Protein supplement intake by non-athlete gym attendees in Jazan region: misconceptions and gender differences.

BACKGROUND: Protein supplements (PSs) have gained widespread popularity among non-athlete gym attendees, who often perceive them as essential tools for muscle growth and recovery. However, misinformation surrounding PSs may lead to inappropriate use and negative health consequences. This study aimed to assess whether non-athlete gym attendees using PSs have greater misconceptions than non-users while also examining the prevalence of PS consumption and gender differences. METHODS: A cross-sectional study of 387 participants in the Jazan region was conducted. Customers of 10 fitness centers were screened with a questionnaire comprising questions to measure PS misconceptions. Participants were divided into PS users and non-users. Data were analyzed using descriptive statistics and the Chi-square test to assess the associations between variables. An independent t-test was used to compare the PS Misconception Index Score between the two groups. RESULTS: A total of 82.4% of non-athlete gym attendees consumed at least one PS. Our findings revealed a significant association between gender and PS utilization (P<0.001), with a higher proportion of females (90.8%) consuming PS than males (77.6%). PS users had a significantly lower PS Misconception Index Score than non-users (26.8 vs. 28.3; P=0.006), indicating that PS users had a higher number of misconceptions. The internet (41.37%) and coaches (gym instructors/trainers) (34.48%) were the most common sources of information about PSs, with muscle gain being the primary reason for consumption (82.75%). CONCLUSIONS: PS consumption is highly prevalent among non-athlete gym attendees in the Jazan region, with many individuals having misconceptions about their benefits and potential risks. Targeted educational interventions are needed to promote evidence-based knowledge about PSs for gym attendees, as well as for coaches, given that they were among the primary sources of information on supplements.

Processos de reflexividade dos psicólogos do esporte e coaches: um estudo fenomenológico / Reflexivity processes of sport psychologists and coaches: a phenomenological study / Procesos de reflexividad de psicólogos del deporte y coaches: un estudio fenomenológico

O objetivo desta pesquisa é identificar e compreender fenomenologicamente, por meio de relato de Psicólogos de Esporte (PE) e de Coaches, em sua vivência prática, como ocorrem os processos reflexivos em sua atuação, conforme apreendidos a partir de relatos de experiências. O método de investigação escolhido foi a fenomenologia, pois oferece os recursos necessários para tal mergulho junto à experiência reflexiva. A amostra intencional foi delineada por PE e Coaches (profissionais de Educação Física que recorrem ao Coaching) em atividade em esportes de alto rendimento, que tenham atuado ou estejam atuando em modalidades esportivas coletivas e/ou individuais. Realizaram-se nove entrevistas (cinco com PE, quatro com Coaches). O acesso ao objeto desse estudo se deu por meio de entrevistas em profundidade e semiestruturadas, orientadas pela escuta suspensiva. As questões disparadoras foram formuladas com base no Procedimento Estruturado de Reflexão adaptado. Para análise das entrevistas, realizou-se uma síntese de cada relato, seguindo-se de cruzamento intencional. Como resultados, percebeu-se que PE e Coaches trazem algumas similaridades no que se refere aos modos de refletir sobre sua prática. No entanto, as experiências que eles fazem desses processos reflexivos é que podem tomar rumos distintos. Os(as) PE amparam-se na regulamentação da profissão e resguardam-se em seus apontamentos, trazendo suas experiências e reflexões sobre os processos vividos. Os(as) Coaches trazem em suas explanações um trabalho coerente, organizado e compatível com o método do Coaching. Problematizar os processos reflexivos desses profissionais permite diferenciar qualitativa e eticamente suas atuações, possibilitando o fomento multiprofissional no esporte.(AU)

The aim of this study consists in phenomenologically identifying and understanding, by the report of Sport Psychologists (SP) and coaches, in their practical experience, how would be the reflexive processes that take place in their performance, as learned from reports of their experiences. The research method chosen was phenomenology, since it offers the necessary resources for such a dive along with the reflective experience. The intentional sample was outlined by SP and coaches (Physical Education professionals who use coaching) active in high performance sports, who have or are working in collective and/or individual sports. Nine interviews were conducted (five with SP, four with coaches). Access to the object of this study took place by in-depth and semi-structured interviews, guided by suspensive listening. The triggering questions were formulated based on the adapted Structured Reflection Procedure. For the analysis of the interviews, a synthesis of each report was carried out, followed by the intentional crossing. As results, it was noticed that SP and coaches bring some similarities regarding the ways of reflecting on their practice. However, their experiences of these reflective processes are that they can take different directions. The SP are based on the regulation of the profession and guard themselves in their notes, bringing their experiences and reflections on the processes experienced. Coaches bring in their explanations a coherent, organized, and compatible work with the coaching method. Problematizing the reflective processes of these professionals allows to differentiate their actuation qualitatively and ethically, making the multiprofessional phenomenon in sport possible.(AU)

El objetivo de este estudio consiste en identificar y comprender fenomenológicamente, a partir de la experiencia práctica de psicólogos del deporte (PD) y coaches, cómo serían los procesos reflexivos que se llevan a cabo en su rendimiento, tal y como se desprende de los informes de experiencias. El método de investigación elegido fue la fenomenología, ya que ofrece los recursos necesarios junto con la experiencia. La muestra intencional fue delineada por PD y coaches (profesionales de la educación física que utilizan el coaching) activos en deportes de alto rendimiento, que tienen o están trabajando en deportes colectivos e/o individuales. Se realizaron nueve entrevistas (cinco con PD, cuatro con coaches). El acceso al objeto de este estudio fue entrevistas en profundidad y semiestructuradas, guiadas por escuchas suspensivas. Las preguntas se formularon desde el procedimiento de reflexión estructurado adaptado. Para el análisis de las entrevistas, se hizo una síntesis de cada informe, seguida del cruce intencional. Como resultados, se notó que los PD y coaches tienen algunas similitudes con respecto a las formas de reflexionar sobre su práctica. Sin embargo, las experiencias que hacen de estos procesos pueden tomar diferentes direcciones. Los(las) PD se basan en la regulación de la profesión y se protegen en sus notas, aportando sus experiencias y reflexiones sobre los procesos vividos. Los(las) coaches plantean en sus explicaciones un trabajo coherente, organizado y compatible con el método de Coaching. Problematizar los procesos reflexivos de estos profesionales permite diferenciar sus acciones de manera cualitativa y ética, además de posibilitar la promoción multiprofesional en el deporte.(AU)

Conhecimentos em nutrição para o esporte e consumo de suplementos por praticantes de musculação em uma rede de academias / Sports Nutrition Knowledge and Supplement Consumption by Resistance Training Practitioners at a Gym Chain

Conhecimentos em nutrição para o esporte e consumo de suplementos por praticantes de musculação em uma rede de academiasARTIGO ORIGINALErivan de Olivindo Cavalcante1, Maria Rosimar Teixeira Matos2Objetivo: Este estudo objetivou avaliar os conhecimentos em nutrição para o esporte e o consumo de suplementos alimentares entre praticantes de musculação de uma rede de academias. Métodos: Trata-se de um estudo transversal, realizado com 168 praticantes de musculação em três unidades de uma rede de academias de Fortaleza, Ceará, Brasil. Foram avaliados os conhecimentos em nutrição para o esporte e o consumo de suplementos através de um questionário estruturado, abordando os dados de identificação, informações sobre a prática de musculação e sobre a utilização de suplementos e questões objetivas acerca dos conhecimentos de nutrição para o esporte, sendo esses posteriormente classificados em baixo, moderado e alto, de acordo com pontuação obtida. A análise estatística foi realizada pela construção de frequências simples e relativas, médias e desvio-padrão, assim como por medidas de correlação, com significância fixada em 5%. Resultados: Observou-se que quase metade dos praticantes referiu o consumo de suplementos alimentares. Dentre os suplementos mais consumidos, destacaram-se os proteicos, estando o consumo independente de gênero, tempo de prática de musculação e conhecimentos em nutrição (p<0,05). A maioria dos indivíduos mostrou conhecimento moderado em nutrição, entretanto, observou-se dificuldade em associar os nutrientes com suas funções e suas utilizações para o esporte, principalmente quanto ao manejo proteico. Conclusão: Os achados deste estudo revelaram uma supervalorização do consumo proteico no âmbito da musculação, predispondo à adoção de práticas alimentares e de suplementação inadequadas. Faz-se necessária, assim, a elaboração e efetivação de ações de educação e assistência nutricional voltadas a esse público. (AU)

Objective: This study aims to assess knowledge on sports nutrition and dietary supplements consumption among resistance-training practitioners at a gym chain. Methods: This is a cross-sectional study, carried out among 168 resistance-training practitioners in three units of a gym chain in Fortaleza, Ceará, Brazil. The participants' sports nutrition and supplement consumption knowledge was assessed using a structured questionnaire that addressed: identification data, information on training and supplement use, and objective questions on sports nutrition awareness, classifying the results as low, moderate and high, accordingly to the obtained scores. Statistical analysis was performed by simple and relative frequencies, mean, standard deviation, and correlation, with significance set as 5%. Results: It was observed that half of the respondents mentioned the consumption of dietary supplements. Among the most consumed, protein-based supplements were prominent, with consumption independent of gender, years of resistance training, and nutrition awareness (p<0.05). Most participants showed moderate nutrition knowledge, despite a perceivable difficulty in associating nutrients to their functions and sport-related uses, especially protein handling. Conclusion: These findings show an overvaluation of protein intake in the context of resistance training, which may lead to the adoption of inadequate dietary and supplementation practices. It is thus necessary to develop and implement education and nutrition assistance actions targeting this public (AU)

Sportsmen's Attitude towards Dietary Supplements and Nutrition Knowledge: An Investigation in Selected Roman Area Gyms.

The non-professional sport environment is a grey zone not as widely assessed as that of elite athletes. The purpose of this research was to investigate the dietary supplementation habits and the nutrition knowledge on sport (NKS) in a sample of gym users. The level of adequacy of NKS was set at ≥60% of correct answers. Almost half (46.4%) of respondents stated they used food supplements, in particular multivitamins (31.0%), amino acid pills (29.5%), minerals (29.1%), and protein powders (28.7%). Supplements were used to increase muscle mass (36.9%) and to repair muscle (35.1%). Gym trainers were the preferred source of information on the use of supplements, especially in males (84%). The NKS correct response rate was 57.1% and the proportion of respondents with a sufficient level of NKS was 47.3%. The prevalence of correct answers was highest in males (61.5%) and for respondents with the highest educational attainment levels (44.5% and 53%). This study demonstrated that non-professional sportsmen do not have sufficient knowledge of nutrition and that the gym environment does not facilitate the circulation of the correct information on the role of supplementation. Considering the importance of nutrition for sportsmen, it is necessary to put in place actions aimed at increasing the knowledge of nutrition of gym users and their trainers.

Consumption of nutritional supplements by teenagers attending gyms supplements and exercise in teenagers / Consumo de suplementos nutricionais por adolescentes frequentadores de academias

ABSTRACT Objective: To describe the supplements used by adolescents in gyms in the city of São Paulo and the factors related to their use. Methods: Participants were 1,012 adolescents of both sexes, aged between 13 and 18 years old, all of them regular regulars at gyms in the city of São Paulo. For data collection, a questionnaire was used to identify the main supplements consumed by adolescents. The chi-square test was used to verify possible associations with a significance of p<0.05. Results: The use of supplements was more frequent in the age group between 16 and 18 years, in the socioeconomic level B, and the use of these supplements was higher as the time of exercise in the gym was longer (>12 months). The amount of exercise modalities practiced in the gym was inversely associated with the use of supplements. Male adolescents consumed significantly more supplements than females, and Physical Education professionals, friends and parents were the ones who most influenced adolescents to use supplements. The main supplements used by the boys were carbohydrate gel (90.9%) and hypercaloric (94.5%). In girls it was fat burner (55.0%) and vitamins and minerals (50.0%). Conclusion: The use of supplements was common among adolescents who exercise in gyms in São Paulo and the indication was made by physical education professional.

RESUMO Objetivo: Descrever os suplementos utilizados por adolescentes em academias da cidade de São Paulo e os fatores relacionados à sua utilização. Métodos: Participaram 1.012 adolescentes de ambos os sexos, com idade variando entre 13 e 18 anos, sendo todos frequentadores regulares de academias de ginástica na cidade de São Paulo. Para coletada de dados, foi utilizado um questionário com objetivo de identificar os principais suplementos consumidos pelos adolescentes. Utilizou-se o teste Qui Quadrado para verificar possíveis associações com significância de p<0,05. Resultados: O uso de suplementos foi mais frequente na faixa etária entre 16 e 18 anos, no nível socioeconômico B, e, o uso desses suplementos foi mais alto a medida que o tempo de prática de exercício na academia foi maior (>12 meses). A quantidade de modalidades de exercício praticada na academia esteve inversamente associada ao uso de suplementos. Adolescentes do sexo masculino consumiram significativamente mais suplementos do que o sexo feminino, e, os profissionais de Educação Física, amigos e pais foram os que mais influenciaram os adolescentes para o uso de suplementos. Os principais suplementos utilizados pelos meninos foram o gel de carboidrato (90,9%) e hipercalóricos (94,5%). Nas meninas foram o fat burner (55,0%) e vitaminas e minerais (50,0%). Conclusão: O uso de suplementos foi comum entre adolescentes praticantes de exercícios em academias de São Paulo e a indicação foi feita basicamente por profissionais de educação física.

Dietary supplements and body management of practicers of physical activity in gyms.

The use of dietary supplements integrates one of the strategies physical activity practicers employ to manage their bodies in contemporary times. This research sought to identify and analyze the multiple uses of dietary supplements done by these practicers and what such uses represent for them with regard to managing their own bodies. A qualitative study was conducted based on the application of online questionnaires to 67 physical activity practicers who frequent gyms. There was also an observation of the groups dynamics in the internet. The resulting empirical material was analyzed using content analysis. Results indicated that part of these practicers believe that dietary supplements aid in gaining muscular mass and improve performance. Furthermore, some of them question the effects of such products on the body although they claim that dietary supplements facilitate diets or should be used only when prescribed by health professionals. In conclusion, there are different ways of using these products, which are often evaluated by consumers.

What and how much do the community health officers and auxiliary nurse midwives do in health and wellness centres in a block in Punjab? A time-motion study.

BACKGROUND: The Government of India introduced a new cadre of Community Health Officers (CHOs) in the primary health-care system through the Ayushman Bharat Health and Wellness Centres (HWCs) program. OBJECTIVES: The study aimed to assess the activities performed and time spent by the existing and new primary health-care team members at the HWC level. METHODS: A time and motion study was undertaken in four HWCs in Punjab over a period of 3 months, to assess the time spent by auxiliary nurse midwives (ANMs) and CHOs on different services and activities. Data were collected through direct continuous observation of four CHOs and four ANMs during working hours for a period of 6 consecutive days of a week, along with structured time allocation interviews of all participants. RESULTS: The CHOs spent 5.7 (5.6-5.9) hours per day on duty of which 57% was productively involved in service delivery. The average time spent by ANMs was 4.9 (4.5-5.3) hours per day, with nearly 62% productive time. While the CHOs spent nearly 40% of their time on services for non-communicable diseases (NCDs), the ANMs spent 51% of their time on maternal, infant, child, and adolescent health services. CONCLUSION: The introduction of HWCs and CHOs has nudged the health system toward comprehensive primary health care by placing a renewed emphasis on NCDs. The study provides useful evidence for staff, program implementers, and policymakers, to aid informed decision-making for human resource management.

Dietary supplements and body management of practicers of physical activity in gyms / Suplementos alimentares e gerenciamentos do corpo de praticantes de atividade física em academias de ginástica

Abstract The use of dietary supplements integrates one of the strategies physical activity practicers employ to manage their bodies in contemporary times. This research sought to identify and analyze the multiple uses of dietary supplements done by these practicers and what such uses represent for them with regard to managing their own bodies. A qualitative study was conducted based on the application of online questionnaires to 67 physical activity practicers who frequent gyms. There was also an observation of the groups dynamics in the internet. The resulting empirical material was analyzed using content analysis. Results indicated that part of these practicers believe that dietary supplements aid in gaining muscular mass and improve performance. Furthermore, some of them question the effects of such products on the body although they claim that dietary supplements facilitate diets or should be used only when prescribed by health professionals. In conclusion, there are different ways of using these products, which are often evaluated by consumers.

Resumo Os usos de suplementos alimentares fazem parte de uma das estratégias em que os praticantes de atividade física gerenciam seus corpos na contemporaneidade. A presente pesquisa buscou identificar e analisar os múltiplos usos dos suplementos alimentares por praticantes de atividade física e o que esses consumos representam para os usuários no que diz respeito a gerenciar o próprio corpo. Empreendeu-se um estudo qualitativo que se baseou nas aplicações de questionários no ambiente da internet a 67 praticantes de atividades físicas de academias de ginástica. Observou-se também a dinâmica dos grupos na internet. O material empírico foi analisado com base na análise de conteúdo. Os resultados indicaram que parte dos praticantes de atividades físicas acredita que os suplementos alimentares potencializam o ganho de massa muscular e aprimoram o desempenho. Já alguns questionam os efeitos de tais produtos no organismo, embora afirmem que facilitam a dieta cotidiana ou devem ser consumidos caso tenham sido prescritos por profissionais de saúde. Conclui-se que existem diferentes maneiras de usar esses produtos, que são frequentemente avaliados pelos consumidores.

Estratégias de educação em saúde no Programa Academia da Saúde no Estado de Goiás / Health education strategies in the Health Academy Program in the State of Goiás

Introdução: A alfabetização ou letramento funcional em saúde (LFS) é um processo educativo voltado a promover a autonomia e o empoderamento individual e coletivo. Objetivos: Analisar atividades educativas desenvolvidas no Programa Academia da Saúde (PAS) e aproximações com a perspectiva de alfabetização e educação em saúde. Método: Estudo exploratório-descritivo, de abordagem qualitativa, com a utilização de dados secundários do monitoramento do PAS no estado de Goiás, através da aplicação de questionários, via Form-SUS, no período de 2015 a 2017; e dados obtidos por meio de entrevistas junto aos usuários (n=11) durante visita in loco em 4 municípios de Goiás. Resultados: Em Goiás, dos polos respondentes ao monitoramento (n=75), em 2017, 98,7% informaram desenvolver ações focadas nas práticas corporais/atividades físicas, 92% desenvolvem práticas de educação em saúde e 85,1% atividades de promoção de alimentação saudável. Retomando o tema "educação em saúde" junto ao PAS, como já exposto, dos 75 (setenta e cinco) participantes do monitoramento, em 2017, 69 (sessenta e nove) polos asseveraram realizar práticas de educação em saúde. Considerações Finais: Observou-se que as ações prioritárias se ancoram no eixo de educação em saúde, por vezes assumindo estratégias vinculadas ao modelo de educação tradicional, pois se utilizam estratégias de palestras e/ou aulas expositivas, ou seja, práticas verticalizadas, hierarquizadas, reprodutivistas e com enfoque na disciplinarização e controle do processo saúde-doença dos sujeitos assistidos junto ao programa

Introduction: Functional Health Literacy (LFS) is an educational process aimed at promoting individual and collective autonomy and empowerment. Objectives: Analyse the educational activities developed in the Health Academy Program (HAP) and approximations with the perspective of Health Literacy. Method: This is an exploratory-descriptive study, with a qualitative approach, which uses secondary data related to the monitoring of the HAP in the state of Goiás, through the application of surveys, via Form-SUS, in the period from 2015 to 2017; and data obtained through interviews with users (n=11) during visit in four municipalities in the State of Goiás. Results: In Goiás, from the places that responded to monitoring (n=75), in 2017, 98.7% reported developing actions focused on body practices / physical activity, 92% develop health education practices and 85.1% activities to promote healthy eating. Resuming the theme "health education" with the HAP, as already exposed, of the 75 (seventy-five) monitoring participants in 2017, in the state of Goiás, 69 (sixty-nine) places assert to carry out education practices in health. Final Considerations: Observed is that the priority actions are anchored in health education axis are strategies linked to the traditional education model, as it assumes strategies of lectures, in form verticalized, hierarchical practices, reproductivist and focusing on disciplining and controlling the health-disease process of those assisted by the program

Práticas corporais/atividades físicas no Programa Academia da Cidade: cuidados em saúde e discursos de usuários / Bodily practices/physical activity in the City Gym Program: health care and participants' discourse / Prácticas corporales/ actividades físicas en el Programa Gimnasio de la Ciudad: cuidados de salud y discursos de usuarios

Neste artigo, objetiva-se investigar as práticas corporais/atividades físicas e os discursos produzidos pelos usuários do Programa Academia da Cidade em Belo Horizonte, Minas Gerais, Brasil, em sua articulação com o cuidado integral na Atenção Primária à Saúde. Realizou-se uma pesquisa qualitativa ancorada no estudo de casos múltiplos com triangulação de métodos, envolvendo observação participante e entrevistas semiestruturadas. Buscamos aproximações com a perspectiva da subjetivação em Michel Foucault. Nas duas unidades pesquisadas constatou-se a presença não apenas da forma hegemônica de produção de cuidados em saúde, representada pela noção de atividade física, mas outras que se aproximaram da noção de práticas corporais. Tal fato contribuiu para se assumir a dupla e imbricada noção atribuída às ações produtoras de cuidados em saúde como práticas corporais/atividades físicas. Ambas se constituíram legítimas na produção de subjetividades dos usuários. (AU)

This article investigates the bodily practices/physical activity and discources produced by participants in the City Gym Program in Belo Horizonte, Brazil in relation to comprehensive primary health care. We conducted a qualitative study anchored in multiple case studies using participant observation and semi-structured interviews and drawing on the concept of subjectivation proposed by Michel Foucault. In the two gyms included in this study, the findings reveal the presence of the hegemonic approach to health care, represented by the notion of physical activity, and other approaches that resemble the concept of bodily practices. This contributed to the adoption of a dual interwined notion of health care as bodily practices/physical activity. Both approaches were legitimate in the production of subjectivities of program participants. (AU)

El objetivo de este artículo es investigar las prácticas corporales /actividades físicas y los discursos producidos por los usuarios del Programa Gimnasio de la Ciudad en Belo Horizonte, Estado de Minas Gerais, Brasil, en su articulación con el cuidado integral en la Atención Primaria de la Salud. Se realizó una investigación cualitativa anclada en el estudio de casos múltiples con triangulación de métodos, envolviendo observación participante y entrevistas semiestructuradas. Buscamos aproximaciones con la perspectiva de la subjetivación en Michel Foucault. En las dos unidades investigadas se constató la presencia no solo de la forma hegemónica de producción de cuidados de salud, representada por la noción de actividad física, sino también otras que se aproximaron de la noción de prácticas corporales. Tal hecho contribuyó para asumir la doble y superpuesta noción atribuida a las acciones productoras de cuidados de salud como prácticas corporales/actividades físicas. Ambas se constituyeron como legítimas en la producción de subjetividades de los usuarios. (AU)

High Prevalence of Supplement Intake with a Concomitant Low Information Quality among Swiss Fitness Center Users.

BACKGROUND: The aim of this study was to screen the prevalence of supplement use in Swiss fitness center users and what information sources they consulted. METHODS: Customers of 10 fitness centers were screened with a quantitative questionnaire. RESULTS: Eighty two percent of the 417 fitness center users consumed at least one supplement per week. Supplement intake correlated with training frequency (rs = 0.253, p < 0.001). The most prevalent products were protein supplements (used by 49% of the study population), magnesium (34%), and multi-micronutrient supplements (31%). The average number of supplement servings per week among consumers was 17.1 (SD: 16.1, median: 11.0) and the average number of different products used was 6.9 (SD: 4.4, median: 6.0). The most frequently used information sources were the coach/trainer (28%), the website of the supplement seller (26%), and training peers (24%). Thirty seven percent were informed or informed themselves about potential risks associated with the supplement used. The leading reasons for selecting the information source were the desire for scientific-based information followed by the education level of the informing person. CONCLUSIONS: A high prevalence of supplement intake among Swiss fitness center users was associated with a low level of information quality and a low prevalence of risk information. A discrepancy between a desire for high quality evidence-based information and a contrasting behavior was detected.

Spa therapy with physical rehabilitation is an alternative to usual spa therapy protocol in symptomatic knee osteoarthritis.

The objective of the study was to demonstrate the non-inferiority of low-frequency spa therapy combined with rehabilitation (Spa-rehab) versus standard spa therapy at 6 months for symptomatic knee osteoarthritis (KOA). A prospective, randomized, monocenter, non-inferiority trial with recruitment of community-based symptomatic KOA patients was performed. Standard spa therapy comprised standardized spa treatment, 6 days a week for 3 weeks, and Spa-rehab therapy comprised spa sessions, 3 days a week for 3 weeks, followed by a dedicated rehabilitation program, 3 days a week for 3 weeks. The primary endpoint was achieving at 6 months a minimal clinically important improvement (MCII) for pain on a visual analog scale and/or an MCII for function on the WOMAC index and no knee surgery (composite MCII). Secondary endpoints were composite MCII at 3 months and achieving a Patient Acceptable Symptom State (PASS) for pain and function at 3 and 6 months. Among 283 patients included, 145 were allocated to standard spa therapy and 138 to Spa-rehab therapy. We could not demonstrate the non-inferiority of Spa-rehab therapy for the primary endpoint: difference for responders - 0.08 [90% CI (- 0.18 to 0.02), p = 0.14]. However, the difference test between the groups was not significant (p = 0.18). Spa-rehab therapy was not inferior to standard spa therapy for the composite MCII at 3 months or the PASS at 3 and 6 months. Spa-rehab therapy can reasonably be proposed to patients with symptomatic KOA. This protocol may be more cost-effective than standard spa therapy and avoid absenteeism from work and accommodation costs for patients who live close to a centre.

Usual care including home exercise with versus without spa therapy for chronic low back pain: protocol for the LOMBATHERM' study, a multicentric randomised controlled trial.

BACKGROUND: Low back pain is highly prevalent and a major source of disability worldwide. Spa therapy is frequently used to treat low back pain, but the associated level of evidence for efficacy is insufficient. To fill this knowledge gap, this protocol proposes an appropriately powered, prospective, evaluator-blinded, multi-centre, two-parallel-arm, randomised (1:1), controlled trial that will compare spa therapy in addition to usual care including home exercise (UCHE) versus UCHE alone for the treatment of chronic low back pain. METHODS: Eligible patients (anticipated sample size of 358) will have had low back pain for more than 3 months and scores for pain greater than 40 mm on a visual analogue scale (VAS). Following initial consent for UCHE and baseline evaluations, patients are randomised (1:1) to UCHE alone, or UCHE plus spa therapy (18 days of mud packs, underwater massages, showers and water exercises under medical supervision). Patients in the latter arm will be requested to sign an additional consent form as per Zelen randomisation. Follow-up visits will occur at approximately months 1, 6 and 12 and (along with baseline assessments) will cover changes over time in VAS pain scores, the impact of lower back pain on daily life (the Rolland and Morris Disability Questionnaire (RMDQ)), inappropriate fears and beliefs about lower back pain (the fear, avoidance, belief questionnaire (FABQ)), general quality of life (the Euroqol Group 5 dimension, 5 level questionnaire (EQ-5D-5 L)), Patient Acceptable Symptom State (PASS), consumption of analgesic drugs and nonsteroidal anti-inflammatory drugs (NSAIDs), and overall state of health. Health resource use and days of sick leave (and subsequently the associated costs) will also be recorded. The primary outcome is the presence/absence of a clinically relevant change (improvement of at least 30%) in the VAS score for pain at 6 months. DISCUSSION: Despite the fact that previous, rather dated recommendations encourage spa therapy for the treatment of low back pain, the current literary corpus is methodologically poor. This protocol has been designed to provide results spanning a thorough range of outcomes at the highest evidence level possible. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03910023. Registered on 10 April 2019.

The value of monitoring data in a process evaluation of hygiene behaviour change in Community Health Clubs to explain findings from a cluster-randomised controlled trial in Rwanda.

BACKGROUND: A cluster-Randomised Controlled Trial evaluation of the impact of the Community Health Clubs (CHCs) in the Community Based Environmental Health Promotion Programme in Rwanda in 2015 appeared to find little uptake of 7 hygiene indicators 1 year after the end of the intervention, and low impact on prevention of diarrhoea and stunting. METHODS: Monitoring data was revisited through detailed community records with all the expected inputs, outputs and external determinants analysed for fidelity to the research protocol. Five household inventory observations were taken over a 40-month period including 2 years after the end of the cRCT in a random selection of the 50 intervention CHCs and data compared to that of the trial. Focus Group Discussion with all Environmental Health Officers of the Ministry of Health provided context to understand the long-term community dynamics of hygiene behaviour change. RESULTS: It was found that the intervention had been jeopardised by external determinants with only 54% fidelity to protocol. By the end of the designated intervention period in June 2014, the treatment had reached only 58% of households with 41% average attendance at training sessions by the 4056 registered members and 51% mean completion rate of 20+ sessions. Therefore only 10% of 50 CHCs provided the full so-called 'Classic' training as per-protocol. However, sustainability of the CHCs was high, with all 50 being active 2 years after the end of the cRCT and over 80% uptake of recommended practices of the same 7 key indicators as the trial was achieved by 2017. CONCLUSIONS: The cRCT conclusion that the case study of Rusizi District does not encourage the use of the CHC model for scaling up, raises concerns over the possible misrepresentation of the potential of the holistic CHC model to achieve health impact in a more realistic time frame. It also questions the appropriateness of apparently rigorous quantitative research, such as the cluster-Randomised Controlled Trial as conducted in Rusizi District, to adequately assess community dynamics in complex interventions.

Dietary supplements in fitness centers: body management and health risks / Suplementos alimentares em academias de ginástica: gerenciamentos do corpo e riscos à saúde

ABSTRACT The purpose of this study was to explore the meanings of supplement use among those who engage in physical activity in fitness centers. A qualitative study was carried out based on 67 questionnaires answered on the internet by practitioners of physical training. There was also an observation of the groups in the Facebook, the dynamic and other aspects such as discussions, messages, profiles and images. It was detected that physical activity practitioners care more about the quantity of substances ingested than any other factor that may lead them to suffer certain health risks. They believe that so-called "excesses" may cause diseases to the internal organs. Although the participants believe that their own consumption of supplements does not compromise their health, a biomedical authority is crucial for them to recognize whether or not they are at risk. The consumption of supplements can vary depending on what is understood to be excessive and which risks may compromise the body. There are many motivations for managing these substances. Health risks should not be analyzed solely from a biomedical perspective, but also addressed by the socio-cultural logic of the perceptions and meanings attributed by the subjects to the body and the management thereof.

RESUMO O objetivo deste estudo foi explorar os significados do uso de suplementos entre aqueles que praticam atividade física em academias de ginástica. Um estudo qualitativo foi realizado com base em 67 questionários respondidos na internet por praticantes de atividade física. Houve também uma observação dos grupos na Facebook, a dinâmica e outros aspectos como discussões, mensagens, perfis e imagens. Foi detectado que os praticantes de atividade física se importam mais com a quantidade de substâncias ingeridas do que com qualquer outro fator que possa levá-los a sofrer certos riscos à saúde. Eles acreditam que os chamados "excessos" podem causar doenças aos órgãos internos. Embora os participantes acreditem que seu próprio consumo de suplementos não compromete a saúde, a autoridade biomédica é crucial para que eles reconheçam se estão ou não em risco. O consumo de suplementos pode variar dependendo do que se entende ser excessivo e quais os riscos que podem comprometer o corpo. Existem muitas motivações para gerenciar essas substâncias. Os riscos para a saúde não devem ser analisados apenas a partir de uma perspectiva biomédica, mas também abordados pela lógica sociocultural das percepções e significados atribuídos pelos sujeitos ao corpo e ao seu gerenciamento.

Perfil hídrico e consumo de suplementos por frequentadores de academias / Water profile and consumption of supplements by academics / Perfil hídrico y consumo de suplementos por frecuentadores de gimnasios

Objetivo: avaliar o perfil hídrico e o consumo de suplementos de pessoas fisicamente ativas inseridas em academias da cidade Montes Claros, Minas Gerais, Brasil. Método: Trata-se de estudo transversal, realizado com praticantes de atividade física, em 2018. Participaram da pesquisa 200 pessoas, maiores de 20 anos, de ambos os sexos, frequentadores de academias. Realizou-se a avaliação nutricional dos participantes, com aplicação de questionário estruturado, contendo questões relacionadas à prática de atividade física, ingestão hídrica e uso de suplementos alimentares. Resultados: dentre os participantes, 52,5% era do sexo feminino e 65% estavam com peso adequado. Verificou-se que a 71% da população estuda consumia mais que dois litros de água por dia. Dentre os praticantes de atividade física, 60,5% e 99% não faziam o uso de suplementos e anabolizantes, respectivamente. Além disso, 96% não utilizavam ergogênicos. Conclusão: este estudo demonstrou que a população estudada possui ingestão adequada de água e baixo consumo de suplementos, anabolizantes e ergogênicos.(AU)

Objective: to evaluate the water profile and the consumption of supplements by physically active people inserted in academies of the city of Montes Claros, Minas Gerais, Brazil. Method: This is a cross-sectional study, carried out with physical activity practitioners in 2018. The study included 200 people, over 20 years old, of both sexes, attending academies. The nutritional evaluation of the participants was carried out with the application of a structured questionnaire containing questions related to the practice of physical activity, water intake and use of dietary supplements. Results: among the participants, 52.5% were female and 47.5% male. Among all respondents, 65% had normal weight. It was found that 71% of the study population consumed more than two liters of water per day. Among practitioners of physical activity, 60.5% and 99% were not using supplements and steroids, respectively. In addition, 96% of the participants did not use ergogenics. Conclusion: this study demonstrated that the population had adequate water intake and low intake of supplements, steroids and ergogenics.(AU)

Objetivo: evaluar el perfil hídrico y el consumo de suplementos de personas físicamente activas insertadas en gimnasios de la ciudad Montes Claros, Minas Gerais, Brasil. Método: Se trata de un estudio transversal, realizado con practicantes de actividad física, en 2018. Participaron de la investigación 200 personas, mayores de 20 años, de ambos sexos, frecuentadores de gimnasios. Se realizó la evaluación nutricional de los participantes, con aplicación de cuestionario estructurado, conteniendo cuestiones relacionadas a la práctica de actividad física, ingestión hídrica y uso de suplementos alimenticios. Resultados: de los participantes, el 52,5% era del sexo femenino y el 47,5% del sexo masculino. Entre todos los entrevistados, el 65% estaba con peso adecuado. Se verificó que el 71% de la población estudia consumía más de dos litros de agua al día. Entre los practicantes de actividad física, el 60,5% y el 99% no hacían el uso de suplementos y anabolizantes, respectivamente. Además, el 96% de los estudiados no utilizaba ergogénicos. Conclusión: este estudio demostró que la población estudiada posee ingestión adecuada de agua y bajo consumo de suplementos, anabolizantes y ergogénicos.(AU)

Workplace health promotion for employees working in offshore wind parks in the German exclusive economic zone: a mixed-methods study.

OBJECTIVES: To investigate the awareness and use of health promotion offers among offshore wind workers and to study associations with demographic and workplace characteristics. To examine employees' reasons for (non-)participation and their wishes for health promotion activities offshore. DESIGN: Mixed-methods study presenting the results from semistructured telephone interviews and a web-based cross-sectional survey. SETTING: Offshore wind parks in the German exclusive economic zone in the North and Baltic Seas. PARTICIPANTS: 21 offshore workers in the qualitative study (19 male/2 female; all German). 303 offshore workers in the quantitative study (287 male/13 female; 275 German/24 other nationalities). OUTCOME MEASURES: Awareness and use of workplace health promotion offers and associations with demographic and workplace characteristics (age, work schedule and wind park phase); reasons for (non-)participation; needs and wishes for health promotion offers. RESULTS: Few workers indicated being aware of health promotion programmes at their workplace. Single offers were reported, with fitness facilities being the most common offer employees recognised and had used (n=168, 55.6%). Employees with a regular work schedule were more likely to have used fitness facilities offshore (adjusted OR (AOR)=3.22, 95% CI 1.53 to 6.80). Workers in the construction phase were more likely to have used massages (AOR=8.19, 95% CI 2.82 to 23.77). Younger workers were less likely to belong to the group of those who were aware of fitness facilities but had not used them (AOR=0.43, 95% CI 0.19 to 0.98). Employees expressed various needs and wishes for behavioural and environmental preventive measures offshore. CONCLUSIONS: The results demonstrate a perceived need among the workers for the development of health promotion programmes offshore. Since the awareness and use of offers may partly depend on personal and organisational characteristics, this should be taken into account in the planning of health promotion activities.

Autopercepção corporal e o consumo de recursos ergôgenicos por frequentadores de academia / Body self-perception and the consumption of ergonomic resources by academic frequenters

Objetivo: caracterizar o perfil de praticantes de musculação quanto ao uso de recursos ergogênicos e relacioná-lo à autopercepção corporal. Método: estudo quantitativo, transversal, realizado em academias de musculação de duas cidades de Minas Gerais com entrevistas estruturadas utilizando um questionário e o conjunto de silhuetas. A análise foi pelo Statistical Package for Social Sciences (SPSS15.0), General Linear Model de medidas repetidas e a correlação de Pearson. Resultados: a prática de musculação, em ambos os sexos, foi pela melhora da saúde. A maioria afirmou que realiza as atividades físicas e consome suplementos sem orientação médica ou nutricional. O mais utilizado é o de proteínas, sendo que os homens consomem mais em relação às mulheres. Conclusão: não houve evidências de alterações de autoimagem relacionadas ao uso de suplementos, apesar da falta de orientação.(AU)

Awareness and Attitude Toward Use of Dietary Supplements and the Perceived Outcomes Among Saudi Adult Male Members of Fitness Centers in Saudi Arabia.

Dietary supplements are believed to enhance athletic performance and/or prevent/reverse pathological states. Despite the increasing use of dietary supplements in Saudi Arabia, systematic studies in this field are lacking. This study aims to assess the relation between demographic and social characteristics and dietary supplement use among adult males in Saudi Arabia. Demographic and dietary supplements data from fitness club participants were collected through a questionnaire, and the Pearson chi-square test was used to determine associations. A total of 448 apparently healthy adult males above 20 years of age, who were registered at fitness centers located in Saudi Arabia, participated in the study. The majority (275 [62%]) of the study participants were younger (20-30 years), of normal weight (189 [43%]), without health problems (332 [79%]), and obtained an undergraduate degree or higher (336 [77%]). The majority (58%) took supplements under the supervision of a professional and the rest depended on Internet (22%), friends (12%), or books (4%) for choosing supplement types. The main motives of the participants for visiting the fitness center were: weight loss (N = 149 [35%]), keeping fit (N = 101 [24%]), and muscle building (N = 151 [35%]). One hundred and fifty-five participants (44%) were taking supplements on a daily basis with 34 (10%) having taken it for a prolonged duration (>1 year). The most commonly used supplements were proteins (29%) and multivitamins (21%). Supplement use was not associated with the participants' family income or level of education but was positively associated with younger age (<31 years), χ2(2, N = 443) = 4.96, p = .03.

Identifying and assessing views among physically-active adult gym members in Israel on dietary supplements.

BACKGROUND: Sports dietary supplements are available for sale in public places including sports clubs. Although there is uncertainty regarding their safety, many gym members who regularly work out consume them. The present study aimed to identify the approaches and perspectives of the public who work out in gyms and take dietary supplements. It examined how professionals view sports dietary supplement consumption, and how they communicate this issue to gym members. The literature discusses the prevalence of SDS use among athletes, but rarely discusses or compares between the risk perceptions of gym members, trainers, and dietitians, who represent the physically-active general public, regarding SDS. METHODS: We conducted constructivist qualitative research in semi-structured one-on-one interviews (n = 34). We held in-depth interviews (n = 20) with a heterogeneous population of adult gym members who take dietary supplements, and (n = 14) with dietitians and fitness trainers. RESULTS: The main finding was a gap in risk perception of dietary supplement use between dietitians, gym members and fitness trainers. There was low risk perception among dietary supplements consumers. Trainers believed that benefits of supplement consumption exceeded risk, and therefore they did not convey a message to their clients about risk. In contrast, dietitians interviewed for this study renounced general use of sports dietary supplements and doubted whether trainers had proper nutritional knowledge to support it. CONCLUSION: Lack of awareness of risks suggests that there is a need for communication on this issue. We recommend that professionals (physicians and dietitians) be present in sports clubs that sell such products in an uncontrolled way.