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In recent decades, the interest in having an ideal body in men has caused a pathological tendency to be muscular, followed by a tendency to use anabolic-androgenic steroids (AASs). This study was designed to evaluate the mediating role of muscle dysmorphia in the relationship between early maladaptive schemas and body image-related cognitive fusion with the tendency to use AAS in male athletes. Out of the total number of men referring to fitness clubs in Isfahan, Iran, 474 men were evaluated using a multistage random cluster sampling method. The questionnaires used in this research included the Muscle Dysmorphic Disorder Inventory, Cognitive Fusion Questionnaire—Body Image, Young Schema Questionnaire—Short Form, and Prototype Willingness Model Questionnaire. The results demonstrated that the relationship of AAS use with body image-related cognitive fusion and the three maladaptive schemas with the mediation of muscle dysmorphia is significant. The present study provides significant implications in the discussion of prevention and treatment of AAS addiction. [ABSTRACT FROM AUTHOR]

To reduce the spread of COVID-19, in March of 2020, the state of Virginia issued a stay-at-home order requiring fitness center closures for 2.4 months. The purpose of this study was to explore how the fitness center closures influenced physical activity (PA) in older adults who previously participated in the centers' exercise classes. Eleven older adults (69.0 ± 6.6 years) completed semistructured interviews, which were transcribed and analyzed to identify emergent themes. Ten participants reported engaging in PA during the stay-at-home order; four participants maintained/increased PA compared to prepandemic levels. Four themes emerged regarding PA are as follows: recognition of the value of PA, high self-efficacy in regard to PA, adaptation to circumstances, and functional limitations. Findings suggest that prior exercise class participation positively influenced PA. While most participants did not maintain prepandemic PA levels, they remained active because they recognized the benefits of PA, had high self-efficacy for exercise, and adapted to their circumstances. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic disrupted the daily life and routines of Americans across the United States (U.S.), including those of our active-duty service members (ADSMs). Limited movement orders enacted during this time to promote social distancing prohibited access to fitness and dining facilities for ADSMs. This study aims to expand on previous work identifying changes in body mass index (BMI) among U.S. Army service members by identifying changes in body mass index (BMI) among active-duty service members from both the Navy and Marine Corps during the same time period. Methods: We conducted a retrospective cohort study of active-duty service members from the Navy and Marine Corps using data from the Military Health System Data Repository. BMI was calculated and categorized according to CDC guidelines both before (February 2019 - January 2020) and during the pandemic (September 2020 - June 2021). Women who were pregnant or delivered during and one year prior to the study periods were excluded. Statistical analyses included paired t-tests evaluating mean BMI, percent change, and the Stuart-Maxwell test for marginal homogeneity. Results: We identified 98,330 active-duty Sailors and 55,298 active-duty Marines for inclusion in this study. During the pandemic period the percentage of Sailors with Underweight decreased by 11%, Healthy weight decreased by 11.1%, Overweight increased by 2.1%, and the percentage of Sailors with Obesity increased by 16.5%. During this same time period, Marines with Underweight decreased by 1%, Healthy weight decreased by 16%, Overweight increased by 3.0%, and Marines with Obesity increased by 51%. The largest increases in service members with overweight and obesity observed among both cohorts were among female service members, service members under age 20, and service members with a Junior Enlisted rank. Conclusions: Significant increases in obesity were observed amongst active-duty United States Navy and Marine Corps service members during DoD pandemic mitigation efforts. Increased rates of obesity likely effected fitness and force readiness. Future interventions should be targeted at younger, Junior-Enlisted Marines and Sailors to promote healthy lifestyles and provide education on nutrition, appropriate exercise, sleep hygiene, and stress management. [ABSTRACT FROM AUTHOR]

AbstractThe increased popularity of swinger clubs across the UK in the past two decades has not been met with commensurate public health initiatives or interventions that engage with the relationship between swinger clubs and sexual health. Consequently, the responsibility for sexual health promotion within these establishments largely depends on the discretion of club managers. Drawing on data from semi-structured interviews with 10 managers from across the UK, the study suggests that the managers’ perceptions of the club-consumer relationship shape the nature of sexual health promotion. Three distinct approaches were evident in the research: those who perceive sexual health promotion as financially detrimental; those who see it as an individual rather than a collective club concern; and those who consider it as part of a broader social community responsibility. These findings highlighted an implicit beneficence of managers towards their customers; a shared assumption that an ideal consumer was heterosexual, partnered and in their forties; and differing perceptions of manager responsibility towards the sexual health of customers. The paper concludes by suggesting that the swinger community is a blind spot in sexual health discussion in the UK and that by talking to the managers of swinger clubs we can further develop our understanding of the area. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is common among older adults and is associated with poor health outcomes. Medical fitness facilities provide a medically focused approach to physical fitness and can improve physical activity in their communities. This study aimed to assess the relationship between membership in the medical fitness model and all-cause mortality, health care utilization, and major adverse cardiac events in older adults. Methods: A propensity weighted retrospective cohort study linked individuals that attended medical fitness facilities to provincial health administrative databases. Older adults who had at least 1 year of health coverage from their index date between January 1st, 2005 to December 31st 2015 were included. Controls were assigned a pseudo-index date at random based on the frequency distribution of index dates in members. Members were stratified into low frequency attenders (< 1 Weekly Visits) and regular frequency attenders (> 1 Weekly Visits). Time to event models estimated the hazard ratios (HRs) for risk of all-cause mortality and major adverse cardiac event. Negative binomial models estimated the risk ratios (RRs) for risk of hospitalizations, outpatient primary care visits and emergency department visits. Results: Among 3,029 older adult members and 91,734 controls, members had a 45% lower risk of all-cause mortality (HR: 0.55, 95% CI: 0.50 – 0.61), 20% lower risk of hospitalizations (RR: 0.80, 95% CI: 0.75 – 0.84), and a 27% (HR: 0.72, 95% CI: 0.66 – 0.77), lower risk of a major adverse cardiovascular event. A dose–response effect with larger risk reductions was associated with more frequent attendance as regular frequency attenders were 4% more likely to visit a general practitioner for a routine healthcare visit (RR: 1.04, 95% CI: 1.01 – 1.07), but 23% less likely to visit the emergency department (RR: 0.87, 95% CI: 0.82 – 0.92). Conclusions: Membership at a medical fitness facility was associated with a decreased risk of mortality, health care utilization and cardiovascular events. The medical fitness model may be an alternative approach for public health strategies to promote positive health behaviors in older adult populations. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity is critical for health promotion and the prevention of noncommunicable illnesses, especially among teenagers. However, teenagers' active participation in physical exercise may be hampered by perceived impediments to physical activity. Objective: This study aimed to identify the external and internal barriers to physical activities among adolescents, as well as any differences in these barriers between males and females. Methods: A cross-sectional study was carried out among 600 adolescent students (aged 11–16) from a public school in Jordan. A self-administered questionnaire with 12 items assessed barriers to physical activity. Internal and external barriers were identified, and statistical analyses were performed using SPSS. Results: Male adolescents reported more perceived hurdles to physical exercise than female adolescents, with lack of time and lack of self-confidence being the most significant impediments. External impediments were more prominent than internal barriers, particularly a lack of resources. The total score for external barriers was significantly higher than that for internal barriers. "Lack of resources" was the most important external barrier (mean = 3.49), and "lack of self-confidence" was the most significant internal barrier (mean = 3.47). Male and female teenagers differed in the obstacles of "lack of self-confidence" (p =.045) and "lack of time" (p =.040). The most significant perceived hurdles included a lack of awareness of the health benefits of exercise, concerns about appearance while exercising, limited access to fitness centers, lack of exercise equipment at home, and insufficient spare time due to a packed class schedule. Conclusion: It is critical to implement interventions that address the identified barriers to physical activity, particularly among female adolescents, such as improving opportunities for physical activity and providing social support for participation. [ABSTRACT FROM AUTHOR]

This study examined the effects of the Nirvana Fitness (NF) program on state body appreciation (BA) and its correlates, as well as the mechanisms that could explain these changes. The study participants were allocated to NF (n = 21) and functional training (control, n = 22) groups and participated in an 8-week exercise intervention. The mean age was 24.4 ± 6.7. The participants filled out online questionnaires on state measures of BA, body surveillance (BS), functionality appreciation, body–mind connection, mindfulness in physical activity (SMS-PA), intrinsic exercise motivation (IM), satisfaction of basic psychological needs, and perceived physical fitness (PPF) immediately after the first and last sessions. The results revealed a significant improvement in state BA and its correlates in both groups, with no changes in PPF in the NF group or IM in either group. An interaction between group and time effects was revealed in a change of relatedness, indicating a stronger effect in the NF group. Positive changes in SMS-PA, BS, and satisfaction of the need for relatedness significantly predicted improvement in state BA. These findings highlight the importance of targeting mindfulness, body surveillance, and relatedness during physical activity in interventions aimed at promoting positive body image in university-aged women. [ABSTRACT FROM AUTHOR]

Background: Despite significant changes in healthcare, work practices, and leisure activity, the proposed precipitating factors for abdominal wall hernias have remained largely unchanged for almost two centuries. We aimed to investigate if there have been shifts in these factors over time by examining patients' perception of precipitating factors for abdominal wall hernia development. This study was conducted in the Royal College of Surgeons In Ireland Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, where patients with abdominal wall hernias completed a questionnaire. Results: A total of 277 patients (mean age 55.7; 85.6% male) with abdominal wall hernia completed the questionnaire (66.1% inguinal; 10.8% umbilical; 6.9% paraumbilical; 10.5% epigastric; 3.2% incisional; 1.4% femoral, and 1.1% port-site). One hundred and twenty patients (43.3%) believed their hernia was due to lifting, 71 (25.6%) cited gym activity and 17 (6.1%) cited other sporting activities as the precipitating factor. Traditional factors – chronic cough and constipation - were cumulatively cited only by 11 patients (4.0%), while prostatic obstruction was not cited by any. Conclusion: This study suggests that fitness pursuits may be an increasing contributor to the development of abdominal wall hernia. Greater attention should be paid to the proper use of gym equipment to minimise the risk of hernia development. Key findings: Almost one quarter of patients attributed their hernia to gym activity which should be further explored in prospective studies. This potentially reflects changes in work practice and lifestyle. Traditional causes like chronic cough and constipation were rarely cited, probably reflecting improved healthcare and lifestyle practices. [ABSTRACT FROM AUTHOR]

Background: Affective responses are increasingly recognized as potentially effective intervention targets that may facilitate exercise and physical activity behavior change. While emerging correlational evidence suggests that more pleasant affective responses are associated with higher participation and adherence, experimental evidence remains scarce. In light of this, we conducted a preregistered, pragmatic, single-blinded, superiority randomized controlled trial with two parallel groups, with the goal of determining the impact of an individualized exercise-intensity prescription targeting pleasure on exercise frequency. Methods: Forty-seven non-regular exercisers were randomized into two groups. For both groups, the intervention consisted of three exercise sessions based on the Frequency-Intensity-Time-Type (FITT) principle. However, the experimental group also received an individualized intensity prescription based on prior assessment of preference for and tolerance of exercise intensity, as well as instructions emphasizing the promotion of pleasure as a basis for self-regulating exercise intensity. The primary outcome was gymnasium attendance over an eight-week follow-up period. Secondary outcomes were affective valence and arousal, post-exercise enjoyment, core affective exercise experiences, and anticipated and remembered affect. Results: Forty-six participants were retained for analysis (Mage = 32.00; SD = 8.62 years; 56.5% female). Compared to the control group, the experimental group exhibited 77% higher session attendance (14.35 vs. 8.13 sessions) over the eight-week follow-up period (group main effect p =.018, η2p =.120; Cohen's d ranged from 0.28 to 0.91 during follow-up). Also, the experimental group reported higher levels of pleasure during the intervention sessions (for all group main effects, p <.001, η2p from.33 to.37) and higher levels of remembered pleasure (group main effect p =.021, η2p =.116) and anticipated pleasure (group main effect p =.022, η2p =.114). No harm was detected. Conclusions: These results demonstrate the practicality and effectiveness of an intervention aimed at enhancing affective responses to exercise in improving short-term session attendance. Trial registration: ClinicalTrial.gov NCT05416593. [ABSTRACT FROM AUTHOR]

Background: People with mobility limitations have a disproportionately higher rate of acquiring secondary conditions such as obesity, cardiovascular comorbidity, pain, fatigue, depression, deconditioning, and type 2 diabetes. These conditions often result from poor access to home and community-based health promotion/wellness programs. The aim of this project was to determine the feasibility of delivering an online community membership-based fitness program for individuals with mobility impairments. Methods: For this prospective single-arm study, participants were recruited from members of a community fitness facility that serves people with physical disabilities and chronic health conditions. While all members had access to the online platform, individuals had to opt-in to participate in the research component. Activity options included 16 pre-recorded videos and 9 live exercise classes. During the 8-week program, participants had an opportunity to earn three exercise incentives for reaching certain activity milestones. Enrollment percentage, attendance, and attrition were tracked to assess program feasibility and acceptability. Changes in participant-reported outcomes including self-reported physical activity, psychosocial outcomes, and health-related quality of life (HRQOL) were examined using non-parametric analyses. Results: A total of 146 eligible individuals were screened of which 33 enrolled (22.6%). Two participants withdrew from the study, so a total of 31 were used for analyses. Participants included 29 women and 12 Black people with an average age of 60 (± 15.9) years. Health conditions included stroke, post-polio, arthritis, neuropathy, cerebral palsy, and obesity. Ten participants used an assistive device to get around inside the home. Twenty-six participants (78.8%) completed the online program, and 5 participants earned all 3 participation incentives. The mean number of live Zoom exercise classes attended by the participants was 12.8 (range = 0–43) over 8 weeks; 3 of 31 participants did not attend any classes. On average, participants watched 128 min (range = 0–704 min) of pre-recorded videos; 6 of 31 participants did not view any pre-recorded videos. Self-reported physical activity showed the largest improvement (11.15 units; 95% CI, 3.08, 19.56) with an effect size of 0.51 (Cohen's d). Conclusions: This pilot study of an online membership-based fitness program for people with mobility impairments demonstrated preliminary effectiveness in increasing physical activity and was found to be feasible and acceptable. Feasibility endpoints do indicate potential to improve retention. These results suggest that online delivery of exercise programs can broaden the reach of specialized community fitness programs and is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy. Trial registration: ClinicalTrials.gov, NCT05138809. Registered September 2, 2021, ClinicalTrials.gov PRS: Record Summary NCT05138809. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine a risk model for eating disorders and exercise dependence in women who regularly attend the gym. This study explored the impact of early maladaptive schemas, parental styles, coping mechanisms, sociocultural attitudes toward appearance, and anxious-depressive symptomatology. A total of 338 women (age range 18-40 years) participated in the study. The results suggest that early maladaptive schemas of imperfection/shame and inflexible standards, generated by parental styles characterized by less affective availability and focused on devaluative criticism, overexertion and internalization of guilt when stipulated standards are not met, lead to increased anxiety for social approval. Being approved becomes the only resource of self-validation found by the individual. Specifically, the results show that women who scored at risk for eating disorders and exercise dependence had higher levels of anxiety and depression. In turn, they more frequently used desiderative thinking and escape as coping mechanisms. [ABSTRACT FROM AUTHOR]

This paper studies the effect of e-Lifestyles on the fitness industry. The aim is to investigate the (mediating) role of e-Lifestyles in the relationship between behavioral intentions to use the fitness center app, app usage behavior, and member overall satisfaction with the fitness center, i.e., explain whether e-Lifestyles allow us to better understand fitness center satisfaction or app usage intention. Results of 1403 members revealed that the relationship between behavioral intentions to use the app and the members' overall satisfaction with the fitness center is positively mediated by e-Lifestyles. Results further demonstrate that there is a direct positive effect of behavioral usage intentions of the app-on-app usage behavior and overall member satisfaction toward the fitness center. The study adds to the literature on e-Lifestyles by demonstrating its significance in the context of fitness center management. This study helps managers conduct more thorough marketing plans and develop differentiated strategies and provides information for app designers. [ABSTRACT FROM AUTHOR]

The anticipated pleasure of participating in physical activity (PA) is one factor that may increase the likelihood of engagement and may be particularly important for long-term engagement. However, the impact of PA characteristics (e.g., intensity, location) on anticipated pleasure of PA remain unclear. This study used a conjoint analytic approach to evaluate the impact of activity intensity, physical context, and social context on the anticipated pleasure of engaging in PA across involvement segments. In conjoint analysis, participants provide overall ratings of hypothetical options (called profiles) described using levels of the selected study factors. Eight-hundred seventy-one participants (mean 48.3, SD 16.5 years, 66.9% female) evaluated 18 PA profiles that varied based on activity intensity, physical context, and social context. Three PA involvement segments were identified (low, moderate, high). Physical context was most impactful for highly and moderately involved participants; activity intensity had the highest impact for the least involved. Light intensity, outdoor PA performed alone or with family/friends was anticipated to be most pleasant for most participants. Vigorous intensity PA, PA performed at a fitness facility, and PA performed as part of a group elicited anticipated displeasure for those with low involvement. Physical context was most important for most people. Activity intensity was most impactful for frequent targets of PA intervention. PA promotion efforts should focus on light intensity activity, performed outdoors either alone or with family or friends to maximise anticipated pleasure for those least active. Conjoint analysis and audience segmentation show promise for future pleasure-related PA research. [ABSTRACT FROM AUTHOR]

A significant advancement in marketing studies has been the use of big data analytics to explore and derive customer experience (CX) insights. With fitness businesses' pivoting towards managing CX along the entire customer journey, this study aimed to understand CX in the commercial fitness industry. A textual corpus of three million words was extracted from a total of 24,231 Yelp reviews on 1,045 fitness clubs in the United States. Structural Topic Modeling (STM), content analysis, and topic network analysis were performed to identify CX themes and their inter-relationships. We then inductively identified topics and themes germane to CX in fitness clubs and derived a general CX model. Sixty-eight relevant topics were identified through an iterative STM and content analysis process and were subsequently interpreted using the CX paradigm and experience design framework (Funk, 2017; Voss et al., 2008). Our final model integrates experience design elements (i.e. stageware, orgware, customerware), customer journey (i.e. pre-usage, usage, post-usage) and CX (i.e. subjective and internal responses) and shows the interrelationships among them. Our model offers an integrative and coherent theoretical framework to examine CX in commercial fitness clubs. Our model and methodology allow researchers and organizations not only to capture CX and the relative salience of CX topics, but also to track CX trends over time, compare the experience design elements of an organization, measure CX performance against competitors, and link CX topics to other criterion variables (e.g. retention rate, financial performance, business survivability). [ABSTRACT FROM AUTHOR]

This article discusses the impact that employers have on individual and community health during public health emergencies. Employers can influence health outcomes through their products, workplace policies, and services. Healthcare-oriented employers, such as hospitals and pharmacies, play a critical role in providing essential services during emergencies. Employers also have a significant impact on health insurance coverage and can provide access to medical care and mental health services. Worksite policies and procedures can protect the health and safety of employees, and employers can serve as a source of credible information for their employees and their families. Additionally, employers can contribute to community health by reducing disease transmission, providing services, and supporting response efforts. Establishing partnerships between public health agencies and employers before emergencies occur is crucial for effective collaboration and response. The article concludes with recommendations for public health and emergency planners to enhance partnerships with employers and improve health outcomes during emergencies. [Extracted from the article]

Background: Eating disorders (EDs) are serious mental health conditions that affect a person physically and psychologically. In the past, EDs were only recognized as a cultural phenomenon/societal by-product of the West. However, research evidence marks its presence in non-western countries also, including South Asia. This study aims to evaluate the feasibility and acceptability of a manualized psychological intervention called Getting Better Bite by Bite (GBBB) in individuals who screened positive on measures of EDs in Pakistan. Methods: The proposed study is a feasibility randomized controlled trial (fRCT). The study will be conducted at five sites across Pakistan: Karachi, Hyderabad, Lahore, Rawalpindi, and Multan to recruit a total of 80 participants. Eligible participants will be randomized to either (1) the intervention group; in which they will receive one-to-one sessions of GBBB along with routine care or (2) the routine care group; in which they will only have access to the routine care. We have received ethics approval by the National Bioethics Committee. The study is registered at clinicaltrials.gov (NCT05724394). The study team has received permission from recruitment centers: hospitals (i.e. the psychiatry department of public and private hospitals based in these cities), fitness centers (i.e., gyms), educational institutes (i.e., colleges and universities), and community settings (i.e. community health clinics). Self-referrals from General Practitioners and community settings will be accepted. The intervention manual has been translated into Urdu and a multidisciplinary team including service users has culturally adapted the content of intervention for local context. Discussion: This study will provide evidence on feasibility and acceptability of a culturally adapted intervention for individuals who screen positive on measures of EDs. The findings of this study will inform a fully powered Randomized Controlled Trial of the proposed intervention. Trial Registration. The study is registered on clinicaltrials.gov (NCT05724394). Protocol version (1.0. 1st June 2022). [ABSTRACT FROM AUTHOR]

Background: The Community Health Club model is a community- based, participatory education model that promotes participant well-being and empowers underserved community members to create sustainable health behavior changes. Community Health Clubs have been widely adopted in lowand middle-income countries, but the model has only recently been adapted for and begun receiving attention in the United States. This article describes the use of Community Health Clubs in a resource-poor community in the Lower Rio Grande Valley of Texas by utilizing a curriculum adapted for Hispanic populations called Salud Con Sabor Latino. The purpose of this article is to assess the impact of the Salud Con Sabor Latino curriculum on Community Health Club participants' nutritional and physical activity knowledge and behaviors and describe other impacts of the model on participants' physical, mental, and social well-being. Methods: The study was conducted in Texas' Lower Rio Grande Valley in July 2019. A mixed methods study design was utilized, combining pre- and post-intervention surveys and post-intervention interviews. Surveys assessed the impact of the curriculum on participants' nutritional and physical activity knowledge and behaviors. Interviews assessed the effect on participants' social, emotional, and mental well-being. Results: Participants were significantly (p=0.01) more likely to report consuming protein in the past 24 hours at post-intervention. Participants were significantly more likely to report greater than 30 minutes of exercise per day at post-intervention (p=0.05) and significantly less likely to report a lack of energy as a barrier to engaging in physical activity at post-intervention (p=0.02). Qualitative interviews showed improved mental well-being, increased motivation due to positive peer pressure, and reduced social isolation. Conclusions: Community Health Clubs seem to improve participant well-being through participatory education, collective behavior change, social support, and positive peer pressure. This study shows that the Community Health Club model can be utilized within Texas' Lower Rio Grande Valley and possibly other marginalized communities within the United States. [ABSTRACT FROM AUTHOR]

The benefits of sport and exercise participation for people with disability are well acknowledged. However, people with disability report numerous barriers to participating in sport and exercise, including negative interactions with fitness professionals. Limited research is available from the perspective of fitness professionals. This study aimed to understand the experience of fitness professionals supporting people with disability to engage in sport and exercise. A cross sectional survey study was used to gather quantitative and qualitative data on community-based fitness professionals from Australia, with or without experience working with a person with disability. A total of 72 fitness professionals took part in the study with most reporting experience and confidence in working with people with disabilities. Several barriers were identified with participants highlighting the lack of disability-specific training. Participants also identified potential facilitators, including effective collaboration with allied health professionals. There is emerging interest for fitness professionals to support people with disability to engage in sport and exercise. However, changes are required within the education provided to fitness professionals and with the current collaborative model with allied health professionals to better support the participation of people with disability in sport and exercise. As physical activity is pertinent to ongoing health and wellbeing of people with disability, with support, fitness professionals could provide a cost-effective solution to assist in enabling people with disability to access sport and exercise activities. Fitness professionals require continuing disability-specific education and input from allied health professionals to appropriately support their clients with disability. Changes are required within the Australian fitness industry and in the model in which allied health and fitness professionals collaborate to better support people with disability to engage in sport and exercise. Additional barriers external to the fitness professional such as the physical environment, funding restrictions and lack of societal awareness, continue to impede on people with disabilities' participation in sport and exercise settings and should also be acknowledged. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore the implementation and impact of management and technical standards within fitness clubs. Methodology: Employing a qualitative research design, the study involved semi-structured interviews with 15 participants, including university professors in sports management, managers and experts from the licensing commission of fitness clubs, and standards specialists. The thematic analysis was used to interpret the data, focusing on the motivations for standard adoption, the processes of implementing these standards, and the perceived impacts on organizational performance and stakeholder engagement. Findings: The study reveals that fitness clubs adopt management and technical standards primarily to improve operational efficiency, ensure compliance with regulations, and enhance service quality. Challenges in standardization include aligning internal processes with external requirements and managing stakeholder expectations. Successful standardization efforts lead to improved operational efficiency, better stakeholder management, and enhanced competitive advantage. The research also highlights the importance of voluntary environmental programs and ISO certifications in signaling commitment to quality and sustainability. Conclusion: The adoption of management and technical standards in fitness clubs plays a crucial role in enhancing operational efficiency, regulatory compliance, and stakeholder satisfaction. Despite the challenges faced during implementation, the benefits of standardization are clear, suggesting that fitness clubs should continue to engage in these practices. Future research should aim to broaden the geographic and demographic scope of participants and incorporate quantitative measures to further validate the findings. [ABSTRACT FROM AUTHOR]

Background: Oral hygiene is essential for low caries or gingivitis prevalence in children. This study aimed to determine the oral hygiene profile of children from secondary schools (10–17 years) in Bucharest, Romania, and to explore options for preventing their future oral diseases. Methods: The study was cross-sectional, with a sample of n = 1595 pupils. The sample was stratified by clusters in city areas, grades, and the criterion of the presence/absence of in-school dental service. Dental check-ups were performed by using a commune dental examination kit. The oral hygiene simplified index (OHI; Silness and Löe) was used to assess the children's oral hygiene status. Five questions were used to determine oral hygiene habits. Results: The mean value of the OHI was 1.04. Some differences in oral hygiene scores were found for different socioeconomic variables, such as parents' education (p < 0.05): parents with vs. without a university degree—0.95/0.94 (male/female) vs. 1.06. Most of the children used manual toothbrushes (88%). Conclusions: The analysis of objective data (OHI) revealed a good level of oral hygiene, with many socioeconomic disparities. [ABSTRACT FROM AUTHOR]

This study presents two simple physiotherapy programs that were implemented for five weeks and showed positive changes in balance, coordination, and motor skills in kindergarteners with ASD. Physiotherapy programs in a gym and games on a smart board with balance plates and an unstable base were applied to improve the physical condition of children with ASD. Thirty children with ASD (4–6 years old) attending special needs kindergarten were enrolled in the study. Three tests were used to assess participants' physical condition before and after the study: the modified Berg Balance Scale, the Imbalance Coordination Sample, and the Bruininks–Oseretsky Motor Proficiency Test (BOTMP). The resulting mean change, calculated from each group's scores, shows that the participants who received physical therapy sessions at the smart board had the greatest change of 1.58 points. It shows that the opportunity to play games on a smart board motivates children with ASD to work harder; therefore, it is a simple and easy way to engage children in different types of physical exercise. A slightly smaller change of 1.51 was obtained in the group that received gym sessions. However, working in the gym was more psychologically challenging for the children with ASD due to their lack of desire and motivation. Both methods are relatively simple and easy to apply at home; therefore, parents can make a significant contribution to improving children's physical condition and that can be an effective tool to assist these individuals with activities in daily life. [ABSTRACT FROM AUTHOR]

The purpose of this study was to draw consensus among an expert panel regarding essential elements of an accessible fitness center guide for people with intellectual disabilities that will enable them to engage in physical activity fully and effectively. The study was situated in the socioecological model of disability. Researchers drew expert consensus regarding the essential features of accessible guides in fitness environments. A three-round Delphi procedure was used, involving repeated circulation of the questionnaire to an expert panel (N = 33). The panel was asked to rate the importance and adequacy of 66 items regarding the accessible fitness guide. A consensus was reached regarding 43 items after three rounds. The items include 7 body-weight exercises, 2 machine exercises, 12 environment-related items, 15 exercise preparations, 4 social etiquettes, and 3 emergencies. [ABSTRACT FROM AUTHOR]

Background: Kidney transplantation constitutes the most effective therapeutic option for patients suffering from end-stage renal disease but remains burdened by a high incidence of cardiovascular disease. To date, exercise is an important preventive strategy that has been underestimated; in kidney transplant patients, exercise programs lead to an improvement in cardiorespiratory performance, muscle strength, arterial stiffness, and patients’ quality of life perception. Summary: The nephrology and transplant community have moved from generic suggestions to specific indications regarding frequency, intensity, time, type, volume, and progression of physical exercise both in the pre- and posttransplant phase. The latest guidelines from the World Health Organization for patients with chronic conditions propose a combination of aerobic, muscle-strengthening, and multicomponent exercises (e.g., balance) to improve health. Based on recent evidence, a combined exercise program (aerobic and strength exercise) is largely proposed to kidney transplant recipients. Aerobic exercise should be performed at an intensity >60% of theoretical maximum heart rate or maximum oxygen uptake possibly every day, and strength training should be performed at a >60% the estimate single maximum repetition, at least 2 times per week. Key Messages: Physical exercise should be personalized in relation to the patient’s baseline performance; increases must be progressive and gradual. Regular physical activity should also be recommended to patients awaiting for a transplant. Eventually, organizational models based on a network of nephrology units, transplant centers, sports medicine centers, and fitness center or outdoor gym are essential elements for overcoming the logistical barriers for prescribing and carrying out regular physical activity. [ABSTRACT FROM AUTHOR]

One of the most important aspects of second language acquisition is vocabulary knowledge. Researchers, educators, and second language learners all agree that vocabulary acquisition is crucial. In our increasingly technologically advanced society, where rapid technological improvement and widespread access to high-speed internet have started to present unique and promising prospects for language teaching and learning, vocabulary growth is becoming a rising subject of interest in second language research. This study presents a review of computer corpora, concordancing, and their possible application to the acquisition of vocabulary in second languages. It also focuses on the application of computer corpora and concordancing in second language vocabulary teaching and learning after giving a brief overview of the concept of vocabulary knowledge and the function of datadriven learning (DDL) in language learning. To illustrate the variety of lexical information that several concordance lines can provide on the target word, the paper provides examples of KWIC (Keyword in Context) concordance lines and some vocabulary exercises centered on concordance. This paper may increase awareness among researchers, educators, and students regarding the possible contribution of computer corpora and concordances to the advancement of second language vocabulary knowledge. [ABSTRACT FROM AUTHOR]

In Commission on Human Rights and Opportunities (CHRO) v. Edge Fitness, LLC, et al., two male patrons located in Connecticut filed complaints arguing that their gyms’ “women only” workout areas were a discriminatory practice. The gyms argued a gender privacy exception was present in the law, but the Connecticut Supreme Court ultimately disagreed. While the legal implications have been examined (Leudman, 2021), the parks and recreation managerial implications have not been discussed. Women’s only spaces are built into many modern fitness facility models and seeing them challenged may open the door to confusion and frustration from patrons. The purpose of this commentary is to reflect on the significance of CHRO v. Edge Fitness, LLC, et al. to parks and recreation spaces and the perspective parks and recreation practitioners can take into the future to reduce cases such as CHRO v. Edge Fitness, LLC, et al. [ABSTRACT FROM AUTHOR]

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The Global Initiative for Chronic Obstructive Lung Disease guidelines recommend pulmonary rehabilitation (PR) for individuals with COPD to improve exercise capacity and health-related quality of life (HRQOL) and reduce symptoms of dyspnea. For cost-effectiveness in COPD care, PR is second only to smoking cessation. However, PR programs typically last 9--12 weeks. The benefits of PR in terms of exercise capacity and HRQOL often decrease toward pre-PR levels as early as 3--6 months after completing PR if patients do not continue to engage in exercise. This review will (1) briefly summarize the efficacy data that informed the 2023 American Thoracic Society (ATS) clinical practice guidelines for maintenance PR, (2) discuss exercise components of maintenance PR studied since 2020 when the last papers were included in the ATS guidelines, (3) explore future directions for delivery of maintenance PR using technology-mediated models, and (4) examine the need for behavior change techniques informed by theoretical models that underpin long-term behavior change. This review will focus on persons with COPD who have completed an out-patient core initial PR program as most of the data on maintenance PR have been published in this patient population. Core PR typically implies a facility-based initial intensive structured program. All patients who complete a core initial PR program should be counseled by PR staff at the discharge visit to engage in ongoing exercise. This usual care is equally as important as referral to a formal PR maintenance program. It is critical to emphasize that usual care after core initial PR means all patients should be supported to participate in regular ongoing exercise, regardless of whether supervised maintenance PR is available. Currently, the optimal frequency, exercise and/or physical activity content, and delivery mode for maintenance PR in persons with COPD and other chronic respiratory diseases remain unknown. Patient safety and degree of in-person supervision required due to the severity of the underlying lung disease need to be considered. Future research of maintenance PR should be underpinned by behavior change techniques. Finally, in the setting of finite resources, balancing the competing priorities of core initial programs with those of maintenance PR programs needs to be achieved. [ABSTRACT FROM AUTHOR]

Health and exercise technology may promote a healthy lifestyle during pregnancy. The objective of this cross-sectional study was to understand and involve the perspective of pregnant women as users in the design of a framework for future e-health and exercise interventions during pregnancy. Pregnant women replied to a questionnaire aimed at understanding their physical activity patterns, needs, and preferences regarding the use of mobile applications (apps). The main results showed that one-third of the women did not practice any type of exercise during pregnancy. Women preferred to exercise in a gym, outdoors, or at home. The majority already had or were currently using a fitness app, but never used any pregnancy-specific app. Most women agreed that it was important to have a specific app for pregnancy to improve knowledge about recommendations on lifestyle, have direct contact with health and exercise professionals, have social interaction with other mothers, and have guidance on preparation for childbirth and postpartum recovery. Understanding and involving the perspective of pregnant women as users will allow researchers to improve the design of a pregnancy-specific app and future e-health and exercise interventions during pregnancy. These preliminary results will lead to the development of the "active pregnancy app" focused on the promotion of an active and healthy lifestyle during pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity (PA) and exercise (EX) participation rates have not been increasing among older adults, with many not meeting recommended guidelines. This qualitative descriptive study examined factors influencing engagement in PA within and outside an older adult fitness club context, using self-determination theory (SDT). Methods: Thirty-seven community-dwelling adults 65 years and older participated in focus groups or telephone interviews. Two researchers independently coded and analyzed transcript data inductively and deductively using SDT. Results: Two broad themes, The Spectrum of Motivating Factors and Facilitators and Barriers, and nine sub-themes, Physical Activity and Exercise Brings Me Joy; Meaningful Personal Impetuses; I Get Active with a Little Help from my Spouse and Others; I See Changes and Improvements (Theme 1); I Can Do This; Connections and Sense of Belonging; I Cannot Do This; Setting, Environment, and People Supports; and Pragmatics (Theme 2), emerged from the data. All participants discussed several motivating factors: enjoyment, managing health conditions, being held 'to account' by others, opportunities for socialization, and seeing improvements in health and well-being. A lack of supportive environments, knowledgeable staff and suitable settings and programs were cited as barriers by participants who were not older adult fitness club members. Discussion: Factors along the extrinsic to intrinsic regulation continuum facilitated or hindered community-dwelling older adults to engage in and sustain PA within and outside an older adult fitness club context. The findings underscore the need for programs, settings, environments, and related components to be expressly older-adult-tailored to enhance motivation through competence, autonomy, and relatedness support for maximal engagement and participation in PA or EX. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to determine the influential factors in marketing music psychology in Mashhad aerobic clubs and physical fitness. Method: The research method is a descriptive survey of which the required data were collected through a questionnaire. The questionnaire from the research background (Morton, Chang velin, 2010) was used. The statistical population included all male and female Mashhad Aerobic and Fitness Clubs (Region 9). Then 220 people on considering the sample size of five to ten times the number of research questions in survey studies. Were selected randomly. Results: Data were analyzed using descriptive and inferential statistics and statistically significant (P ≤ 0.05). The results of exploratory factor analysis showed that five factors could identify, and in total, 53.8% of the marketing variance explained the psychology of music. Also, the mean score of all components indicated a favorable relative status. Conclusion: According to the extracted factors, mental factors, psychological emotion, recognition power, influence power, and musical personality was the highest priority. The importance of marketing and customer attraction for clubs, especially concerning the fundamentals of music psychology, indicates the need to understand the influential components of sports spaces and venues. This review can have a positive and different impact on attracting customers to clubs. The psychology of music and the attention it has to people's influence can be used as a new way of marketing and attracting customers. [ABSTRACT FROM AUTHOR]

Background: Generally, the health condition of those with higher socioeconomic status (SES) is better compared to those with lower SES. The application of appropriate strategies to reach low SES populations with electronic health (eHealth) interventions is thus of major importance to reduce health inequalities. eHealth-studies providing detailed information on recruitment strategies are scarce, despite the fact that this information is crucial for comparable research and implementation. Objective: To provide insight into the reach, sample characteristics and costs of three pre-planned strategies for recruiting adults aged 50 years and older with low SES for participation in an online physical activity intervention, as part of a field study. Methods: Recruitment took place via (1) invitation letters via a municipality, (2) gyms and (3) social media advertisements, aiming to include 400 participants. Additional procedures were followed to reach specifically the low SES group. Response rates, sociodemographic characteristics and costs per strategy were assessed. Results: The highest response was shown for the municipality approach (N = 281), followed by social media (N = 71) and gyms (N = 45). Ten participants were recruited via family/friends. The most low-educated participants were reached via the municipality (N = 128) followed by social media (N = 9), gyms (N = 8) and family/friends (N = 5). Recruitment costs were with €2,142.37 the highest for the municipality compared to €96.81 for social media and no costs for gyms. Conclusions: Recruitment via invitation letters through a municipality has the highest potential for reaching low SES participants of the three applied strategies, although the higher recruitment costs need to be taken into account. [ABSTRACT FROM AUTHOR]

Given the need to explore the factors that can account for a better understanding of the intention-behavior gap in exercise practice in health club settings, and considering the emergence of hedonic assumptions related to exercise adherence, this cross-sectional study aimed to test the moderation effect of the intensity traits agreement/disagreement in three relevant outcomes of exercise enjoyment: exercise habit, intention to continue exercising, and exercise frequency. A sample consisted of 273 exercisers (male = 127; Mage = 36.21; SD = 11.29) enrolled in nine health clubs who voluntarily fulfilled a battery of questionnaires. All analyses were performed using SPSS v. 23.0/PROCESS v. 3.5. The results of the study presented a moderation effect of exercise intensity traits agreement on three relevant enjoyment outcomes: exercise habit, intention to continue exercising, and exercise frequency. No relevant results emerged from intensity traits disagreement. The results suggest that assessing and tailoring exercise prescription and supervision in order to customize exercise intensity may influence future exercise participation. [ABSTRACT FROM AUTHOR]

Weight stigma is the negative social judgment of people based on their weight. Despite the negative consequences of weight stigma, its prevalence is well-documented including within the physical activity (PA) landscape. Research shows that a wide range of PA-related professionals hold negative attitudes toward fat people, including physical education teachers, kinesiology students, and fitness trainers. This article describes a collaboration across disciplines and fields to develop a weight stigma reduction intervention for exercise professionals. Weight Inclusive Thinking for Fitness Spaces (WIT FITS) is a two-hour, self-paced, interactive online course grounded in the Health at Every Size® paradigm and research-informed strategies for improving exercise professionals' attitudes toward fatness and fostering weight inclusivity in fitness settings. WIT FITS was the result of a three-year interdisciplinary collaboration with scholars from pedagogy, public health, sport and exercise psychology, and nutrition. Community partners involved in the development, implementation, and evaluation of WIT FITS included body liberation activists, web and instructional designers, and campus recreation leaders. [ABSTRACT FROM AUTHOR]

Some individuals who go to fitness centers for various purposes perform resistance exercise (RE) alone, while others engage in combined exercise (CE) by including cardio exercises along with RE. Studying the effects of these two different training methods on left ventricular (LV) systolic and diastolic parameters and left atrial mechanical function is an important step toward understanding the effects of different types of exercise on cardiac function. This knowledge has significant implications for public health, as it can inform the development of targeted and effective exercise programs that prioritize cardiovascular health and reduce the risk of adverse outcomes. Therefore, the primary aim of this study is to comprehensively investigate the LV systolic and diastolic parameters of athletes who engage in RE and CE using ECHO, to contribute to the growing body of literature on the cardiovascular effects of different types of exercise. Forty-two amateur athletes aged between 17 and 52 were included in our study. The participants consisted of the RE (n = 26) group who did only resistance exercise during the weekly exercise period, and the CE group (n = 16) who also did cardio exercise with resistance exercises. After determining sports age (year), weekly exercise frequency (day), and training volume (min) in addition to demographic information of RE and CE groups, left ventricular systolic and diastolic parameters and left atrial functions were determined by ECHO. Findings from our study revealed that parameters including the left ventricular end-diastolic diameter (LVEDD) (p =.008), left ventricular end-diastolic volume (LVEDV) (p =.020), stroke volume index (SV-I) (p =.048), conduit volume (CV-I) (p =.001), and aortic strain (AS) (p =.017) were notably higher in the RE group compared to the CE group. Also left atrial active emptying volüme (LAAEV) of CE was higher than the RE group (p =.031). In conclusion, the cardiac parameters of the RE group showed more athlete's heart characteristics than the CE group. These results may help to optimize the cardiovascular benefits of exercise routines while minimizing the potential risks associated with improper training. [ABSTRACT FROM AUTHOR]