Cardiorespiratory fitness is associated with sickness absence and work ability.

BACKGROUND: Physical activity may sustain the physical aspect of work ability despite health problems such as musculoskeletal disorders and anxiety, which are the most prevalent work-related health problem in Europe. AIMS: To evaluate the association of Finnish municipal workers' accelerometer-measured physical activity, sedentary behaviour, and cardiorespiratory and muscular fitness with their sickness absence levels, perceived work ability and health-related quality of life. METHODS: In connection with a randomized controlled trial recruiting 185 municipal workers, the authors performed baseline data analysis utilizing quantile regression to examine relationships between the outcome variables (all-cause sickness absence for 6 months, perceived work ability and health-related quality of life) and cardiorespiratory fitness, muscular fitness, and physical activity, and sedentary behaviour. All results were adjusted for age, sex and education level. RESULTS: The median duration of all-cause sickness absence over the preceding 6 months was lowest among participants with high cardiorespiratory fitness relative to the lowest tertile (2.0 versus 6.0 days; P < 0.05), and the highest perceived work ability was found among those with high or moderate cardiorespiratory fitness as compared to the lowest tertile (8.0 versus 7.0; P < 0.001). Moderate-to-vigorous physical activity correlated positively with the physical component of health-related quality of life (P < 0.01) and with a high cardiorespiratory-fitness level (P < 0.05). CONCLUSIONS: High cardiorespiratory fitness was associated with decreased all-cause sickness absence days and improved work ability among municipal workers.

Performance in dynamic movement tasks and occurrence of low back pain in youth floorball and basketball players.

BACKGROUND: Prospective studies investigating risk factors for low back pain (LBP) in youth athletes are limited. The aim of this prospective study was to investigate the association between hip-pelvic kinematics and vertical ground reaction force (vGRF) during landing tasks and LBP in youth floorball and basketball players. METHODS: Three-hundred-and-eighty-three Finnish youth female and male floorball and basketball players (mean age 15.7 ± 1.8) participated and were followed up on for 3 years. At the beginning of every study year the players were tested with a single-leg vertical drop jump (SLVDJ) and a vertical drop jump (VDJ). Hip-pelvic kinematics, measured as femur-pelvic angle (FPA) during SLVDJ landing, and peak vGRF and side-to-side asymmetry of vGRF during VDJ landing were the investigated risk factors. Individual exposure time and LBP resulting in time-loss were recorded during the follow-up. Cox's proportional hazard models with mixed effects and time-varying risk factors were used for analysis. RESULTS: We found an increase in the risk for LBP in players with decreased FPA during SLVDJ landing. There was a small increase in risk for LBP with a one-degree decrease in right leg FPA during SLVDJ landing (HR 1.09, 95% CI 1.02 to 1.17, per one-degree decrease of FPA). Our results showed no significant relationship between risk for LBP and left leg FPA (HR 1.04, 95% CI 0.97 to 1.11, per one-degree decrease of FPA), vGRF (HR 1.83, 95% CI 0.95 to 3.51) or vGRF side-to-side difference (HR 1.22, 95% CI 0.65 to 2.27) during landing tasks. CONCLUSIONS: Our results suggest that there is an association between hip-pelvic kinematics and future LBP. However, we did not find an association between LBP and vGRF. In the future, the association between hip-pelvic kinematics and LBP occurrence should be investigated further with cohort and intervention studies to verify the results from this investigation. LEVEL OF EVIDENCE: Prognosis, level 1b.

Kids Out; evaluation of a brief multimodal cluster randomized intervention integrated in health education lessons to increase physical activity and reduce sedentary behavior among eighth graders.

BACKGROUND: Most Finnish adolescents are not sufficiently physically active. Health education (HE) provides beneficial starting point for physical activity (PA) promotion in schools. This study evaluates an intervention integrated into three HE lessons to increase PA and reduce sedentary behavior (SB) among eighth graders. METHODS: All public secondary schools in Tampere, Finland participated and were randomized to intervention (INT, n = 7) and comparison group (COM, n = 7). In INT (690 students, 36 classes) the teachers (n = 14) implemented behavioral theory-driven content during three HE lessons. In COM (860 students, 41 classes) the teachers (n = 14) carried out standard lessons. The evaluation was based on RE-AIM: Effectiveness was assessed from baseline to 4 weeks (Follow-up 1) and Maintenance from 4 weeks to 7 months (Follow-up 2) with change in students' PA and SB and related psychosocial and parental factors. Methods included questionnaire, accelerometer and activity diary. Linear mixed models with baseline adjustments and random effect correction were used to compare the difference in change between INT and COM. Data on Reach, Adoption and Implementation were collected during the process. RESULTS: Intervention effects were only seen in the self-reported data favoring INT in the weekly number of days with at least 1 h of brisk leisure PA (0.3 [95%CI 0.1 to 0.6]), proportion of students meeting PA recommendations (4.1 [95%CI 2.5 to 5.7]), proportion of students reporting that their family sets limitations for screen time (5.4 [95%CI 3.3 to 7.4]) and in the number of days on which the students intended to do leisure PA in the following week (0.3 [95%CI 0.1 to 0.6]). The effects on PA were still beneficial for INT at Follow-up 2. The intervention reached 96% of the students, was adopted in all 7 schools and was implemented by 13/14 teachers in 35/36 classes. CONCLUSIONS: The intervention was feasible and had small favorable effects on students' self-reported PA, intention to do PA and family norm in screen time. The effects on PA persisted until Follow-up 2. It is likely that for greater impacts the HE lessons should have been supported with other actions without compromising feasibility. TRIAL REGISTRATION: NCT01633918 (June 27th, 2012).

Acute and overuse injuries among sports club members and non-members: the Finnish Health Promoting Sports Club (FHPSC) study.

BACKGROUND: Physical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members. METHODS: In this cross-sectional survey targeted at 14-16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type. RESULTS: At least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P < 0.001). The sex-adjusted odds ratio (OR) for acute injury in sports club members compared to non-members was 3.13 (95% confidence interval (95% CI) 2.54-3.87). Thirty-five percent of sports club members and 17.4% of non-members (P < 0.001) reported at least one overuse injury during the past year. The overuse injury OR for sports club members was 2.61 (95% CI 2.09-3.26). Sports club members who trained 7-14 h per week during training (OR 1.61, 95% CI 1.21-2.12, P = 0.001) or competition season (OR 1.55, 95% CI 1.18-2.06, P = 0.002) were more likely to report an injury compared to members who trained 3-6 h per week. Those sports club members who participated in forty competitions or more compared to 7-19 competitions per year were more likely to report an acute injury (OR 1.55, 95% CI 1.05-2.08, P = 0.028) or for an overuse injury (OR 1.53, 95% CI 1.02-2.30, P = 0.038). CONCLUSIONS: Both acute and overuse injuries are common among youth sports club members, and the number increases along with increasing amounts of training and competitions. More effective injury prevention is needed both for adolescents engaging in sports club activities and for other adolescents.

Reliable recognition of lying, sitting, and standing with a hip-worn accelerometer.

Hip-worn accelerometers are widely used to estimate physical activity (PA), but the accuracy of acceleration threshold-based analysis is compromised when it comes to identifying stationary and sedentary behaviors, let alone classifying body postures into lying, sitting, or standing. The purpose of this study was to devise a novel method for accurate classification of body posture using triaxial data from hip-worn accelerometer and to evaluate its performance in free-living conditions against a thigh-worn accelerometer. The posture classification rested on 2 facts: constant Earth's gravity vector and upright walking posture. Thirty healthy adults wore a hip-mounted accelerometer and underwent an array of lying, sitting, standing, and walking tasks. Task type, their order, and length were randomly assigned to each participant. During walking, the accelerometer orientation in terms of gravity vector was taken as reference, and the angle for posture estimation (APE) was determined from the incident accelerometer orientation in relation to the reference vector. Receiver operating characteristic (ROC) curve yielded an optimal cut-point APE of 64.9° (sensitivity 100% and specificity 100%) for lying and sitting and 11.6° (94.2%; 94.5%) for sitting and standing. In free-living conditions, high agreement (89.2% for original results and 90.4% for median-filtered results) in identifying sedentary periods (sitting and lying) was observed between the results from hip- and thigh-worn accelerometers. Walking provides a valid reference activity to determine the body posture. The proposed APE analysis of the raw data from hip-worn triaxial accelerometer gives accurate and specific information about daily times spent lying, sitting, and standing.

Investigation of knee control as a lower extremity injury risk factor: A prospective study in youth football.

This prospective study in youth football examined the relationship between frontal plane knee projection angle (FPKPA) during the single-leg squat and sustaining an acute lower extremity injury or acute non-contact lower extremity injury. Secondly, side-to-side asymmetry in FPKPA and sex as injury risk factors were explored. In addition, we investigated the influence of age, sex, and leg dominance on the FPKPA. A total of 558 youth football players (U11 to U14) participated in the single-leg squat test and prospective injury registration. FPKPA was not found as a risk factor for injuries at this age. There was no difference in the mean FPKPA between sexes. However, FPKPA was associated with age; oldest subjects displayed the smallest FPKPA. Among boys, the frontal plane knee control improved by age. Among girls, the relationship between age and FPKPA was not as clear, but the oldest girls displayed the smallest mean FPKPA in the study (12.2° ± 8.3°). The FPKPA was greater on the dominant kicking leg compared to the non-dominant support leg (P < .001 for boys, P = .001 for girls). However, side-to-side asymmetry in FPKPA was not associated with future injuries. In conclusion, frontal plane knee control in the single-leg squat was not associated with lower extremity injuries among young football players. As the single-leg squat to 90° knee flexion was too demanding for many subjects, easier single-leg squat test procedure or a different movement control test, such as a double-legged squat, could be more suitable for the young football players.

Self-reported health-enhancing physical activity recommendation adherence among 64,380 finnish adults.

The Finnish recommendations for health-enhancing physical activity (PA) for adults (≥18 years) recommend: (i) ≥150 minutes of moderate-to-vigorous-intensity physical activity (MVPA) and (ii) activities that develop muscle strength and balance ≥2 days/week. However, adherence to these recommendations among the Finnish adults is currently unknown. This study reports on the self-reported adherence to the PA recommendations and associations with sociodemographic factors among Finnish adults. Data were used from the Finnish "Regional Health and Well-being Study." In 2013-2014, postal questionnaires were sent to 132,560 persons, with 69,032 responding (response rate =52.1%). The weighted proportions adhering to the: (i) MVPA recommendation, (ii) sufficient muscle-strengthening activity (≥2 days/week), (iii) sufficient balance training (≥2 days/week), and (iv) Finnish health-enhancing PA recommendations (Finnish recommendations) were calculated. Associations with sociodemographic variables (eg, age, education level, self-rated health) were assessed using multiple logistic regression analyses. Of 69,032 respondents, 92.6% (n=64,380, response rate =48.6%, 18-98 years) reported on their physical activity levels. A total of 31.2% (95% CI: 30.8%-31.6%) met the aerobic MVPA recommendation, 17.2% (95% CI: 16.9%-17.6%) reported sufficient muscle-strengthening activity, 6.7% (95% CI: 6.4%-6.9%) reported sufficient balance training, and 10.8% (95% CI: 10.5%-11.1%) met the Finnish recommendations. In the adjusted analysis, those with poorer self-rated health, older age, lower education levels, and those classified overweight or obese were independently associated with lower odds of meeting the Finnish recommendations. The vast majority of Finnish adults do not meet the full PA recommendations. Public health action is needed to increase PA in Finland.

High ankle injury rate in adolescent basketball: A 3-year prospective follow-up study.

This prospective study investigated the incidence and pattern of acute time-loss injuries in young female and male basketball players. Eight basketball teams (n=201; mean age 14.85±1.5) participated in the follow-up study (2011-2014). The coaches recorded player participation in practices and games on a team diary. A study physician contacted the teams once a week to check new injuries and interviewed the injured players. In total, 158 injuries occurred. The overall rate of injury (per 1000 hours) was 2.64 (95% CI 2.23-3.05). Injury rate was 34.47 (95% CI 26.59-42.34) in basketball games and 1.51 (95% CI 1.19-1.82) in team practices. Incidence rate ratio (IRR) between game and practice was 22.87 (95% CI 16.71-31.29). Seventy-eight percent of the injuries affected the lower limbs. The ankle (48%) and knee (15%) were the most commonly injured body sites. The majority of injuries involved joint or ligaments (67%). Twenty-three percent of the injuries were severe causing more than 28 days absence from sports. Number of recurrent injuries was high (28% of all injuries), and most of them were ankle sprains (35 of 44, 79%). No significant differences were found in injury rates between females and males during games (IRR 0.88, 0.55, to 1.40) and practices (IRR 1.06, 0.69, to 1.62). In conclusion, ankle and knee ligament injuries were the most common injuries in this study. Moreover, the rate of recurrent ankle sprains was alarming.

Tuberculosis in immigrants in Finland, 1995-2013.

Increasing immigration from high tuberculosis (TB) incidence countries is a challenge for surveillance and control in Finland. Here, we describe the epidemiology of TB in immigrants by using national surveillance data. During 1995-2013, 7030 (84·7%) native and 1199 (14·4%) immigrant cases were identified. The proportion of immigrant cases increased from 5·8% in 1995 to 32·1% in 2013, consistent with increasing immigrant population (2·1-5·6%) and decreasing incidence of TB in the native population (from 12·1 to 3·5/100 000). TB cases in immigrants were significantly younger, more often female, and had extrapulmonary TB more often than native cases (P < 0·01 for all comparisons); multidrug resistance was also more common in immigrants than natives (P < 0·01). Immigrant cases were born in 82 different countries; most commonly in Somalia and the former Soviet Union/Russia. During 2008-2013, 433 Mycobacterium tuberculosis isolates from immigrants were submitted for spoligotyping; 10 different clades were identified. Clades were similar to those found in the case's country of birth. Screening immigrants from high-incidence countries and raising awareness of common characteristics and symptoms of TB is important to ensure early diagnosis and to prevent transmission.

Greater levels of cardiorespiratory and muscular fitness are associated with low stress and high mental resources in normal but not overweight men.

BACKGROUND: The aim of the present study was to investigate how cardio respiratory (CRF) and muscular fitness (MF) together with leisure-time physical activity (LTPA) influence stress symptoms and mental resources among normal-weight and overweight men, because it is not known how body weight affects this association. METHODS: In a cross-sectional study, 824 men (mean ± SD: age 25 ± 5 y, weight 81 ± 13 kg, BMI 25 ± 4 kg/m(2)) underwent CRF and MF tests and completed LTPA and stress questionnaires. For the analysis, the subjects were divided into BMI groups (normal vs. overweight) and CRF / MF / LTPA (low, moderate, high) tertiles. RESULTS: Normal-weight men with low CRF reported 12 % (p = 0.001) more stress symptoms (SS) compared to normal-weight men with moderate CRF, and 13 % (p = 0.004) more SS compared to normal-weight men with high CRF. Normal-weight men with low MF reported 13 % (p = 0.001) higher SS compared to normal-weight men with moderate MF and 16 % (p = 0.002) more SS compared to men with high MF. Among overweight men, there were no significant differences in SS or mental resources (MR) between the low, moderate and high CRF and MF tertiles. Overweight men with high CRF experienced 8 % (p = 0.039) more SS compared to normal-weight participants with high CRF when age, tobacco and alcohol use, MF and LTPA were considered as covariates (p = 0.014). CONCLUSION: Higher CRF and MF are associated with lower stress and higher mental resources in normal-weight men, but in overweight men, these relationships may differ.

Low back and neck and shoulder pain in members and non-members of adolescents' sports clubs: the Finnish Health Promoting Sports Club (FHPSC) study.

BACKGROUND: The objective of this study was to investigate the prevalence of self-reported low back pain (LBP) and neck and shoulder pain (NSP), and the related factors in members and non-members of adolescents' sports clubs. METHODS: This cross-sectional study was based on surveys of 14-16-year-olds as a part of the Finnish Health Promoting Sports Club (FHPSC) Study. The surveys on self-reported health behaviours, injuries, and musculoskeletal health were conducted among sports club members (n = 962) and non-members (n = 675). Binary logistic regression analysis was applied to study the associations between dependent variables of LBP and NSP, and the independent factors. RESULTS: The prevalence of LBP during the preceding 3 months was 35.0 % in girls and 24.5 % in boys (p < 0.05 for sex difference). The prevalence of NSP was 55.9 % in girls and 27.3 % in boys (p < 0.001 for sex difference). Being a sports club member increased the odds for LBP in boys (odds ratio [OR] 2.35, 95 % CI 1.48-3.72). On the other hand, sports club participation was associated with lower odds of frequent NSP in girls (OR 0.52, 95 % CI 0.33-0.82). No associations were found between other leisure-time physical activity and LBP or NSP. Higher screen time (computer games, TV/DVD, phone, Internet) during leisure-time increased the odds of NSP in boys and LBP in boys and girls. CONCLUSIONS: In this study, self-reported LBP and NSP were already relatively common among adolescents. Girls have a higher risk for reporting LBP and NSP. Measures that are more effective in the prevention of LBP in male sports club members are needed. Excessive screen time is weakly associated with LBP and NSP, which should be taken into account in health promotion among adolescents.

Effect of Continuous and Intermittent Exercises on Oxidised HDL and LDL Lipids in Runners.

We studied the effects of different types of exercises on the concentrations of oxidised HDL (oxHDLlipids) and LDL lipids (oxLDLlipids), serum lipids, antioxidant potential, paraoxonase and malondialdehyde in endurance runners by performing both a 40-min continuous run (velocity corresponding to 80% VO2max) and a 40-min intermittent run (2-min run, velocity corresponding to 100% VO2max, and 2-min rest) using a treadmill. Blood samples were taken before exercise, after 20 and 40 min of exercise, and 15 and 90 min after the end of exercise. The concentrations of oxLDLlipids remained unchanged during the running tests, but after a 90-min recovery the concentrations decreased by 4% (P<0.05) for the intermittent run and by 16% (P<0.01) for the continuous run. The acute effect of the intermittent and continuous run increased the concentrations of oxHDLlipids by 26 and 25%, respectively (P<0.001 for both). Interestingly, oxHDLlipids did not increase after the first half of the run in middle-distance runners during the intermittent run, and a similar phenomenon was seen in marathon runners during the continuous run. These results may indicate that acute physical exercise increases the transport of lipid oxidation products by HDL, although a different training history or genetic background may alter these acute responses.

Knee Control and Jump-Landing Technique in Young Basketball and Floorball Players.

Poor knee alignment is associated with increased loading of the joints, ligaments and tendons, and may increase the risk of injury. The study purpose was to compare differences in knee kinematics between basketball and floorball players during a vertical drop jump (VDJ) task. We wanted to investigate whether basketball players, whose sport includes frequent jump-landings, exhibited better knee control compared with floorball players, whose sport involves less jumping. Complete data was obtained from 173 basketball and 141 floorball players. Peak knee valgus and flexion angles during the VDJ were analyzed by 3D motion analysis.Larger knee valgus angles were observed among basketball players (- 3.2°, 95%CI -4.5 to - 2.0) compared with floorball players (- 0.9°, 95%CI -2.3 to 0.6) (P=0.022). Basketball players landed with a decreased peak knee flexion angle (83.1°, 95%CI 81.4 to 84.8) compared with floorball players (86.5°, 95%CI 84.6 to 88.4) (P=0.016). There were no significant differences in height, weight or BMI between basketball and floorball players. Female athletes exhibited significantly greater valgus angles than males. This study revealed that proper knee control during jump-landing does not seem to develop in young athletes simply by playing the sport, despite the fact that jump-landings occur frequently in practice and games.

Maximal strength, muscular endurance and inflammatory biomarkers in young adult men.

The aim was to study associations of maximal strength and muscular endurance with inflammatory biomarkers independent of cardiorespiratory fitness in those with and without abdominal obesity. 686 young healthy men participated (25±5 years). Maximal strength was measured via isometric testing using dynamo-meters to determine maximal strength index. Muscular endurance index consisted of push-ups, sit-ups and repeated squats. An indirect cycle ergometer test until exhaustion was used to estimate maximal aerobic capacity (VO2max). Participants were stratified according to those with (>102 cm) and those without abdominal obesity (<102 cm) based on waist circumference. Inflammatory factors (C-reactive protein, interleukin-6 and tumour necrosis factor alpha) were analysed from serum samples. Maximal strength and muscular endurance were inversely associated with IL-6 in those with (ß=-0.49, -0.39, respectively) (p<0.05) and in those without abdominal obesity (ß=-0.08, -0.14, respectively) (p<0.05) adjusted for smoking and cardio-respiratory fitness. After adjusting for smoking and cardiorespiratory fitness, maximal strength and muscular endurance were inversely associated with CRP only in those without abdominal obesity (ß=-0.11, -0.26, respectively) (p<0.05). This cross-sectional study demonstrated that muscular fitness is inversely associated with C-reactive protein and IL-6 concentrations in young adult men independent of cardiorespi-ratory fitness.

Associations of maximal strength and muscular endurance with cardiovascular risk factors.

The aim was to study the associations of maximal strength and muscular endurance with single and clustered cardiovascular risk factors. Muscular endurance, maximal strength, cardiorespiratory fitness and waist circumference were measured in 686 young men (25±5 years). Cardiovascular risk factors (plasma glucose, serum high- and low-density lipoprotein cholesterol, triglycerides, blood pressure) were determined. The risk factors were transformed to z-scores and the mean of values formed clustered cardiovascular risk factor. Muscular endurance was inversely associated with triglycerides, s-LDL-cholesterol, glucose and blood pressure (ß=-0.09 to - 0.23, p<0.05), and positively with s-HDL cholesterol (ß=0.17, p<0.001) independent of cardiorespiratory fitness. Muscular endurance was negatively associated with the clustered cardiovascular risk factor independent of cardiorespiratory fitness (ß=-0.26, p<0.05), whereas maximal strength was not associated with any of the cardiovascular risk factors or the clustered cardiovascular risk factor independent of cardiorespiratory fitness. Furthermore, cardiorespiratory fitness was inversely associated with triglycerides, s-LDL-cholesterol and the clustered cardiovascular risk factor (ß=-0.14 to - 0.24, p<0.005), as well as positively with s-HDL cholesterol (ß=0.11, p<0.05) independent of muscular fitness. This cross-sectional study demonstrated that in young men muscular endurance and cardiorespiratory fitness were independently associated with the clustering of cardiovascular risk factors, whereas maximal strength was not.

Physical fitness and volume of leisure time physical activity relate with low stress and high mental resources in young men.

AIM: There is limited evidence available regarding the relationship between physical fitness, especially muscular fitness, and the mental well-being among young healthy men. Therefore, the aim of the present study was to investigate the impact of measured cardiovascular and muscle fitness and self reported leisure time physical activity (LTPA) on outcomes of stress and mental resources in Finnish young men. METHODS: In a cross-sectional study, 831 men (mean age 25 y) underwent cardiovascular and muscle fitness test and completed LTPA and Occupational Stress Questionnaires (OSQ). For analysis, the subjects were divided to LTPA, CVF and MFI tertiles. RESULTS: The group with low LTPA reported 6% and 13% more stress (ANCOVA using age, body mass index, smoking and alcohol use as covariates, P<0.05 in both) and 6% and 12% (P<0.05 in both) less mental resources than the moderate and high LTPA groups, respectively. The group having low cardiovascular fitness experienced 8% and 9% (P<0.001 in both) more stress and 7% and 7% (P<0.05 in both) less mental resources than moderate and high cardiovascular fitness groups. The low muscle fitness index (MFI) group reported 7% (P<0.01) less mental resources than those with moderate MFI and 8% (P<0.001) more stress and 8% (P<0.001) less mental resources than those with high MFI. CONCLUSION: Both good aerobic and muscular fitness together with high LTPA are associated with low stress and high mental resources.

Physical activity measured by accelerometry among adolescents participating in sports clubs and non-participating peers.

The purpose of this descriptive cross-sectional study is to describe the amount and intensity of physical activity (PA) measured by accelerometry among adolescents participating in organized sports (SCP) and age-matched non-participating peers (NP). SCPs (332) and NPs (139) wore an accelerometer on the hip for seven days. PA was reported using the 1-min exponential moving average. The current moderate-to-vigorous physical activity (MVPA) recommendation of at least an average of 60 min of MVPA daily was reached by 85% of SCPs and 45% of NPs (p < .001). During training days, the MVPA times among SCPs ranged from 153 ± 39 min in males and 109 ± 35 min in females participating in basketball to 113 ± 33 min in males participating in floorball and 83 ± 32 min in females participating in gymnastics. Sports participation contributes rather strongly to the accumulation of the recommended amount of MVPA. During training days, SCPs, except for females participating in gymnastics, accumulated more MVPA than NPs. During non-training days, only males participating in cross-country skiing and females participating in track and field accumulated more MVPA than NPs.HIGHLIGHTSPA of Finnish adolescents participating in nine different organized sports and age-matched non-participating peers was measured by accelerometry for one week and the results are reported using the 1-min exponential moving average.Adolescents participating in many organized sports accumulated more PA than non-participants; this was observed in meeting the PA recommendations, total amount of PA at different intensities, and step count.The current PA recommendation of at least an average of 60 min of MVPA per day was reached by 85% of SCPs and 45% of non-participating peers. Vigorous physical activity at least three times per week was incorporated by 96% of SCPs and 81% of NPs.During training days, males participating in soccer, basketball, and cross-country skiing spent more time in MVPA than females participating in the same sports. During non-training days, the time spent in MVPA was similar between males and females participating in sports clubs.

Clinical standards for diagnosis, treatment and prevention of post-COVID-19 lung disease.

BACKGROUND: The aim of these clinical standards is to provide guidance on 'best practice' care for the diagnosis, treatment and prevention of post-COVID-19 lung disease.METHODS: A panel of international experts representing scientific societies, associations and groups active in post-COVID-19 lung disease was identified; 45 completed a Delphi process. A 5-point Likert scale indicated level of agreement with the draft standards. The final version was approved by consensus (with 100% agreement).RESULTS: Four clinical standards were agreed for patients with a previous history of COVID-19: Standard 1, Patients with sequelae not explained by an alternative diagnosis should be evaluated for possible post-COVID-19 lung disease; Standard 2, Patients with lung function impairment, reduced exercise tolerance, reduced quality of life (QoL) or other relevant signs or ongoing symptoms ≥4 weeks after the onset of first symptoms should be evaluated for treatment and pulmonary rehabilitation (PR); Standard 3, The PR programme should be based on feasibility, effectiveness and cost-effectiveness criteria, organised according to local health services and tailored to an individual patient's needs; and Standard 4, Each patient undergoing and completing PR should be evaluated to determine its effectiveness and have access to a counselling/health education session.CONCLUSION: This is the first consensus-based set of clinical standards for the diagnosis, treatment and prevention of post-COVID-19 lung disease. Our aim is to improve patient care and QoL by guiding clinicians, programme managers and public health officers in planning and implementing a PR programme to manage post-COVID-19 lung disease.

Physicians' self-assessment of cancer pain treatment skills--more training required.

PURPOSE: Adequate pain control is essential in cancer treatment. We surveyed Finnish physicians' perception on their skills and training needs on palliative pain management. METHODS: A structured questionnaire with multiple choices and open ended questions was used for collecting data in 2006-2008. Of 720 physicians participating, 59 were working in oncology and 661 physicians in internal medicine, geriatrics, and primary health care. RESULTS: The principles of the WHO guidelines of cancer pain management were not well known. Forty-six percent of oncologists and 32% of other physicians (P < 0.0001) knew the analgesic ladder consisting of three steps. Forty-seven percent of oncologists and 61% of other physicians considered pain treatment of cancer patients being well managed in Finland. Only 24% of oncologists and 5% of other physicians considered the education in palliative care being currently at a satisfactory level. Oncologists reported a need of training in interaction and communication skills, ethical questions, and palliative home care. The other physicians expressed the strongest need for training in pain management and palliative care. CONCLUSIONS: To have more confidence in treating cancer, pain physicians would benefit in training and education in palliative care. It should be systematically included both in general and specialist training and continuous medical education.

Both poor cardiorespiratory and weak muscle fitness are related to a high concentration of oxidized low-density lipoprotein lipids.

Good physical fitness is associated with favorable serum lipids. Oxidized low-density lipoprotein (ox-LDL) could be even more atherogenic than serum lipids. We studied the association of ox-LDL and serum lipids with physical fitness. Healthy young (mean age 25 years) men (n=846) underwent maximal oxygen uptake (VO(2max)) and muscle fitness index (MFI) tests and completed a leisure-time physical activity (LTPA) questionnaire. Age (ANCOVA1), age+waist circumference+systolic blood pressure+fasting blood glucose+smoking (ANCOVA3) were used as covariates. The groups with the lowest VO(2max), MFI and LTPA had 23%, 16% and 8% higher concentrations of ox-LDL than the groups with the highest VO(2max) (P<0.0001), MFI (P=0.022) and LTPA (P=0.039) groups, respectively. Subjects with poor fitness (low VO(2max) or low MFI) or low LTPA had elevated levels of ox-LDL/high-density lipoprotein (HDL)-cholesterol, total cholesterol, LDL-cholesterol, triglycerides and a low level of HDL-cholesterol (ANCOVA1, in all, P<0.05). Furthermore, low VO(2max) is associated with a high level of ox-LDL/HDL-cholesterol and triglycerides, and with a low level of HDL-cholesterol (ANCOVA3, in all, P<0.05). Also, subjects with low LTPA had a high ratio of ox-LDL/HDL-cholesterol (ANCOVA1, P=0.001). In conclusion, both poor fitness (both low VO(2max) and low MFI) and low LTPA are associated with a higher concentration of ox-LDL lipids and serum lipids, which may indicate a higher risk for atherosclerosis.