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This study investigated whether an internet-based intervention aimed at enhancing the psychological well-being of female soccer players before the competitive season could be effective approach to meet the needs of the players. Players (n= 43; 17–26 years old)on the four separated teams in Finland’shighest league were assigned to either a guided six-week online Acceptance and Commitment Therapy intervention (ACTi) or to a control condition (CON). A between-groups pre–post (ACTi vs. CON) design was implemented before the competitive season. Players in the ACTi were offered three group sessions, performed internet-based tasks, and were individually supported by a guide. The results demonstrated that the ACTi players maintained their sports-related well-being (between-group, d = 0.72), while the sports-related well-being of the CON players, especially emotional and social well-being, had declined. In addition, ACTi players’perceived stress (d = 0.60) and depression (d = 0.88) declined, while their psychological flexibility in sports (d = 0.41) increased compared to the CON players. These results suggest that before the competitive season, players’ sports-related well-being decreases. The ACT intervention seemed to prevent this decrease and provide players with the skills to cope with emotional and social stressors related to the competitive season.

Schools are key settings for the promotion of students' physical activity, fitness, and motor competence. The purpose of our study was to investigate the efficacy of a 5-month-long intervention program that aimed to increase students' motor competence and health-related fitness during school days. We conducted a quasi-experimental study with 325 Finnish Grade 5 (Mage = 11.26, SD = 0.33) students from five schools. Two schools were allocated to the intervention group and three schools to the control group. The intervention consisted of three components: (a) weekly 20 min session during regular PE lessons, (b) weekly 20 min session during recess, and (c) daily 5-minute-long classroom activity breaks. All activities were designed to systematically develop different elements of motor competence and fitness. The following assessments were conducted at baseline and 5-months: cardiorespiratory fitness levels were measured by 20-meter shuttle run test, muscular fitness by curl-up and push-up tests, and motor competence by 5-leaps and throwing–catching combination tests. We analyzed the data using a multi-group latent change score modeling. Results showed that students in the intervention group developed significantly better in 20-meter shuttle run test (β = 0.269, p = 0.000, 95% CI [0.141, 0.397]; +5.0 laps), push-up (β = 0.442, p = 0.000, 95% CI [0.267, 0.617]; +6.5 repetitions), curl-up (β = 0.353, p = 0.001, 95% CI [0.154, 0.552]; +7.8 repetitions), and throwing–catching combination tests (β = 0.195, p = 0.019, 95% CI [0.033, 0.356]; +1.1 repetitions) than students in the control group. The intervention program appeared to be feasible and effective in increasing students' cardiorespiratory fitness, muscular fitness, and object control skills. This indicates that guided school-based physical activity programs can be influential in promoting physical fitness and motor competence among early adolescent students. peerReviewed

Background Many people do not regularly participate in physical activity, which may negatively impact their health. Current physical activity guidelines are focused on promoting weekly accumulation of at least 150 min of moderate to vigorous intensity physical activity (MVPA). Whilst revised guidance now recognises the importance of making small changes to physical activity behaviour, guidance still focuses on adults needing to achieve at least 150 min of MVPA per week. An alternative ‘whole day’ approach that could motivate the public to be more physically active, is a concept called Snacktivity™. Instead of focusing on achieving 150 min per week of physical activity, for example 30 min of MVPA over 5 days, Snacktivity™ encourages the public to achieve this through small, but frequent, 2–5 min ‘snacks’ of MVPA throughout the whole day. Methods The primary aim is to undertake a feasibility trial with nested qualitative interviews to assess the feasibility and acceptability of the Snacktivity™ intervention to inform the design of a subsequent phase III randomised trial. A two-arm randomised controlled feasibility trial aiming to recruit 80 inactive adults will be conducted. Recruitment will be from health and community settings and social media. Participants will be individually randomised (1:1 ratio) to receive either the Snacktivity™ intervention or usual care. The intervention will last 12 weeks with assessment of outcomes completed before and after the intervention in all participants. We are interested in whether the Snacktivity™ trial is appealing to participants (assessed by the recruitment rate) and if the Snacktivity™ intervention and trial methods are acceptable to participants (assessed by Snacktivity™/physical activity adherence and retention rates). The intervention will be delivered by health care providers within health care consultations or by researchers. Participants’ experiences of the trial and intervention, and health care providers’ views of delivering the intervention within health consultations will be explored. Discussion The development of physical activity interventions that can be delivered at scale are needed. The findings from this study will inform the viability and design of a phase III trial to assess the effectiveness and cost-effectiveness of Snacktivity™ to increase physical activity. Trial registration ISRCTN: 64851242.

The aim of this intervention study was to explore how the emphasised use of self-assessment in Swedish language classes affects ninth graders’ perceptions of self-regulated learning and their self-assessments in Finland. The dataset includes the survey responses of 36 students and their written self-assessments. The results suggest that the quality of the self-assessments increased during the intervention, although the level of reflection was still superficial. The students exhibited more positive perceptions of their skills in self-regulated learning at the end of the intervention. The results indicate that incorporating self-assessment into teaching boosts students’ perceptions of self-regulated learning and enhances the quality of their self-assessments. Swedish language teachers should consider the extent to which they use self-assessment in courses and whether their practices could be adjusted to promote reflection and self-regulated learning. peerReviewed

Introduction: This is one of the first intervention studies to examine how low- (LIT) and high-intensity endurance training (HIT) affect durability, defined as ‘time of onset and magnitude of deterioration in physiological-profiling characteristics over time during prolonged exercise’.Methods: Sedentary and recreationally active men (n = 16) and women (n = 19) completed either LIT (average weekly training time 6.8 ± 0.7 h) or HIT (1.6 ± 0.2 h) cycling for 10 weeks. Durability was analyzed before and after the training period from three factors during 3-h cycling at 48% of pretraining maximal oxygen uptake (VO2max): 1) by the magnitude and 2) onset of drifts (i.e. gradual change in energy expenditure, heart rate, rate of perceived exertion, ventilation, left ventricular ejection time, and stroke volume), 3) by the ‘physiological strain’, defined to be the absolute responses of heart rate and its variability, lactate, and rate of perceived exertion.Results: When all three factors were averaged the durability was improved similarly (time x group p = 0.42) in both groups (LIT: p = 0.03, g = 0.49; HIT: p = 0.01, g = 0.62). In the LIT group, magnitude of average of drifts and their onset did not reach statistically significance level of p < 0.05 (magnitude: 7.7 ± 6.8% vs. 6.3 ± 6.0%, p = 0.09, g = 0.27; onset: 106 ± 57 min vs. 131 ± 59 min, p = 0.08, g = 0.58), while averaged physiological strain improved (p = 0.01, g = 0.60). In HIT, both magnitude and onset decreased (magnitude: 8.8 ± 7.9% vs. 5.4 ± 6.7%, p = 0.03, g = 0.49; onset: 108 ± 54 min vs. 137 ± 57 min, p = 0.03, g = 0.61), and physiological strain improved (p = 0.005, g = 0.78). VO2max increased only after HIT (time x group p < 0.001, g = 1.51).Conclusion: Durability improved similarly by both LIT and HIT based on reduced physiological drifts, their postponed onsets, and changes in physiological strain. Despite durability enhanced among untrained people, a 10-week intervention did not alter drifts and their onsets in a large amount, even though it attenuated physiological strain.

Purpose The purpose of this research was to develop, implement, and test the efficacy of a theory-driven, evidence-informed peer leadership program for elementary school students (Grade 6 and 7; age 11–12 years) and the Grade 3/4 students with whom they were partnered. The primary outcome was teacher ratings of their Grade 6/7 students’ transformational leadership behaviors. Secondary outcomes included: Grade 6/7 students’ leadership self-efficacy, as well as Grade 3/4 motivation, perceived competence, general self-concept, fundamental movement skills, school-day physical activity, and program adherence, and program evaluation. Methods We conducted a two-arm cluster randomized controlled trial. In 2019, 6 schools comprising 7 teachers, 132 leaders, and 227 grade 3 and 4 students were randomly allocated to the intervention or waitlist control conditions. Intervention teachers took part in a half-day workshop (January 2019), delivered 7 x 40 minute lessons to Grade 6/7 peer leaders (February and March 2019), and these peer leaders subsequently ran a ten-week physical literacy development program for Grade 3/4 students (2x30 minutes sessions per week). Waitlist-control students followed their usual routines. Assessments were conducted at baseline (January 2019) and immediately post-intervention (June 2019). Results The intervention had no significant effect on teacher ratings of their students’ transformational leadership (b = 0.201, p = .272) after controlling for baseline and gender. There was no significant condition effect for Grade 6/7 student rated transformation leadership (b = 0.077, p = .569) or leadership self-efficacy (b = 3.747, p = .186) while controlling for baseline and gender. There were null findings for all outcomes related to Grade 3 and 4 students. Discussion Adaptions to the delivery mechanism were not effective in increasing leadership skills of older students or components of physical literacy in younger Grade 3/4 students. However, teacher self-reported adherence to the intervention delivery was high. Trial registration This trial was registered on December 19th, 2018 with Clinicaltrials.gov (NCT03783767), https://clinicaltrials.gov/ct2/show/NCT03783767.

Studies have shown that, on average, children’s physical activity (PA) levels in early childhood education and care (ECEC) environments are low, thus opening up the possibility of interventions. We examined the effect of the teacher-implemented one-year long ‘home-and-childcare-based intervention to promote physical activity’ (HIPPA) study on children’s PA in ECEC settings in Finland. Participating four-year-old children (N = 128) were cluster-randomised into two groups, intervention (seven childcare centres) and control (seven childcare centres), in autumn 2011. The children were observed directly during their ECEC times. Multilevel linear analysis was used to test the PA differences between the intervention conditions. Post-intervention results showed that the HIPPA intervention increased the children’s PA. To enhance the real-life effectiveness of the present multicomponent intervention, we examined methods based on the intervention’s success and found areas of development for future studies. Overall, promoting active play by ECEC personnel offers an effective way to enhance children’s PA. Furthermore, to ensure the sustainability of the intervention effects, specific changes in practice have been identified that should be transferred into the policies intended for ECEC settings. peerReviewed

Osa yksin asuvista ikääntyneistä on vaarassa jäädä sekä sosiaalisten suhteiden että riittävien palveluiden ulkopuolelle. Heidän hyvinvointinsa edistämiseksi tarvitaan elämänlaatua kokonaisvaltaisesti tukevia interventioita ja tutkimustietoa niiden vaikuttavuudesta. Tässä tutkimuksessa tarkastellaan PROMEQ-tutkimushankkeessa kehitetyn ja pilotoidun osallistavan ryhmämuotoisen palveluohjauksen vaikuttavuutta. Tutkimuskysymyksenä on: Millaisia vaikutuksia osallistavalla ryhmämuotoisella palveluohjausinterventiolla on osallistujien koettuun elämänlaatuun, yksinäisyyteen, institutionaaliseen luottamukseen ja osallisuuteen (a) kuuden kuukauden pituisen intervention päättyessä ja (b) 15 kuukautta intervention aloittamisen jälkeen? Osallistujien tarpeiden pohjalta ryhmäkohtaisesti räätälöity interventio sisälsi viisi ohjattua ryhmätapaamista, joiden lisäksi ryhmäläisiä kannustettiin omaehtoisiin lisätapaamisiin. Tutkimus toteutettiin sosiaalipalveluiden tutkimuksessa harvinaisempana käytännöllisenä satunnaistettuna kontrolloituna tutkimuksena Jyväskylän, Kuopion, Eksoten ja Siun soten alueilla osana ikääntyneiden palveluohjausyksiköiden toimintaa. Tutkimukseen osallistui 392 yksin asuvaa 65–99-vuotiasta ikäihmistä (interventioryhmä: 185, kontrolliryhmä: 207), jotka kokivat haasteita hyvinvoinnissaan tai terveydessään. Tutkimusaineistona käytettiin alkukyselyä (0 kk) ja kahta seurantakyselyä (6 kk ja 15 kk). Vaikuttavuutta tarkasteltiin ensisijaisesti suhteessa elämänlaatuun (mittari: WHOQOL-BREF). Toissijaisia vaikuttavuusmuuttujia olivat yksinäisyys, institutionaalinen luottamus sekä osallisuus. Vaikuttavuusanalyyseissä menetelmänä käytettiin yleistettyä lineaarista mallinnusta (GEE). Tuloksien mukaan interventiolla ei ollut merkittäviä vaikutuksia osallistujien elämänlaatuun, yksinäisyyteen, institutionaaliseen luottamukseen tai osallisuuteen heti intervention päättymisen jälkeen, eikä 15 kuukauden kuluttua sen alkamisesta. Lisäanalyysit osoittivat, että interventio voi vähentää yksinäisyyttä, mikäli interventioon osallistuneet jatkavat yhteydenpitoa toisiinsa järjestettyjen ryhmätapaamisten päätyttyä. Interventiota on mahdollista edelleen kehittää monitasoisen saatavilla olevan arviointitiedon pohjalta. Jatkossa tulisi myös kehittää luotettavia hyvinvoinnin eri osa-alueita mittaavia mittareita, jotka soveltuvat paremmin moniulotteisten sosiaalihuollon interventioiden ja hyvinvointia edistävien palveluiden vaikuttavuuden arviointiin.

Supplemental Digital Content is available in the text., Objective: We recently showed that measurement of the susceptibility of LDL (low-density lipoprotein) to aggregation is an independent predictor of cardiovascular events. We now wished to compare effects of overfeeding different dietary macronutrients on LDL aggregation, proteoglycan-binding of plasma lipoproteins, and on the concentration of oxidized LDL in plasma, 3 in vitro parameters consistent with increased atherogenicity. Approach and Results: The participants (36 subjects; age, 48±10 years; body mass index, 30.9±6.2 kg/m2) were randomized to consume an extra 1000 kcal/day of either unsaturated fat, saturated fat, or simple sugars (CARB) for 3 weeks. We measured plasma proatherogenic properties (susceptibility of LDL to aggregation, proteoglycan-binding, oxidized LDL) and concentrations and composition of plasma lipoproteins using nuclear magnetic resonance spectroscopy, and in LDL using liquid chromatography mass spectrometry, before and after the overfeeding diets. LDL aggregation increased in the saturated fat but not the other groups. This change was associated with increased sphingolipid and saturated triacylglycerols in LDL and in plasma and reduction of clusterin on LDL particles. Proteoglycan binding of plasma lipoproteins decreased in the unsaturated fat group relative to the baseline diet. Lipoprotein properties remained unchanged in the CARB group. Conclusions: The type of fat during 3 weeks of overfeeding is an important determinant of the characteristics and functional properties of plasma lipoproteins in humans. Registration: URL: http://www.clinicaltrials.gov; Unique identifier NCT02133144.

Sourcing - identifying, evaluating, and using information about the sources of information - assists readers in determining what to trust when seeking information on the Internet. To survive in the post-truth era, students should be equipped with sufficient sourcing skills. This study investigated the efficacy of a teacher-led intervention aimed at fostering upper secondary school students’ (N = 365) sourcing during online inquiry. The intervention (4 × 75 min) was structured in accordance with the phases of online inquiry: locating, evaluating, synthesizing, and communicating information. During the intervention, teachers demonstrated why and how to source, and students practiced sourcing by investigating a controversial topic on the Internet. Students worked in small groups and their work was supported with analysis and reflection prompts. Students’ sourcing skills were measured with a web-based online inquiry task before and after the intervention. Compared to controls, the intervention fostered students’ abilities in three of the four skills measured (sourcing in search queries, credibility judgments, and written product). Depending on the sourcing skill, 4–25% of students showed improved performance. The students with low sourcing skills to begin with, benefited the most from the intervention. The study demonstrated that students’ sourcing skills can be supported throughout online inquiry.

The daily physical activity (PA) of children in Finland does not meet WHO recommendations, causing concern over children’s well-being. One solution would be to integrate PA into the school day. The aims of this dissertation are to analyse evidence on the effects of school-based PA interventions on performance in mathematics, describe the experiences and perceptions of participants in the Moving Maths intervention and present the effects of this intervention on mathematics performance. The Moving Maths study was conducted between 2017 and 2020 in Finland on pupils aged 9 years. This randomised controlled trial was designed to investigate the effects of two different types of mathematics lessons on learning and engagement: one with PA integrated into learning goals and another with PA implemented through short breaks. A third group was allocated as a control. This dissertation is compiled from four original articles. The results of the first study (a systematic review and meta-analysis) indicated that 45% of the included school-based PA interventions positively influenced mathematics performance. The second study was based on interview data and comprised an investigation into pupils’ experiences and perceptions of student engagement during the nine-week pilot study. The pupils in the PA break group expressed mixed experiences, while the integrated PA group experienced positive emotional and social engagement and improved concentration. Based on individual interviews, the third study focused on teachers’ experiences and perceptions of student engagement during the five-month intervention. Although positive emotional and social engagement was indicated in both PA groups, some concerns were reported about learning outcomes and behavioural engagement. The results of the final article indicated that the Moving Maths intervention did not affect pupils’ performance in mathematics. In conclusion, this dissertation presents evidence that indicates PA can positively impact pupils’ emotional and social engagement during mathematics lessons and could enhance learning. Moreover, the introduction of PA during mathematics lessons had no detrimental effects on learning. Consequently, reinforcing the role of PA can be recommended to ensure children’s well-being and healthy development. Tiivistelmä Lasten päivittäinen fyysinen aktiivisuus Suomessa ei täytä WHO:n suosituksia, mikä on huolestuttavaa lasten hyvinvoinnille. Yksi vaihtoehto lisätä lasten liikkumista on sisällyttää sitä koulupäiviin. Tämän väitöskirjan tavoitteena on analysoida kouluissa toteutettuja interventiotutkimuksia, joissa lisättiin liikkumista koulupäiviin, kuvailla Liikkuvaa matikkaa -tutkimuksen osallistujien kokemuksia ja käsityksiä interventiosta sekä esittää intervention vaikutukset oppilaiden matematiikan oppimistuloksiin. Tutkimus toteutettiin Suomessa vuosina 2017–2020. Satunnaistetussa kontrolloidussa tutkimuksessa selvitettiin fyysisesti aktiivisten matematiikan oppituntien vaikutusta yhdeksänvuotiaiden matematiikan oppimiseen ja oppimiseen sitoutumiseen. Liikkuen matikkaa -ryhmässä integroitiin liikkumista matematiikan oppimistavoitteisiin, kun taas Liikuntatauot-ryhmän oppilaat aktivoitiin liikuntatauoilla. Tutkimukseen kuului myös vertailuryhmä. Tämä väitöskirja koostuu neljästä artikkelista. Ensimmäisen katsausartikkelin tulosten mukaan 45 % koulupäivän aikaisista liikkumista lisäävistä interventioista vaikutti positiivisesti oppilaiden matematiikan oppimistuloksiin. Toinen artikkeli perustui haastatteluun, jossa selvitettiin oppilaiden kokemuksia oppimiseen sitoutumisesta pilottitutkimuksen aikana. Liikuntatauot-ryhmässä kokemukset olivat vaihtelevia, kun taas Liikkuen matikkaa -ryhmä oli kokenut positiivista tunnetason ja sosiaalisen tason sitoutumista. Kolmas tutkimus selvitti haastattelujen avulla opettajien kokemuksia oppilaiden sitoutumisesta viiden kuukauden intervention aikana ja osoitti, että tunnetason ja sosiaalisen tason sitoutuminen oli positiivista molemmissa tutkimusryhmissä. Osa opettajista ilmaisi kuitenkin huolensa oppilaiden oppimistuloksista ja osaa huolestutti oppilaiden käytöksen tason sitoutuminen. Neljännen artikkelin tulokset osoittivat, että Liikkuvaa matikkaa -interventio ei vaikuttanut matematiikan oppimistuloksiin. Tämä väitöskirja esittää näyttöä siitä, että liikkumisen lisääminen oppitunneille voi vaikuttaa positiivisesti oppilaiden tunne- ja sosiaalisen tason sitoutumiseen matematiikan oppituntien aikana. Liikkumisen lisäämisellä matematiikan oppitunneille ei ole haitallisia vaikutuksia oppimiselle, ja siksi fyysisen aktiivisuuden roolin vahvistamista voidaan suositella lasten hyvinvoinnin ja terveen kehityksen takaamiseksi.

Background: Physical and cognitive interventions have been shown to induce positive effects on older adults’ executive functioning. However, since participants with different background characteristics may respond differently to such interventions, we investigated whether training effects on executive functions were associated with sex, training compliance, and age. We also investigated if change in global cognition was associated with physical and cognitive training intervention-induced changes in executive functions. Methods: Exploratory data from a randomized controlled trial were analyzed. Participants were 70–85-year-old men and women who received a 12-month physical (PT) or physical and cognitive training (PTCT) intervention. Measurements of executive functions related to inhibition (Stroop), set shifting (Trail Making Test B) and updating (Verbal Fluency) were performed at baseline and 12 months. Data were analyzed using a longitudinal linear path model for the two measurements occasion. Results: Stroop improved significantly more in women and participants in the low compliance subgroup who received PTCT than in counterparts in the PT subgroup (difference –8.758, p = 0.001 and difference –8.405, p = 0.010, respectively). In addition, TMT B improved after the intervention in the low compliance PTCT subgroup and worsened in the corresponding PT subgroup (difference –15.034, p = 0.032). No other significant associations were observed. Conclusion: Executive functions in women and in the participants, who only occasionally engaged in training showed greater improvement after the PTCT than PT intervention. However, the additional extra benefit gained from the PTCT intervention was uniquely expressed in each executive function measured in this study. publishedVersion

Background Digital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are widely accessible, personalized, and theory- and evidence-based are still limited. Objective This study aimed to develop a digital behavior change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and use these to provide tailored support. Methods We applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of a logic model of the problem, a model of change, intervention design and intervention production, the implementation plan, and the evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research—including 4 focus groups (n=40), expert consultations (n=12), and interviews (n=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from a variety of relevant backgrounds (including nutrition, physical activity, and the health care sector). Results Following a structured process, we developed a tailored intervention that has the potential to reduce excess body weight and support behavior changes in people with overweight and obesity. The Choosing Health intervention consists of tailored, personalized text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. The intervention content includes behavior change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support, and addressing physical and psychological resources. Conclusions The use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of the general public, we were able to map out program facilitators and barriers while increasing the ecological validity of the program to ensure that we build an intervention that is useful, user-friendly, and informative. We also summarized the lessons learned for the Choosing Health intervention development and for other health promotion programs. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-040183

ObjectiveThis study investigated the effects of a school-based skill-training intervention in attention control and executive functions for pupils with hyperactivity-impulsivity (H-I) and cognitive control (CC) deficits. The main aim was to examine whether the intervention differently influenced H-I and CC, and whether cognitive abilities or conduct problems moderated response to the intervention.MethodElementary school pupils from 41 schools participated the study and were divided into an intervention group (n = 71) and a waitlist control group (n = 77). Intervention outcomes were assessed with an inventory assessing executive function difficulties (including H-I and CC) completed by classroom teachers.ResultsSignificant intervention effects and positive changes were detected in CC but not in H-I. Significant intervention effects were found mainly among pupils with low levels of conduct problems.ConclusionsThe results suggest that a skill-training intervention has specific positive effects on CC, but conduct problems may diminish response to intervention.

Objective: To examine whether pre-admission community mobility explains the effects of a rehabilitation program on physical performance and activity in older adults recently discharged from hospital. Design: A secondary analysis of a randomized controlled trial. Setting: Home and community. Participants: Community-dwelling adults aged ⩾60 years recovering from a lower limb or back injury, surgery or other disorder who were randomized to a rehabilitation ( n = 59) or standard care control ( n = 58) group. They were further classified into subgroups that were not planned a priori: (1) mild, (2) moderate, or (3) severe pre-admission restrictions in community mobility. Interventions: The 6-month intervention consisted of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program, physical activity counselling, and standard care. Measurements: Physical performance was measured with the Short Physical Performance Battery and physical activity with accelerometers and self-reports. Data were analysed by generalized estimating equation models with the interactions of intervention, time, and subgroup. Results: Rehabilitation improved physical performance more in the intervention ( n = 30) than in the control group ( n = 28) among participants with moderate mobility restriction: score of the Short Physical Performance Battery was 4.4 ± 2.3 and 4.2 ± 2.2 at baseline, and 7.3 ± 2.6 and 5.8 ± 2.9 at 6 months in the intervention and control group, respectively (mean difference 1.6 points, 95% Confidence Interval 0.2 to 3.1). Rehabilitation did not increase accelerometer-based physical activity in the aforementioned subgroup and did not benefit those with either mild or severe mobility restrictions. Conclusions: Pre-admission mobility may determine the response to the largely counselling-based rehabilitation program.

Funder: Opetus- ja Kulttuuriministeriö; doi: http://dx.doi.org/10.13039/501100003126, Funder: Sosiaali- ja Terveysministeriö; doi: http://dx.doi.org/10.13039/501100008487, Purpose: We studied the effects of a physical activity and dietary intervention on plasma lipids in a general population of children. We also investigated how lifestyle changes contributed to the intervention effects. Methods: We carried out a 2-year controlled, non-randomized lifestyle intervention study among 504 mainly prepubertal children aged 6–9 years at baseline. We assigned 306 children to the intervention group and 198 children to the control group. We assessed plasma concentrations of total, LDL, HDL, and VLDL cholesterol, triglycerides, HDL triglycerides, and VLDL triglycerides. We evaluated the consumption of foods using 4-day food records and physical activity using a movement and heart rate sensor. We analyzed data using linear mixed-effect models adjusted for age at baseline, sex, and pubertal stage at both time points. Furthermore, specific lifestyle variables were entered in these models. Results: Plasma LDL cholesterol decreased in the intervention group but did not change in the control group ( − 0.05 vs. 0.00 mmol/L, regression coefficient (β) = − 0.0385, p = 0.040 for group*time interaction). This effect was mainly explained by the changes in the consumption of high-fat vegetable oil-based spreads (β = − 0.0203, + 47% change in β) and butter-based spreads (β = − 0.0294, + 30% change in β), moderate-to-vigorous physical activity (β = − 0.0268, + 30% change in β), light physical activity (β = − 0.0274, + 29% change in β) and sedentary time (β = − 0.0270, + 30% change in β). The intervention had no effect on other plasma lipids. Conclusion: Lifestyle intervention resulted a small decrease in plasma LDL cholesterol concentration in children. The effect was explained by changes in quality and quantity of dietary fat and physical activity. Clinical Trial Registry Number: NCT01803776, ClinicalTrials.gov

Background The aim of this study is to investigate whether combined cognitive and physical training provides additional benefits to fall prevention when compared with physical training (PT) alone in older adults. Methods This is a prespecified secondary analysis of a single-blind, randomized controlled trial involving community-dwelling men and women aged 70–85 years who did not meet the physical activity guidelines. The participants were randomized into combined physical and cognitive training (PTCT, n = 155) and PT (n = 159) groups. PT included supervised and home-based physical exercises following the physical activity recommendations. PTCT included PT and computer-based cognitive training. The outcome was the rate of falls over the 12-month intervention (PTCT, n = 151 and PT, n = 155) and 12-month postintervention follow-up (PTCT, n = 143 and PT, n = 148). Falls were ascertained from monthly diaries. Exploratory outcomes included the rate of injurious falls, faller/recurrent faller/fall-related fracture status, and concern about falling. Results Estimated incidence rates of falls per person-year were 0.8 (95% confidence interval [CI] 0.7–1.1) in the PTCT and 1.1 (95% CI 0.9–1.3) in the PT during the intervention and 0.8 (95% CI 0.7–1.0) versus 1.0 (95% CI 0.8–1.1), respectively, during the postintervention follow-up. There was no significant difference in the rate of falls during the intervention (incidence rate ratio [IRR] = 0.78; 95% CI 0.56–1.10, p = .152) or in the follow-up (IRR = 0.83; 95% CI 0.59–1.15, p = .263). No significant between-group differences were observed in any exploratory outcomes. Conclusion A yearlong PTCT intervention did not result in a significantly lower rate of falls or concern about falling than PT alone in older community-dwelling adults. Clinical Trial Registration ISRCTN52388040

A randomized controlled trial was conducted to study the effectiveness of two readers’ theater (RT) programs in promoting reading skills and motivation of dysfluent readers in Grades 3–4. One program (RT Goal) included a goal of preparing a performance for an audience (n = 50), while another program (RT Practice) did not include such a goal (n = 49). A group of dysfluent readers receiving traditional oral reading intervention (Control group; n = 59) and a group of classroom peers (Mainstream group; n = 159) served as controls. The results indicate that both RT groups and the Control group developed at a higher rate in oral reading speed during the intervention period than the Mainstream group. The RT Goal program was associated with higher engagement ratings and a temporary reduction in reading errors and oral reading anxiety. RT had no effects on silent reading skills or reading self-efficacy. peerReviewed

Self-efficacious children are expected to be more task-focused in challenging achievement situations and consequently have better chances of overcoming learning difficulties than children who have lower self-efficacy. The present study investigates this presumption with Finnish-speaking first graders struggling with reading acquisition ( N = 285). The development of the children’s reading fluency, self-efficacy, and task avoidance was followed from the middle of Grade 1 to the end of Grade 2, and a 6-week mobile game-based intervention was administered to those who exhibited the greatest risk for reading disabilities (≤ 5th percentile). Exploratory structural equation modeling was used to test the theoretical model. The results suggest that higher self-efficacy in the middle of Grade 1 predicted lower task avoidance and higher reading fluency at the end of Grade 1, but no support for the mediating role of task avoidance was found. The intervention benefited both self-efficacy and reading fluency.

Exercise and diet are treatments for nonalcoholic fatty liver disease (NAFLD) and prediabetes, however, how exercise and diet interventions impact gut microbiota in patients is incompletely understood. We previously reported a 8.6-month, four-arm (Aerobic exercise, n = 29; Diet, n = 28; Aerobic exercise + Diet, n = 29; No intervention, n = 29) randomized, singe blinded (for researchers), and controlled intervention in patients with NAFLD and prediabetes to assess the effect of interventions on the primary outcomes of liver fat content and glucose metabolism. Here we report the third primary outcome of the trial—gut microbiota composition—in participants who completed the trial (22 in Aerobic exercise, 22 in Diet, 23 in Aerobic exercise + Diet, 18 in No Intervention). We show that combined aerobic exercise and diet intervention are associated with diversified and stabilized keystone taxa, while exercise and diet interventions alone increase network connectivity and robustness between taxa. No adverse effects were observed with the interventions. In addition, in exploratory ad-hoc analyses we find that not all subjects responded to the intervention in a similar manner, when using differentially altered gut microbe amplicon sequence variants abundance to classify the responders and low/non-responders. A personalized gut microbial network at baseline could predict the individual responses in liver fat to exercise intervention. Our findings suggest an avenue for developing personalized intervention strategies for treatment of NAFLD based on host-gut microbiome ecosystem interactions, however, future studies with large sample size are needed to validate these discoveries. The Trial Registration Number is ISRCTN 42622771.

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The aim of this pilot study was to examine the immediate and long-term effects of an intervention program that aims to improve preschoolers' (Le but de cette étude pilote était d'examiner les effets immédiats et à long terme d'un programme d'intervention qui vise à améliorer les compétences précoces en numératie des enfants d'âge préscolaire (N = 36, M = 4.49 ans, SD = 0.35) en combinant l'apprentissage des compétences par la lecture d'histoires avec la pratique des habiletés motrices fondamentales. Le programme d'intervention a été piloté avec deux plans d'étude : un plan à mesures répétées intra-sujet avec 18 enfants (étude I) et un plan d'étude quasiexpérimental avec 18 enfants (étude II). La numératie précoce des enfants, le traitement de la magnitude symbolique et les habiletés motrices fondamentales ont été mesurés. Les résultats ont démontré que la numératie précoce des enfants et en particulier les compétences relationnelles numériques se sont améliorées au cours de l'intervention, et l'intervention a eu des effets plus importants sur la numératie précoce et les compétences relationnelles numériques des enfants par rapport à la période témoin (étude I) et au groupe témoin (étude II). De plus, les résultats après le test ont démontré que les effets se maintenaient de 4.5 à 8 semaines après l'intervention. Ces résultats fournissent des preuves préliminaires qu'il est possible de soutenir les compétences précoces en numératie des enfants avec l'apprentissage combiné des compétences relationnelles numériques par la lecture d'histoires et les habiletés motrices fondamentales malgré le contexte socio-économique ou linguistique, et de réduire l'écart entre les enfants peu performants et les enfants moyenne.El objetivo de este estudio piloto fue examinar los efectos inmediatos y a largo plazo de un programa de intervención educativa. Dicho programa busca mejorar las habilidades numéricas tempranas de niños en edad prescolares (N = 36, M = 4.49 años, SD = 0.35). Mediante de la combinación del aprendizaje de habilidades de relación numérica a través de la lectura de cuentos con la práctica de habilidades motoras fundamentales. El programa de intervención se ha pilotado con dos diseños de estudio distintos: un estudio de observación y medidas reiteradas de un mismo sujeto, con 18 niños (estudio I); y un estudio cuasiexperimental con otros 18 niños (estudio II). En ellos se midieron las habilidades numéricas tempranas, el procesamiento de magnitudes simbólicas y las habilidades motoras fundamentales. Los resultados han demostrado que durante la intervención, y en comparación con el periodo de control (estudio I) y el grupo de control (estudio II), se han mejorado las habilidades numéricas tempranas de los niños y, en especial, las habilidades de relación numérica. Además, los resultados de la evaluación posterior a la intervención demostraron que los efectos se mantuvieron durante 4.5 - 8 semanas después de la intervención. Estos resultados aportan una evidencia preliminar que defiende la posibilidad de mejorar las habilidades numéricas tempranas de los niños a través del trabajo de las mismas con lectura de cuentos y el desarrollo de funciones motoras fundamentales. Todo ello a pesar del entorno socioeconómico o lingüístico del niño; lo que permite reducir las diferencias entre los niños de bajo y medio rendimiento.

This study examined the malleability of math self-efficacy (SE) among children with poor calculation fluency via an intervention that targeted four sources of SE (mastery experiences, vicarious experiences, social persuasions, and emotional and physiological states). The effect of pure strategy training was contrasted with an intervention that integrated strategy training and explicit SE support. Moreover, the changes in SE source experiences and their relation with math SE, as well as the relation between math-SE profiles and calculation fluency development, were examined. In a quasi-experimental design, 60 Finnish children with calculation fluency problems in Grades 2 to 4 participated in strategy training (N = 38) or in an intervention that integrated SE support with strategy training (N = 32) for 12 weeks. The results showed that the explicit SE intervention integrated with strategy training enhanced math SE among children with poor calculation fluency and low SE (effect size, r = 0.61). Changes in mastery experiences and social persuasions were positively associated with changes in math SE among children who received the explicit SE intervention. An initially high math-SE profile and a profile indicating an increase from low to high math SE were related to growth in calculation fluency that approached the children's average age level during the interventions. In conclusion, an integrated approach that combined skill training and SE intervention was especially beneficial for children with poor calculation fluency and low math SE. peerReviewed

BackgroundExecutive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown.MethodsData from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70-85 years old community-dwelling men and women from Jyväskylä, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models.ResultsNo significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720-1.614, pConclusionsCognitive training did not have additive effects over physical training alone on physical activity, but multicomponent training and higher executive function at baseline may support adaptation to and maintenance of a physically active lifestyle among older adults.

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Purpose: We tested the effects of an autonomy-supportive intervention in physical education (PE) on high-school students’ autonomous motivation in PE, and their autonomous motivation, intentions, and physical activity (PA) behavior in a leisure time guided by the trans-contextual model. Method: PE classes in two schools were assigned to receive either an autonomy-supportive intervention and/or a control intervention via random allocation by the school. The PE teacher of the school assigned to the autonomy-supportive intervention was trained to provide autonomy support while the PE teacher of the school assigned to the control intervention received no training. Students (N = 256) in all classes completed measures of perceived teacher autonomy support, autonomous motivation in PE and leisure time, and beliefs, intentions, and PA in leisure time before and immediately after the intervention. Results: Results revealed direct effects of the autonomy-supportive intervention on changes in perceived autonomy support. However, there were no direct intervention effects on change in intentions and PA behavior. The intervention also had indirect effects on changes in autonomous motivation in PE and leisure time. Additionally, change in perceived autonomy support had direct effects on change in autonomous motivation in PE and indirect effects on change in leisure-time autonomous motivation. Changes in autonomous motivation in leisure time had direct effects on changes in beliefs and indirect effects on changes in intentions and PA behavior through changes in beliefs. Conclusion: The study provides valuable information on the effect of autonomous supportive climate on students’ beliefs toward PA in PE lessons and in their leisure time outside of school. peerReviewed

Background Individuals with cerebral palsy (CP) have problems in everyday tasks such as walking and climbing stairs due to a combination of neuromuscular impairments such as spasticity, muscle weakness, reduced joint flexibility and poor coordination. Development of evidence-based interventions are in pivotal role in the development of better targeted rehabilitation of CP, and thus in maintaining their motor function and wellbeing. Our aim is to investigate the efficacy of an individually tailored, multifaceted exercise intervention (EXECP) in children and young adults with CP. EXECP is composed of strength, flexibility and gait training. Furthermore, this study aims to verify the short-term retention of the adaptations three months after the end of the EXECP intervention. Methods Twenty-four children and young adults with spastic CP will be recruited to participate in a 9-month research project with a 3-month training intervention, consisting of two to three 90-min sessions per week. In each session, strength training for the lower limbs and trunk muscles, flexibility training for the lower limbs and inclined treadmill gait training will be performed. We will evaluate muscle strength, joint flexibility, neuromuscular and cardiometabolic parameters. A nonconcurrent multiple baseline design with two pre-tests and two post-tests all interspaced by three months is used. In addition to the CP participants, 24 typically developing age and sex-matched participants will perform the two pre-tests (i.e. no intervention) to provide normative data. Discussion This study has a comprehensive approach examining longitudinal effects of wide variety of variables ranging from physical activity and gross motor function to sensorimotor functions of the brain and neuromuscular and cardiometabolic parameters, providing novel information about the adaptation mechanisms in cerebral palsy. To the best of our knowledge, this is the first intervention study providing supervised combined strength, flexibility and gait training for young individuals with CP. Trial registration number ISRCTN69044459, prospectively registered (21/04/2017).

Previous research indicates that programmes employing Hellison?s Teaching Personal and Social Responsibility (TPSR) model in physical activity have had a positive impact on youth development by increasing participants? positive values, autonomy, life skills, and prosocial behaviour. Despite encouraging results of the effects of TPSR-based programmes, there remains lack of research on the effective content of these programmes, and their implementation and evaluation. The current protocol article describes the development of a TPSR-based instructor training programme and a plan for an intervention study in which novice instructors learn to understand and apply the TPSR model in practice. The participants of the TPSR-based training intervention study are novice instructors who are matched and randomly allocated to a 20-hour TPSR-based training intervention and a six-hour control instructor training without the TPSR content. The proposed study examines whether the intervention is effective in teaching novice physical activity instructors to understand and apply the TPSR model, whether the instructors? personal and social responsibility develops, and whether the training intervention is feasible.

The deleterious effects of aging on force production are observable from the age of 40 upwards, depending on the measure. Neural mechanisms contributing to maximum force production and rate of force development have been suggested as descending drive from supraspinal centers, spinal motoneuron excitability, and corticospinal inhibition of descending drive; all of which influence motor unit recruitment and/or firing rate. Resistance-trained Master athletes offer a good source of information regarding the inevitable effects of aging despite the countermeasure of systematic resistance-training. However, most evidence of neural adaptation is derived from longitudinal intervention studies in previously untrained (i.e. resistance-training naïve) older adults. There is good evidence for the effect of resistance-training on the end-point of neural activation, i.e. motor unit behavior, but little to no data on the generation of descending drive from e.g. transcranial magnetic stimulation or cortical imaging studies in older adults. This, along with tracking master athletes over several years, would provide valuable information and could be the focus of future research. peerReviewed

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IntroductionDigital behavioural weight loss interventions have the potential to improve public health; however, these interventions are often not adequately tailored to the needs of the participants. This is the protocol for a trial that aims to determine the effectiveness and cost-effectiveness of the Choosing Health programme as a means to promote weight loss and weight loss maintenance among overweight/obese adults.Methods and analysisThe proposed study is a two-group randomised controlled trial with a nested interrupted time series (ITS) within-person design. Participants (n=285) will be randomly assigned to either the Choosing Health digital intervention or a control group. For intervention participants, ecological momentary assessment will be used to identify behavioural determinants for each individual in order to tailor evidence-based behaviour change techniques and intervention content.Control group participants will receive non-tailored weight loss advice via e-book and generic emails. The primary outcome is the mean difference in weight loss between groups at 6 months controlled for baseline. Secondary outcomes include blood pressure and percentage of body fat; self-reported measures of physical activity, sitting time, quality of life, cost and theory-derived correlates of weight loss. Secondary outcomes will be measured at baseline, 3, 6 and 12 months. The primary outcome for ITS will be daily weight loss plan adherence. Data will be analysed using regression and time series analyses.Ethics and disseminationEthics approval was granted by Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland, approval number 03/P/12/2019. The project results will be disseminated through structured strategy implemented in collaboration with the Ministry of Health.Trial registration detailsThis trial was registered with www.clinicaltrials.gov; registration number NCT04291482.

Aims/hypothesis We studied for the first time the long-term effects of a combined physical activity and dietary intervention on insulin resistance and fasting plasma glucose in a general population of predominantly normal-weight children. Methods We carried out a 2 year non-randomised controlled trial in a population sample of 504 children aged 6–9 years at baseline. The children were allocated to a combined physical activity and dietary intervention group (306 children at baseline, 261 children at 2-year follow-up) or a control group (198 children, 177 children) without blinding. We measured fasting insulin and fasting glucose, calculated HOMA-IR, assessed physical activity and sedentary time by combined heart rate and body movement monitoring, assessed dietary factors by a 4 day food record, used the Finnish Children Healthy Eating Index (FCHEI) as a measure of overall diet quality, and measured body fat percentage (BF%) and lean body mass by dual-energy x-ray absorptiometry. The intervention effects on insulin, glucose and HOMA-IR were analysed using the intention-to-treat principle and linear mixed-effects models after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The measures of physical activity, sedentary time, diet and body composition at baseline and 2 year follow-up were entered one-by-one as covariates into the models to study whether changes in these variables might partly explain the observed intervention effects. Results Compared with the control group, fasting insulin increased 4.65 pmol/l less (absolute change +8.96 vs +13.61 pmol/l) and HOMA-IR increased 0.18 units less (+0.31 vs +0.49 units) over 2 years in the combined physical activity and dietary intervention group. The intervention effects on fasting insulin (regression coefficient β for intervention effect −0.33 [95% CI −0.62, −0.04], p = 0.026) and HOMA-IR (β for intervention effect −0.084 [95% CI −0.156, −0.012], p = 0.023) were statistically significant after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The intervention had no effect on fasting glucose, BF% or lean body mass. Changes in total physical activity energy expenditure, light physical activity, moderate-to-vigorous physical activity, total sedentary time, the reported consumption of high-fat (≥60%) vegetable oil-based spreads, and FCHEI, but not a change in BF% or lean body mass, partly explained the intervention effects on fasting insulin and HOMA-IR. Conclusions/interpretation The combined physical activity and dietary intervention attenuated the increase in insulin resistance over 2 years in a general population of predominantly normal-weight children. This beneficial effect was partly mediated by changes in physical activity, sedentary time and diet but not changes in body composition. Trial registration ClinicalTrials.gov NCT01803776

PurposeThe study investigated emotional competence at work and elaborated emotional competence in relation to sociocultural aspects of emotions at work.Design/methodology/approachEmotional competence at work was explored via interviews, surveys and observations. The study was conducted over one year, during which an emotion-training intervention was conducted within a medium-sized company, operating in the healthcare sector.FindingsThe study shed light on emotional competence at work, identifying three domains: individual emotional competence, emotional competence within interactions and emotional competence embedded in workplace practices.Research limitations/implicationsThis study was conducted in one organization.Practical implicationsOrganizational developers are recommended to implement activities such as training interventions in order to build emotional competence; this applies not only at the individual level but also to achieve interaction among members of the organization within collective workplace practices.Originality/valuePrevious studies on emotional competence have been limited to the individual level. The sociocultural approach to emotional competence adopted in this study recognizes – in addition to the individual and interactional level of emotional competence – emotional competence at work as related to practices at work.

Physical activity is beneficial for improving health and reducing sick leave absences. This article describes a protocol for an intervention using an interactive accelerometer smartphone application, telephone counselling, and physical activity recordings to increase the physical activity of workers in the military and improve their health. Under the protocol, employees from six military brigades in Finland will be randomly assigned to intervention and control groups. The intervention group’s participants will use accelerometers to measure their daily physical activities and their quality of sleep for six months. They will receive feedback based on these measurements via a smartphone application. The intervention group’s participants will be encouraged to exercise for two hours per week during working hours, and to participate in telephone counselling. The control group’s participants will continue with their normal exercise routines, without the accelerometer or feedback. The participants of both groups will be measured at the baseline, after the intervention period, and six months after the end of the intervention. The measurements will include accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and questionnaires on sociodemographic factors, physical activities, and health. The primary outcomes will indicate changes in physical activity, physical fitness, and sick leave absences. The findings will help to develop a straightforward and cost-effective model for supporting the health and working capabilities of employees in the military and other workplaces. publishedVersion

Social welfare service and health care providers are in a key position to implement successful domestic violence (DV) interventions. However, it is known that DV intervention and prevention work is often lacking in coordination and continuity. In addition, the limited resources, hectic work pace, and changing practices negatively affect the development of successful ways to prevent and intervene in DV. This qualitative study involving 11 focus groups, composed of social welfare and health care professionals ( n = 51) in a midsized Finnish hospital, examined the challenges and possibilities within DV interventions and the adoption of good practices produced by a DV intervention development project funded by the European Union (EU). The results show that short-term development projects, amid the pressure of limited time and resources, encounter serious challenges when applied to wicked and ignored problems, such as DV. Developing successful violence intervention practices requires a broad understanding of the challenges that rapid development projects present to professionals and social welfare service and health care practices at the organizational level. Hence, the implementation of good practices requires continuity in managerial and organizational support, distribution of information, documentation of DV, awareness raising, education, training, and agreement on basic tasks and responsibilities. Otherwise, the failure to continue development work derails the results of such work, and short project durations lead to unnecessary work and the need to reinvent temporary work practices time and again. Short-term interventions provide inefficient solutions to the problem of DV, and a built-in organizational structure can prevent the misuse of organizational and human resources.

This study investigated whether a teacher-led intervention program on online inquiry improved sixth graders' performance in a credibility evaluation task. Students (N = 342) were divided into two conditions, an intervention group (190 students) and a control group (152 students). The intervention program (21 × 45 min lessons) was implemented during a six-week course as a part of normal schoolwork. The program included explicit teaching of online inquiry skills: searching for information (3 lessons), evaluating credibility of information (3 lessons), and synthesizing information (3 lessons). In addition, the skills taught were applied in two online inquiry projects comprising 12 lessons in total. The control group received business-as-usual teaching. Students’ performance in the credibility evaluation task was measured before and after the program by pre- and post-tests. In these tests, students evaluated three Web pages dealing with two topics (Computer Gaming or Reading on Screen) varying in their perspectives and argumentation. Students rated the credibility of each Web page and justified their ratings. Topic order was counterbalanced in both conditions. The background variables (Pre-test scores, Reading comprehension, Reading fluency, Gender, Topic order, and Test order in the pre-test) were controlled for in the multilevel negative binomial regression analysis. The results showed that the intervention program helped students better justify their credibility ratings by reference to source features but not to the argumentation or other aspects of the content compared to controls. Instructional implications of the findings are discussed.

Background and objectives More knowledge is needed of the effectiveness of complex interventions that aim to promote the wellbeing of older people. This study examines the effects of ‘participatory group-based care management’ conducted among community-dwelling older adults living alone in Central and Eastern Finland. The intervention aimed to promote wellbeing and quality of life (QoL) using a needs-based and participatory approach. Methods The study was carried out as a randomized control trial (intervention group n = 185, control group n = 207). In this article, baseline and 6-month follow-up surveys were used. QoL (WHOQOL-Bref instrument), loneliness (Revised UCLA Loneliness Scale; single-item question), and trust (two items of generalized trust and six items of institutional trust) were used as outcome measurements, and generalized estimating equations (GEE) modeling as the analysis method. Both per-protocol and intention-to-treat analyses were applied. Results According to the per-protocol analysis, the intervention had no effects on QoL. Loneliness decreased among older people with poor QoL at the baseline. Additionally, the intervention enhanced trust in other people and some dimensions of institutional trust. The intention-to-treat analysis did not result in any significant effects on QoL or loneliness, but some small positive changes in institutional trust were found. Conclusions Based on some evidence of small positive effects, the intervention may be beneficial in alleviating loneliness and enhancing trust among older people living alone. Because of the contradictory results, more research is needed to examine the complexity of ‘participatory group-based care management´ from the perspective of process evaluation. peerReviewed

Background: Parental support and participation in physical activity (PA) with children and parents' acting as a role model for less sedentary behaviors (SB) are critical factors for children's healthier lifestyle. The purpose of the study was to assess the relationship between mothers' enjoyment and participants' sedentary behavior (SB) and physical activity (PA) as a secondary analysis of a randomized controlled trial (RCT) using data from Moving Sound RCT in the Pirkanmaa area of Finland. Methods: The participants were 108 mother-child dyads (child age 5-7 years) who completed the eight-week exercise intervention using a movement-to-music video program in their homes. Mothers' enjoyment was examined using a modified version of the enjoyment in sport questionnaire. The proportion of SB, standing, light PA, moderate-to-vigorous PA, and Total PA were derived from accelerometers at baseline and during the final week of the intervention. Analyses were performed using linear mixed-effect models for (1) intervention and control groups, (2) groups based on mothers' enjoyment. Results: The results highlighted that mothers' enjoyment of exercise with their children was overall high. Although there was no difference between the intervention and control groups, mothers in the intervention group increased their enjoyment during the intervention (p = 0.007). With mothers' higher enjoyment at baseline, children's light PA increased (p < 0.001), and with mothers' lower enjoyment, children's SB increased (p = 0.010). Further, if mothers' enjoyment decreased during the study, their own LPA increased (p = 0.049), and their children's SB increased (p = 0.013). If mothers' enjoyment remained stable, children's light PA (p = 0.002) and Total PA (p = 0.034) increased. Conclusions: In this RCT, no differences were found between the intervention and control groups or groups based on mothers' enjoyment, possibly due to the low power of the study. However, mothers' enjoyment of exercise with their children increased within the intervention group, and mothers' enjoyment influenced children's SB and PA. For future studies, it would be essential to focus on children's enjoyment and factors behind the behavior change. BACKGROUND: Parental support and participation in physical activity (PA) with children and parents' acting as a role model for less sedentary behaviors (SB) are critical factors for children's healthier lifestyle. The purpose of the study was to assess the relationship between mothers' enjoyment and participants' sedentary behavior (SB) and physical activity (PA) as a secondary analysis of a randomized controlled trial (RCT) using data from Moving Sound RCT in the Pirkanmaa area of Finland. METHODS: The participants were 108 mother-child dyads (child age 5-7 years) who completed the eight-week exercise intervention using a movement-to-music video program in their homes. Mothers' enjoyment was examined using a modified version of the enjoyment in sport questionnaire. The proportion of SB, standing, light PA, moderate-to-vigorous PA, and Total PA were derived from accelerometers at baseline and during the final week of the intervention. Analyses were performed using linear mixed-effect models for (1) intervention and control groups, (2) groups based on mothers' enjoyment. RESULTS: The results highlighted that mothers' enjoyment of exercise with their children was overall high. Although there was no difference between the intervention and control groups, mothers in the intervention group increased their enjoyment during the intervention (p = 0.007). With mothers' higher enjoyment at baseline, children's light PA increased (p

IntroductionHamstring muscle injuries (HMI) continue to plague professional football. Several scientific publications have encouraged a multifactorial approach; however, no multifactorial HMI risk reduction studies have been conducted in professional football. Furthermore, individualisation of HMI management programmes has only been researched in a rehabilitation setting. Therefore, this study aims to determine if aspecificmultifactorial and individualised programme can reduce HMI occurrence in professional football.Methods and analysisWe conducted a prospective cohort study over two seasons within the Finnish Premier League and compare the amount of HMI sustained during a control season to an intervention season. Injury data and sport exposure were collected during the two seasons (2019–2020), and a multifactorial and individualised HMI risk reduction programme will be implemented during intervention season (2020). After a hamstring screening protocol is completed, individual training will be defined for each player within several categories: lumbo-pelvic control, range of motion, posterior chain strength, sprint mechanical output and an additional non-individualised ‘training for all players’ category. Screening and respective updates to training programmes were conducted three times during the season. The outcome will be to compare if there is a significant effect of the intervention on the HMI occurrence using Cox regression analysis.Ethics and disseminationApproval for the injury and sport exposure data collection was obtained by the Saint-Etienne University Hospital Ethics Committee (request number: IORG0007394; record number IRBN322016/CHUSTE). Approval for the intervention season was obtained from the Central Finland healthcare District (request and record number: U6/2019).

Tämän kaksivaiheisen tutkimuksen tarkoituksena on tutkia synnytysvalmennusta kätilötyön interventiona sekä testata sen vaikuttavuutta ensisynnyttäjien synnytykseen valmistautumisen tukemisessa. Synnytysvalmennus on perinteinen äitiyshuollon palvelu Suomessa, mutta samaan aikaan kun valmennuksen osana ollut tutustumiskäynti synnytyssairaalaan on yhä useammassa sairaalassa muutettu virtuaaliseksi, ovat synnytyspelkodiagnoosin saaneiden äitien sekä raskaudenaikaisten poliklinikkakäyntien määrät nousseet. Lisäksi tutkimustieto synnytysvalmennuksen parhaista toteutustavoista on vähäistä, ja tieto synnytysvalmennuksen vaikuttavuudesta ensisynnyttäjien synnytyspelkoihin ja äitiyshuollon palvelujen käyttöön suomalaisen äitiyshuollon kontekstissa puuttuu. Tutkimuksen ensimmäisen vaiheen tavoitteena on tuottaa tietoa ensisynnyttäjien ja heidän puolisoidensa (n=12) kokemuksista sairaalaympäristössä järjestetystä synnytysvalmennuksesta. Tietoa hyödynnettiin toisessa vaiheessa lopullisen synnytysvalmennus-intervention toteutuksessa sekä tutkimushypoteesien muodostamisessa. Kokonaisvaltainen tutustuminen tulevaan synnytysympäristöön muodostui tutkimuksessa yhdeksi tärkeimmäksi kokemukseksi. Tutkimuksen toisen vaiheen tavoitteena on tuottaa tietoa synnytysvalmennuksen vaikuttavuudesta ensisynnyttäjien synnytyspelkoihin, arvioihin synnytyskokemuksesta ja synnytyskivusta selviytymisestä sekä synnytyskivunlievityksen käytöstä. Tutkimusasetelmana oli satunnaistettu kontrolloitu koe, jossa vertailtiin synnytysvalmennus-intervention ylimääräisenä palveluna saaneita ensisynnyttäjiä normaalisti valmentautuneisiin ensisynnyttäjiin. Synnytysvalmennus-interventio sisälsi kirjallisen ennakkotyöskentelymateriaalin sekä kahden tunnin synnytysvalmennuksen synnytyssairaalassa. Normaaliksi valmentautumiseksi määriteltiin neuvolan synnytysvalmennukseen osallistuminen sekä synnytyssairaalaan tutustuminen. Osallistujat olivat 18–40-vuotiaita, normaalin ultraääniseulatutkimustuloksen saaneita suomenkielisiä ensisynnyttäjiä (n=715), jotka rekrytoitiin ensimmäisen ultraäänitutkimuksen yhteydessä ennen raskausviikkoa 14. Synnytyspelkoja mitattiin raskauteen ja synnytykseen liittyvät pelot ja turvallisuus -mittarilla. Synnytyskivusta selviytymistä ja synnytyskokemuksen tyydyttävyyttä mitattiin yhdellä asenneväittämällä. Synnytysvalmennuksiin osallistumista kartoitettiin yhdellä kysymyksellä. Lisäksi äitien synnytysdokumenteista kerättiin tietoja synnytyskivunlievityksen käytöstä, sairaalassa oloajan pituudesta ennen lapsen syntymää sekä äitiyspoliklinikkakäyntien määristä. Aineistot analysoitiin tilastollisesti perus- ja monimuuttujamenetelmillä. Mittauksia tehtiin kolmena eri ajankohtana: Alkumittaus tehtiin kyselyillä sairaalan äitiyspoliklinikalla rekrytoinnin yhteydessä. Synnytysvalmennus-intervention jälkeiset seurantamittaukset tehtiin raskausviikkojen 34 jälkeen postikyselynä kotiin, kyselyllä synnytyksen jälkeen lapsivuodeosastolla sekä poimimalla tietoja äitien synnytysdokumenteista. Tulosten mukaan interventio lievensi ja vähensi äitien raskaudenaikaisia synnyttämiseen liittyneitä pelkoja sekä pelon vaikutuksia jokapäiväiseen elämään. Äitiyshuollon palvelujen käytön vaikuttavuutena tuli esiin interventio-ryhmän äitien vähäisempi synnytysvalmennuksiin osallistuminen kontrolliryhmän äiteihin verrattuna. Tutkimustulokset toivat varmuutta synnytysvalmennuksesta ensisynnyttäjiä hyödyttävänä raskaudenaikaisena palveluna. Tuotettua tietoa voidaan jatkossa hyödyntää äitiyshuollon palvelujen kehittämisessä synnytykseen valmentautumisen osalta. Jatkotutkimuksena synnytysvalmennusjärjestelmästä voisi kehittää yksittäistä valmennustapahtumaa laajemman mallin ja testata sen vaikuttavuutta. The purpose of this two-phase study are to examine childbirth education as a midwifery intervention, and to test its effectiveness in supporting first-time mother as they prepare for childbirth. Childbirth education arranged by the maternity clinic, including a brief excursion to the maternity hospital, is a longstanding maternity healthcare service in Finland. However, as more and more hospitals have replaced the physical excursion with a virtual substitute, there have been increasing numbers both of antenatal visits and of mothers receiving official diagnose of tokophobia. Very little research has been conducted into the best ways in which to implement childbirth education. There is also inadequate knowledge of its effectiveness in allaying the childbirth fears of first-time mothers, and of its effectiveness to the use of maternity health-care services in Finland. The first phase of the study aimed to gather knowledge of first-time mothers’ and their spouses’ (n= 12) experiences of childbirth education, as arranged by the maternity hospital. This knowledge was harnessed in the final version of the childbirth education intervention, and in defining the hypotheses of the study’s second phase. The holistic way of getting to know the future place of birth was the most important experience for the parents. The second phase of the study aimed to accumulate knowledge of the effectiveness of childbirth education on the use of maternity healthcare services, first-time mothers’ fears of childbirth, their evaluation of the birthing experiences and the use of medical pain relief during parturition. Designed as a randomised controlled trial, the study compares an intervention group of first-time mothers receiving extended childbirth education with a control group of first-time mothers receiving normal childbirth education. The intervention comprised both pre-working material and two hours of childbirth education at the maternity hospital. Normal education was defined as participation in a childbirth education class arranges by the maternity clinic, and a brief excursion to the maternity hospital. The participants were 18 ̶ 40-year-old Finnish speaking first-time mothers whose ultrasound results were normal (n= 715) and who were willing to participate in the study. They were recruited at the first ultrasound screening, prior to 14 weeks’ of gestation. Participants’ fear of childbirth was measured using the instrument ‘Feelings of Fear and Security Associated with Pregnancy and Childbirth’. Participants’ ability to control the labour pain and their satisfaction with the birthing experience were measured on a Likert-type scale, and the frequency with which they attended childbirth education sessions was measured with one question. The data on the amount of medicine used to alleviate pain during labour, the duration of stays at the hospital before the baby was born, and the number of visits to the hospital’s maternity outpatient clinic were gathered from patient records after delivery. The data were analysed statistically using basic and multivariate methods. Measurements were carried out at three different points: the baseline was established through questionnaires conducted during recruitment at the hospital’s maternity outpatient clinic. The effectiveness of the intervention was measured by questionnaires sent out by regular mail after 34 weeks’ gestation and after childbirth in the postnatal ward, as well as by the information contained in patient records after delivery. The intervention mitigated and reduced childbirth-related fear and its impact on mothers’ everyday lives. At the level of maternity services, the intervention had a positive influence, lessening the frequency of attendance of other childbirth educational sessions. These results confirmed the understanding that childbirth education is a beneficial antenatal service for first-time mothers preparing for childbirth. The knowledge provided can be used to improve maternity healthcare services designed to help mothers prepare for childbirth. In future, the childbirth education system should be renewed and developed into an extended model, the effectiveness of which should then be tested further.