were 34.44 [+ or -] 4.62 and 48.64 [+ or -] 4.63 ml x [kg.sup.-1] x [min.sup.-1] vs. 33.39 [+ or -] 4.77 and 49.49 [+ or -] 5.47 ml x [kg.sup.-1] x [min.sup.-1], respectively, for N and I. Both N and I had a high lactic threshold (LT), at 76 and 82% of [Vo.sub.2]max, respectively. Values for UB and LB force velocity (9.75 [+ or -] 1.12 and 15.07 [+ or -] 4.25 vs. 10.63 [+ or -] 0.95 and 15.87 [+ or -] 1.25 W x [kg.sup.-1]) and Wingate power output (10.43 [+ or -] 0.74 and 10.98 [+ or -] 3.06 vs. 9.58 [+ or -] 0.60 and 13.46 [+ or -] 1.34 W x [kg.sup.-1]) were also consistent for N and I. These findings confirm the consistency of [Vo.sub.2]max values presented for gymnasts in the last 4 decades, together with an increase in peak power values. Consistent values for aerobic and anaerobic performance suggest that the significant difference in training volume is related to other aspects of perfomance that distinguish N from I gymnasts. Modern gymnastics training at N and I levels is characterized by a focus on relative strength and peak power. In the present study, the high LT is a reflection of the importance of strength training, which is consistent with research for sports such as wrestling. KEY WORDS. [Vo.sub.2]max, peak power output, strength training, lactic threshold

The aim of this study was to examine the effects of sprint running training on sloping surfaces (3[degrees]) on selected kinematic and physiological variables. Thirty-five sport and physical education students were randomized into 4 training groups (uphill-downhill, downhill, uphill, and horizontal) and a control group, with 7 participants in each group. Pre- and posttraining tests were performed to examine the effects of 6 weeks of training on the maximum running speed at 35 m, step rate, step length, step time, contact time, eccentric and concentric phase of contact time, flight time, selected posture characteristics of the step cycle, and peak anaerobic power performance. Maximum running speed and step rate were increased significantly (p < 0.05) in a 35-m running test after training by 0.29 m x [s.sup.-1] (3.5%) and 0.14 Hz (3.4%) for the combined uphill-downhill group and by 0.09 m x [s.sup.1] (1.1%) and 0.03 Hz (2.4%) for the downhill group, whereas flight time shortened only for the combined uphill-downhill training group by 6 milliseconds (4.3%). There were no significant changes in the horizontal and control groups. Overall, the posture characteristics and the peak anaerobic power performance did not change with training. It can be suggested that the novel combined uphill-downhill training method is significantly more effective in improving the maximum running velocity at 35 m and the associated horizontal kinematic characteristics of sprint running than the other training methods are. KEY WORDS. combined uphill-downhill training, posture characteristics, Wingate test

Objective. The evidence base for child obesity treatment is weak. Children&apos;s weight-loss camps, despite their popularity, have not been properly evaluated. This study evaluated the effectiveness of a residential weight-loss camp program for overweight and obese children. Methods. A total of 185 overweight children (mean age: 13.9 years) enrolled in 1 of 4 consecutive programs between 1999 and 2002 (intervention group) were compared with 94 children of similar ages who were not camp attendees, ie, 38 overweight children and 56 normal-weight children. The intervention group attended a 6-week (maximum) summer residential weight-loss camp. The program included a daily schedule of six 1-hour, skill-based, fun, physical activity sessions, moderate dietary restriction, and group-based educational sessions. All children were assessed for body weight, height, and other anthropometric measures, blood pressure, aerobic fitness, self-esteem, and selected sports skills. Results. Campers, who stayed for a mean of 29 days, lost 6.0 kg, reduced their BMI by 2.4 units, and reduced their BMI SD scores by 0.28. Fat mass decreased significantly (from 42.7 to 37.1 kg), whereas fat-free mass did not change. In contrast, both comparison groups gained weight during this period. Camp attendees also showed significant improvements in blood pressure, aerobic fitness, and self-esteem. Longer durations of stay were associated with greater improvements in outcomes. Conclusions. In the short term at least, this weight-loss program was effective across a range of health outcomes. Ongoing research is examining the maintenance of these improvements. Future research should investigate whether benefits can be generalized across weight-loss camps and how the intervention can be adapted to nonresidential, term-time settings., Child obesity has been described as a "pandemic of the new millennium." (1) This reflects the rising worldwide prevalence of obesity among children, the increased risk for adult obesity, and [...]

The addition of carbohydrate (CHO) to an acute creatine (Cr) loading regimen has been shown to increase muscle total creatine content significantly beyond that achieved through creatine loading alone. However, the potential ergogenic effects of combined Cr and CHO loading have not been assessed. The purpose of this study was to compare swimming performance, assessed as mean swimming velocity over repeated maximal intervals, in high-performance swimmers before and after an acute loading regimen of either creatine alone (Cr) or combined creatine and carbohydrate (Cr + CHO). Ten swimmers (mean [+ or -] SD of age and body mass: 17.8 [+ or -] 1.8 years and 72.3 [+ or -] 6.8 kg, respectively) of international caliber were recruited and were randomized to 1 of 2 groups. Each swimmer ingested five 5 g doses of creatine for 4 days, with the Cr + CHO group also ingesting ~100 g of simple CHO 30 minutes after each dose of creatine. Performance was measured on 5 separate occasions: twice at 'baseline' (prior to intervention, to assess the repeatability of the performance test), within 48 hours after intervention, and then 2 and 4 weeks later. All subjects swam faster after either dietary loading regimen (p < 0.01, both regimens); however, there was no difference in the extent of improvement of performance between groups. In addition, all swimmers continued to produce faster swim times for up to 4 weeks after intervention. Our findings suggest that no performance advantage was gained from the addition of carbohydrate to a creatine-loading regimen in these high-caliber swimmers. KEY WORDS. creatine loading, carbohydrate ingestion, swimming performance

Complex training is the method of coupling heavy and light loads into an organized sequence with the aim of facilitating postactivation potentiation. Anecdotal evidence has supported the use of complex training sequences, but scientific studies investigating the effects of sequencing isometric loads with dynamic muscle actions have been limited. The purpose of this study was to examine the effects of a preconditioning sequence of maximal isometric knee extensions on performance standards in selected dynamic whole-body exercise. Fourteen track and field athletes (23 [+ or -] 5.7 years; 71.53 [+ or -] 6.93 kg; 172.6 [+ or -] 5.8 cm) were randomly assessed in selected whole-body exercises (drop and countermovement jumps, 5-second cycle sprint, knee extension) following a sequence of maximal voluntary isometric contractions (MVC; 3 repetitions of 3 seconds or 3 repetitions of 5 seconds) or in the absence of prior loading (control). Electromyographic (EMG) assessments of muscle activity were also made during the knee extension assessment. Significant (p [less than or equal to] 0.05) increases in jump height (5.03%), maximal force (4.94%), and acceleration impulse (9.49%) were observed in the drop jump following 3 repetitions of 3-second MVC only. Knee extension maximal torque was also significantly increased (6.12%) following the 3-second MVC. No significant changes in countermovement jump or cycle sprint measures were observed for any of the experimental conditions. Though adaptations were found, changes in EMG activity were not significantly different for any of the experimental conditions. These data indicate that performing a sequence of repeated maximal isometric knee extensions (3 repetitions of 3 seconds) prior to selected dynamic exercise ([less than or equal to] 0.25 seconds) may have favorable effects on performance beyond standards achieved without prior heavy loading. Key Words: neuromuscular, force, contraction, complex training, potentiation