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Background: Elevated postprandial glucose (PPG) is an independent risk factor for cardiovascular disease. Post-meal exercise effectively reduces PPG concentrations. However, the effect of accumulated versus continuous post-meal exercise on PPG control remains unclear. This study aimed to investigate the effects of individualized accumulated or continuous exercise on PPG in young adults with obesity. Twenty young adults with obesity (11 males) completed three 4-h randomized crossover trials with 6–14-day washout periods: (1) sitting (SIT), (2) one 30-min walking bout (CONT), and (3) three 10-min walking bouts separated by 20-min resting (ACCU). Walking was initiated 20 min before individual PPG peak after breakfast, which was predetermined by continuous glucose monitoring. Blood samples were collected at 15–30 min intervals, and the 24-h glucose was monitored via continuous glucose monitoring. Results: The 4-h PPG incremental area under the curve (iAUC) was 12.1%±30.9% and 21.5%±21.5% smaller after CONT (P = 0.022) and ACCU (P < 0.001), respectively, than after SIT. PPG concentrations were lower during CONT at 30–60 min and during ACCU at 30–105 min after breakfast than during SIT (all P < 0.05). The 4-h plasma insulin and C-peptide iAUC, and mean amplitude of glycemic excursions were lower after CONT and ACCU than after SIT (all P < 0.05). Conclusions: Both continuous and accumulated exercises reduced PPG, insulin, and C-peptide concentrations and improved glucose fluctuations. Accumulated exercise maintained lower PPG concentrations for a longer time than continuous exercise in young adults with obesity. Clinical Trial Information: Clinical trial registration No. ChiCTR 2000035064, URL: ; (registered July 29, 2020). Both continuous and accumulated walking lowered post-meal glucose, insulin and C-peptide levels and improved glucose fluctuation. Postprandial glucose was kept lower for a longer time in accumulated than continuous walking. Accumulated post-meal exercise (e.g. three 10-min bouts of walking) could be recommended as a feasible and practical alternative protocol for postprandial glucose control, especially for those who have difficulty performing sufficient exercise in one session. [ABSTRACT FROM AUTHOR]

Background: Postprandial dysmetabolism, an important cardiovascular disease risk factor, can be improved by exercise. Further systematic review and meta-analysis is needed to compare the effects of accumulated exercise with a single session of energy-matched continuous exercise on postprandial glucose (PPG), insulin, and triglycerides in adults with or without diabetes. Methods: Eight electronic databases were searched on August 28, 2020, and updated on April 27, 2021. Eligible studies were randomized, quasi-randomized, or non-randomized controlled or crossover trials that evaluated the acute or longitudinal effects of accumulated exercise compared with a single session of energy-matched continuous exercise on PPG, postprandial insulin, and triglycerides in diabetic and non-diabetic adults. Same-day and second-morning effects were assessed separately for acute intervention studies. Subgroup analyses were conducted based on the number of exercise bouts (2–3 bouts or frequent brief bouts (e.g., 1–6 min) throughout the day at 20–60-min intervals (known as physical activity [PA] breaks, ≥ 5 bouts)), exercise intensity, and populations. Risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Pooled effects were reported as standardized mean differences (SMD) and 95% CI using a random effects model. Results: Twenty-seven studies (635 participants) were included. A significant difference was found for same-day PPG control, which favored accumulated exercise over one bout of energy-matched continuous exercise (SMD − 0.36 [95%CI: (− 0.56, − 0.17)], P = 0.0002, I2 = 1%), specifically in accumulated exercise with PA breaks (SMD − 0.36 [95%CI: (− 0.64, − 0.08)], P = 0.01, I2 = 30%), low-moderate intensity exercise (SMD − 0.38 [(95%CI: (− 0.59, − 0.17)], P = 0.0005, I2 = 0%), and in non-diabetic populations (SMD − 0.36 [95%CI: (− 0.62, − 0.10)], P = 0.007, I2 = 16%). No differences were found for same-day postprandial insulin and triglycerides, and second-morning effects (postprandial or fasting glucose, insulin, and triglycerides) between different exercise patterns. Conclusion: Compared with one session of continuous exercise, accumulated exercise—specifically in subgroups of PA breaks, low-moderate intensity exercises—produced greater acute effects on same-day PPG control for non-diabetic adults. There were no differences between continuous and accumulated patterns of exercise in terms of same-day postprandial insulin and triglycerides, and second-morning effects on all previously mentioned markers. The findings provide additional PA options for PPG control for individuals with limited time or exercise capacity to engage in PA in one session. Registration: PROSPERO (identification code: CRD42021251325). [ABSTRACT FROM AUTHOR]

Every year the Medical University of Plovdiv opens its doors to hundreds of foreign students studying in the Programmes of "Medicine", "Dental Medicine" and "Pharmacy". Their training is conducted in English, while Bulgarian is studied as compulsory language in the first and second year or as a facultative discipline after the third year. For future doctors, the communicative skills of speaking, writing, listening and reading in Bulgarian are very important during their medical practice. This requires purposeful expansion and consolidation of knowledge in oral and written speech. The article focuses on models for mastering basic verbal and non-verbal communicative forms necessary for the dialogue between doctor-patient, patient-doctor, doctor-medical staff. Speaking in medical practice is spontaneous, rarely premeditated, so the language training of foreign students emphasizes on the acquisition of structures characteristic of medical scientific expression, as well as achieving certain communicative intentions such as presentation, asking appropriate and accurate questions during the inquiry of anamnesis, giving instructions for medical tests, examination and treatment, making a request, consent, disagreement, giving advice. In the exposition of the article we offer tested practices in the learning process: structuring a dialogue on a given topic of studied diseases, constructing a text, role-playing games and discussing speech situations occurring in a dialogue between doctor and patient. Our main goal is to achieve good communicative competence of students and to be able to implement what they have learned in their medical practice. [ABSTRACT FROM AUTHOR]

No prospective studies have investigated if repeated testing of physical performance and body composition are associated with exercise attendance or patterns in fitness club members. This study aimed to investigate if repeated physical testing was associated with exercise attendance and patterns in gym members and to report prospective data on use of the fitness club's facilities and products. Untrained new members were recruited and divided into a test group (n = 125) and as controls (n = 125). All participants answered a survey including exercise involvement, at onset, and after 3, 6, and 12 months follow-up. The test group also measured body composition, maximal oxygen uptake, and maximal muscle strength (onset, and after 3 and 12 months). In total 73.6% answered all surveys, and in the test group, 44.8% completed all physical tests. Regular exercise attendance was defined as ≥2 sessions/week. Repeated testing showed no association with long-term regular exercise attendance (test group: 19.6%, controls: 19.8%; p = 0.638). At 3 months, a lower proportion in the test group reported engagement in resistance exercise (35.3% and 60.2%; p = 0.003) and had lower exercise frequency (2.0 and 2.6 days/week; p = 0.008) than controls. The test group had higher participation in group exercise classes (28.0% and 13.6%; p = 0.040). Exercise frequency decreased from onset to 12 months (from 2.6 to 2.2 days/week; p = 0.025) At 3, 6, and 12 months, 51.8%, 37.6%, and 37.4% reported regular exercise attendance, and 16.9% at all follow-ups. At all time-points, most common workout mode was individual resistance exercise (43.8% to 46.3%). Few attended group exercise classes (7.5% to 13.8%) or used a personal trainer (22.5% to 27.5%). Repeated physical testing did not improve exercise attendance, and we found no changes in members' use of the fitness club's facilities and products. Only 16.9% reported regular exercise attendance throughout the first year of membership. [ABSTRACT FROM AUTHOR]

From the beginning of the second semester of the academic year 2019-2020, the training in Bulgarian language for medical purposes was realized through Distance Learning. The lecturers at the Department of Languages and Specialized Training at the Medical University – Plovdiv, are faced before the challenge to achieve communicative competence in the Bulgarian language as a foreign one for the purposes of medical communication of foreign students with the help of communication technologies. The inclusion of electronic resources in the educational process in the Bulgarian language is not new. Each Bulgarian language teacher tries to adapt scientific and technical achievements and to use them in their lessons in the most rational way, so as to improve the efficiency in teaching and to stimulate the motivation of students to study. It is undisputable that electronic resources open a wide range of opportunities for the introduction and consolidation of new grammar, new vocabulary, new medical terms, for the construction of questions and answers; as well as for the creation of narrative texts. With their help, the educational content is presented in a more attractive way and is accepted more easily by the new high-tech generation. The large-scale digitalization at universities, as well as the presence of sufficient electronic resources, led for the quality realization of distance learning. The article presents tested exercise patterns for developing the listening comprehension, reading comprehension, speaking, and writing skills, as the leading principle is the accessibility of presenting the educational content, and the reading, writing, listening, and speaking skills are equally included in every unit. [ABSTRACT FROM AUTHOR]

Undergraduate (n = 561) and graduate (n = 104) students at a large mid-Atlantic university were surveyed to determine their usage patterns and beliefs about the climate of a newly constructed student recreation center (SRC) on their campus. Analyses attempted to identify differences between those students who used the facility (n = 547) and those who did not (n = 118) in relation to gender, age, year on campus, stage of change for exercise, and motivational orientation. Results revealed that SRC users were at higher stages along the transtheoretical model (Prochaska & DiClemente, 1983) and were significantly more likely to have participated in high school athletics than non-users. Non-users were significantly more likely to live off-campus, smoke, and be female than SRC users. The discussion offers suggestions for enticing non-users to exercise and use the facility, and feel more comfortable while doing so. [ABSTRACT FROM AUTHOR]

Maintaining health and postponing chronic disease are assuming a higher priority in our aging society. It is therefore more critical than ever to understand the specific contribution that exercise makes toward the achievement of independent and healthy living for as many individuals as possible. Scientists have already shown that exercise plays an important role in maintaining cardiovascular health, muscular strength and endurance, balance, flexibility, and neuromuscular coordination. What remains for researchers of the future is to clarify the relationships among fitness, cognition, emotional health, and well-being in the elderly. More important, the greatest challenge for future researchers is to determine how an adult population that recognizes the benefits of exercise but continues to to be sedentary can be transformed into a population that incorporates an adequate level of physical activity into its lifestyle. [ABSTRACT FROM AUTHOR]

The study aimed to explore Chinese university administrators' physical activity (PA) levels and its relationships to self-rated health and body mass index (BMI). A pre-validated survey was used to collect the data. In total, 443 participants took part in the study. The percentages of participants meeting the recommended PA and BMI were calculated. MANOVA was performed to analyze the PA differences in age and gender, and BMI and self-rated health, respectively. It was found that 75.2% of the participants did not meet the recommended PA and 43.8% of them were overweight and/or obese. Self-rated health was a significant factor influencing their light PA only. No gender differences in PA were found, however. The data from the study suggested that there was an urgent need to promote healthy lifestyles among Chinese university administrators by increasing their PA levels and reducing the prevalence of weight problems. [ABSTRACT FROM AUTHOR]

With over 22 million children considered overweight or obese, research needs to examine factors related to overweightness and obesity. Parents seem to have an influence on their children's eating behaviors such as taste likes and dislikes and quality and quantity of food. Parents also seem to influence their children's physical activity levels. A link between physical activity level and obesity exists, indicating that less active children have an increased risk for high BMIs, with children from single parent families having higher than normal BMIs compared to children from two-parent families. The purpose of this study is to examine whether family structure influences eating and exercise patterns of adolescent youth. The current study employed a secondary data analysis utilizing data from the HBSC (N = 6733). According to the data, participants engaged in approximately 3.76 healthy consumption behaviors per week and moderate levels of exercise (mean = 2.38). The linear regression analysis indicated a significant relationship between family structure and consumption patterns, as youth from single parent families, stepparent families, and multigenerational families have fewer healthy consumption patterns (−.256, −.142, and −.164, respectively) compared to youth from two-parent families. Healthy eating initiatives need to target both parents and children, as a relationship between consumption patterns and family structure exists. Additionally, future research needs to examine initiatives targeted at promoting physical activity, particularly among overweight and obese youth who are less likely to engage in physical activity. [ABSTRACT FROM AUTHOR]

Exergames are videogames based on full-body interaction that foster physical exercise during gameplay. Much research has focused on whether exergames foster sufficient physical activity and with which intensity they do so. This is usually measured through energy expenditure and compared to traditional physical activities such as sports or physical education exercises. However, little research has been undertaken on the quality of the physical activity, understood not as how well the movement is done, but as the richness and diversity of physical activity defined by experts, such as diverse types of motor skills (jumps, turns, pivots, manipulative actions, etc) and diverse types of conditioning capabilities (endurance, stretch, general strength, coordination, etc.). Hence, exergames typically address only aerobic (cardiovascular) activity and other types tend to be ignored. In this paper we propose a method for analyzing the types of physical activity (quality) that an exertion interface elicits. We propose this method as an analytical tool which can provide key information to categorize exergames, aid to their design and help designers make sure they achieve game mechanics that elicit the desired types of physical activity. We describe the method through the analysis of two exergames that we developed in the past for our exertion interface for children, called the Interactive Slide. We present the results of a systematic observational method, until now used mainly in sports analysis, which is based on applying sequential body movement analysis to obtain the play characteristics of 48 children. These results -action events and time-based patterns- typify the movement found in the two aforementioned exergames for this platform. We have found significant movement differences between the two, as well as some differences associated to age. Moreover, we show that sequential body movement analysis, which has already been successfully used in the past to analyze sports, can also be effective in analyzing exergames and hence allow grounded discussion on health issues related to their use. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is a major cause of death in many developed countries. Impaired clearance of postprandial triacylglycerol has been associated with an increase in cardiovascular disease risk. Physical activity can reduce many cardiovascular disease risk factors including postprandial triacylglycerol concentrations. Public health guidelines suggest that physical activity can be accumulated in several short bouts throughout the day, with a minimum duration of 10 minutes per activity bout. Until recently, limited evidence was available to support the effect of accumulating physical activity on postprandial lipaemia. Thus, the authors conducted a series of investigations to examine the influence of accumulated physical activity on postprandial lipaemia. The implications of the research findings are discussed in keeping with practical guidance for those wishing to engage in exercise that will lower postprandial triacylglycerol concentrations.

Purpose: This cross-sectional study was designed to explore potential factors associated with perceived cognitive impairment (PCI) in breast cancer survivors compared to controls and gain insight into perceived levels of severity for cognitive complaints.Methods: Women (N = 363, 317: breast cancer, 46: healthy controls) completed demographic questionnaire, MD Anderson Symptom Inventory, Attentional Function Index, and Functional Assessment for Cancer Therapy-Cognition. Group classification included pre-chemotherapy, current chemotherapy, and postchemotherapy (<1, >1- < 2, >2- < 5, >5 years).Results: A significant group effect was seen for PCI (F 6, 355 = 7.01, p < 0.0001). Controls reported less PCI than all other groups. Neuropathy was inversely correlated with PCI (r = -0.23; p < 0.0001) for participants with breast cancer. A significant association was demonstrated between exercise frequency and PCI in women exposed to chemotherapy (F 3, 135 = 3.78, p < 0.05). A multiple linear regression model built using forward selection methods explained 24 % of the variance (adjusted R (2)) for PCI in breast cancer participants and included group, body mass index (BMI), exercise, fatigue, and distress. Exercise frequency moderated the relationship between BMI and PCI for breast cancer participants (F 3, 198 = 2.4, p = 0.07) and reduced the negative effects of high BMI. The moderating effect of exercise was significant (F 3, 133 = 3.1, p = 0.03) when limited to participants exposed to chemotherapy.Conclusions: PCI decreased for women >5 years postchemotherapy. Overweight survivors who exercised frequently reported less PCI than sedentary survivors. Study results provide support for a relationship between BMI and PCI in breast cancer survivors and exercise as a potential intervention for cognitive complaints. Further investigation of the influence of weight and exercise on cognitive function is warranted. [ABSTRACT FROM AUTHOR]

Ingestive and exercise behaviors are important determinants of whole body energy balance and weight control. An acute bout of exercise generates a transient energy deficit, which is only partially compensated for by food intake at the next eating occasion or within the next day (loose dietary coupling). Such an energy deficit, when repeated chronically, leads to moderate weight loss and improved body composition. For this narrative review, we assessed the effects of exercise patterns on energy intake, energy balance, and weight control in adults primarily using results from randomized acute exercise and chronic training studies. The patterns assessed were exercise mode (e.g. resistance, aerobic exercise), intensity, duration, time of day, and frequency. The body of evidence indicates that exercise training frequency and quantity are influential for weight loss. Aerobic training is superior to resistance training for weight loss, although resistance training helps preserve lean body mass better. Weight loss does not differ among different intensities when energy expenditure is matched by adjusting duration. Differing patterns of physical activity exhibited by normal weight, overweight, and obese people during weekdays and weekend days are consistent with their weight status; leaner people are more physically active. Collectively, these findings support acute and chronic exercise patterns as important modifiable behaviors to improve energy balance and weight control in adults while having minor effects on absolute energy intake. [ABSTRACT FROM AUTHOR]

Hultquist CN, Duckham R, Stinson C, and Thompson DL. College Physical Activity is Related to Mid-Life Activity Levels in Women. JEPonline 2009;12(4):1-7. It has been suggested, but not clearly established, that physical activity (PA) during the college years is a determinant of long-term PA patterns. The purpose of this study was to examine the relationship between PA during the college years and current PA in college-educated women. Fifty-five college-educated women, aged 39.3 ± 6.5 y, were recruited for this study and were, on average, 14.9 ± 7.4 y post-college. Participant's history of PA during college years and the present time was determined from the Lifetime Physical Activity Questionnaire. A brief demographic questionnaire that addressed current PA patterns was also administered. Results showed a significant correlation between leisure activity (LA) during college years and current LA (r = 0.424, p = 0.001). There was no difference between median college LA and current LA (22.4 and 27.9 MET hours per week, respectively, p = 0.129). However, total college PA reported was significantly lower than total current PA (34.7 and 70.7 MET hours per week, respectively, p = 0.001), with this difference due to an increase in household activities during mid-life. Marital status, the presence of children under the age of 18 in the home, and employment status had no significant impact on LA for this sample. These data suggest that leisure-time PA patterns practiced during college years may carry over to mid- life. [ABSTRACT FROM AUTHOR]

Objectives To examine whether physical-activity patterns over a period of 4 years are associated with well-being. Design A sample of 399 women aged 50-60 years participated in the study. Measures included rate of physical activity and other life style behaviors, well-being, health status, and interpersonal stress. Sufficient and insufficient exercisers were identified, and the association of this dichotomy with well-being, along with the contribution of the other variables, was examined. Results The distribution of physical-activity patterns remained stable over the 4 years of the study, with 40% of the women exercising leisurely and 15-20% exercising vigorously four to seven times a week. Approximately 50% of the women were considered sufficiently active in terms of public recommendations. Random effects regression analysis revealed that sufficient exercise along with a low frequency of daily hassles, relatively few menopausal symptoms, and a low level of interpersonal stress significantly contributed to the variability of well-being. Conclusions These data evoke the need for a better understanding of exercise behavior and its promising potential contribution to the well-being of middle-aged women. [ABSTRACT FROM AUTHOR]

Ingestive and exercise behaviors are important determinants of whole body energy balance and weight control. An acute bout of exercise generates a transient energy deficit, which is only partially compensated for by food intake at the next eating occasion or within the next day (loose dietary coupling). Such an energy deficit, when repeated chronically, leads to moderate weight loss and improved body composition. For this narrative review, we assessed the effects of exercise patterns on energy intake, energy balance, and weight control in adults primarily using results from randomized acute exercise and chronic training studies. The patterns assessed were exercise mode (e.g. resistance, aerobic exercise), intensity, duration, time of day, and frequency. The body of evidence indicates that exercise training frequency and quantity are influential for weight loss. Aerobic training is superior to resistance training for weight loss, although resistance training helps preserve lean body mass better. Weight loss does not differ among different intensities when energy expenditure is matched by adjusting duration. Differing patterns of physical activity exhibited by normal weight, overweight, and obese people during weekdays and weekend days are consistent with their weight status; leaner people are more physically active. Collectively, these findings support acute and chronic exercise patterns as important modifiable behaviors to improve energy balance and weight control in adults while having minor effects on absolute energy intake., (Copyright © 2014 Elsevier Inc. All rights reserved.)