RESUMEN
Physical activity has numerous health benefits, enhancing overall wellbeing. However, it can also lead to injuries, impeding exercise capacity and hindering work. Limited knowledge exists about the prevalence of overuse gym injuries and whether they vary across different gym activities. This study aims to estimate sport injuries at fitness centers in Saudi Arabia, comparing injuries between various activities and session durations. This is a cross-sectional, questionnaire-based study surveyed regular gym-goers in Saudi Arabia with overuse injuries. The online survey, distributed through social media apps, collected data using a validated Google form questionnaire. Questioanire consists of 3 parts. First part of the questionnaire included demographic characteristics of participants. Second part contains characteristics related to gym as gym session's duration, frequency of attending gym per week, sport types, type of injuries and site of injuries. Third part contains Oslo Sports Trauma Research Centre (OSTRC) Overuse injury questionnaire that included 4 questions about difficulties in participation, reduction of training, affection of performance and symptoms. Study included 1012 participants, majority male (76.2%), with age range of 18 to 50 years, and significant proportion falling between 26 and 30 years (52.6%). Majority of participants were from Central Province (42.9%). Gym sessions typically lasted 1 to 2 hours (68.3%), and most common attendance frequency was 4 days/week (39.6%). Common injury sites were shoulder (25.2%), knee (20.2%), and lower back (17.7%). Bodybuilding (50.6%), running (45.8%), and weightlifting/powerlifting (45.1%) were predominant sports. Strain/muscle rupture/tear (35.70%) and muscle cramps/spasm (19.3%) were commonest injury types. Longer gym sessions (>2 hours) were associated with higher prevalence of strain/muscle rupture/tear, dislocation, and subluxation (Pâ <â .001). Shorter sessions (<1 hour) had higher prevalence of muscle cramps/spasm and contusion/hematoma/bruise (Pâ <â .001). Gym sessions lasting 1 to 2 hours had high prevalence in tendinosis/tendinopathy. Strain/muscle rupture/tear was significantly higher in bodybuilding, weightlifting/powerlifting, swimming, cycling, and running. Tendinosis/tendinopathy was higher in crossfit. (OSTRC) Overuse injury questionnaire revealed decreased participation, training volume, performance, and increased pain with longer gym sessions. In conclusion, gym-related injuries are common, with bodybuilding and running being prevalent activities. Preventative measures should be taken, and individuals are advised to undergo a physical and medical examination before engaging in physical activity at fitness centers.
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Traumatismos en Atletas , Trastornos de Traumas Acumulados , Humanos , Estudios Transversales , Arabia Saudita/epidemiología , Adulto , Trastornos de Traumas Acumulados/epidemiología , Masculino , Prevalencia , Femenino , Persona de Mediana Edad , Adulto Joven , Adolescente , Traumatismos en Atletas/epidemiología , Encuestas y Cuestionarios , Centros de Acondicionamiento/estadística & datos numéricos , Ejercicio FísicoRESUMEN
This cohort study investigates mortality and cause of death among a large cohort of androgenic anabolic steroid users, compared with a control group, in Denmark from January 3, 2006, to March 1, 2018.
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Anabolizantes , Esteroides Anabólicos Androgénicos , Causas de Muerte , Trastornos Relacionados con Sustancias , Adulto , Humanos , Masculino , Adulto Joven , Anabolizantes/efectos adversos , Esteroides Anabólicos Androgénicos/efectos adversos , Andrógenos/efectos adversos , Dinamarca/epidemiología , Estudios de Seguimiento , Mortalidad , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/mortalidad , Centros de Acondicionamiento/estadística & datos numéricos , Política de Salud , Sistema de Registros/estadística & datos numéricosRESUMEN
The Mediterranean diet (MD) is based on the traditional cuisine of south European countries, and it is considered one of the healthiest dietary patterns worldwide. The promotion of combined MD and physical activity has shown major benefits. However, the association between physical activity and the MD in regular fitness center users is still insufficiently investigated. This cross-sectional survey-based study was conducted on 1220 fitness center users in Croatia. The survey consisted of three parts: general information, the Mediterranean Diet Serving Score (MDSS) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). The results showed that 18.6% of fitness center users were adherent to the MD, and there was a significant positive correlation between the level of physical activity and the MDSS score (r = 0.302, p < 0.001). Moreover, after dividing the sample into tertiles based on the IPAQ-SF score, the third tertile (MET > 3150 min/wk) had the most fitness center users (34.4%) adherent to the MD, while the first tertile (MET < 1750 min/wk) had the least (6.1%). These outcomes emphasize the importance of physical activity as they imply that, with higher levels of physical activity, people are also possibly more aware of the importance that a healthy and balanced diet has on their well-being.
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Dieta Mediterránea/estadística & datos numéricos , Ejercicio Físico/estadística & datos numéricos , Centros de Acondicionamiento/estadística & datos numéricos , Adolescente , Adulto , Anciano , Croacia , Estudios Transversales , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Substantial cross-sectional evidence and limited longitudinal research indicates that the availability of recreational facilities (e.g., parks, fitness centres) is associated with physical activity participation. However, few intervention trials have investigated how recreational infrastructure can be used to reduce inactivity levels in communities. The MOVE Frankston study aimed to assess the impact of low intensity strategies to promote use of a multi-purpose leisure and aquatic centre in a socioeconomically diverse, metropolitan community. This randomised controlled trial of two years' duration compared public awareness raising (control condition) with two interventions: mailed information about the centre and a free entry pass (I-O); and this minimal intervention supplemented by customer relations management support through telephone contact, mailed promotional materials and additional incentives (I+S). Participants (n = 1320) were inactive adults living in the City of Frankston, Melbourne Australia. There were 928 people (70.3%) followed up at 12 months (61.2% female, 52% ≥55 yrs). Compared with controls, attendance at the Centre once or more was higher in both the I-O (OR 1.79, 95% CI 1.28-2.50) and I+S groups (OR 1.46, 95% CI 1.03-2.07). The proportion of people using the centre weekly did not differ by group. The odds of being in contemplation or preparation to use the Centre were higher in both the I-O (OR 1.76, 95% CI 1.28-2.42) and I+S groups (OR 1.48, 95% CI 1.07-2.06). Total physical activity and related social and cognitive factors did not differ between the groups. The findings show that the low intensity promotional strategies prompted occasional attendance and increased readiness to use this recreational facility, a level of behaviour change unlikely to reduce non-communicable disease risk. It is recommended that more frequent customer relations contact, and involvement of healthcare providers, be tested as strategies to encourage inactive adults to take up physical activity opportunities at recreational facilities of this type.
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Ejercicio Físico , Centros de Acondicionamiento/estadística & datos numéricos , Promoción de la Salud/métodos , Adulto , Australia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Población Urbana/estadística & datos numéricosRESUMEN
No prospective studies have investigated if repeated testing of physical performance and body composition are associated with exercise attendance or patterns in fitness club members. This study aimed to investigate if repeated physical testing was associated with exercise attendance and patterns in gym members and to report prospective data on use of the fitness club`s facilities and products. Untrained new members were recruited and divided into a test group (n = 125) and as controls (n = 125). All participants answered a survey including exercise involvement, at onset, and after 3, 6, and 12 months follow-up. The test group also measured body composition, maximal oxygen uptake, and maximal muscle strength (onset, and after 3 and 12 months). In total 73.6% answered all surveys, and in the test group, 44.8% completed all physical tests. Regular exercise attendance was defined as ≥2 sessions/week. Repeated testing showed no association with long-term regular exercise attendance (test group: 19.6%, controls: 19.8%; p = 0.638). At 3 months, a lower proportion in the test group reported engagement in resistance exercise (35.3% and 60.2%; p = 0.003) and had lower exercise frequency (2.0 and 2.6 days/week; p = 0.008) than controls. The test group had higher participation in group exercise classes (28.0% and 13.6%; p = 0.040). Exercise frequency decreased from onset to 12 months (from 2.6 to 2.2 days/week; p = 0.025) At 3, 6, and 12 months, 51.8%, 37.6%, and 37.4% reported regular exercise attendance, and 16.9% at all follow-ups. At all time-points, most common workout mode was individual resistance exercise (43.8% to 46.3%). Few attended group exercise classes (7.5% to 13.8%) or used a personal trainer (22.5% to 27.5%). Repeated physical testing did not improve exercise attendance, and we found no changes in members` use of the fitness club`s facilities and products. Only 16.9% reported regular exercise attendance throughout the first year of membership.
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Composición Corporal , Ejercicio Físico , Centros de Acondicionamiento/estadística & datos numéricos , Rendimiento Físico Funcional , Adulto , Anciano , Análisis de Varianza , Índice de Masa Corporal , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular , Consumo de Oxígeno , Estudios Prospectivos , Entrenamiento de Fuerza/estadística & datos numéricos , Factores de Tiempo , Adulto JovenRESUMEN
ObjectivesãApproximately 40% of new fitness club (FC) members drop out within the first six months; however, the factors associated with FC membership resignation are largely unknown. This study aimed to identify the association between psychological attitudes toward exercise and FC membership resignation.MethodsãWe conducted a cohort study enrolling participants from 17 FCs. All individuals who became members at FCs between April 1st, 2015 and March 31st, 2016 (n=5,421) were invited to participate in the study, and those who agreed to participate completed a self-administered baseline questionnaire (n=2,934). We excluded participants aged <20 years (n=167) and those with missing values (n=702). Psychological factors were evaluated using the short version of the perceived benefit and barriers to exercise scale. Participants were followed until September 30th, 2016, at which time we assessed the FC membership drop-out rate. Cox proportional-hazards models were used to evaluate the association between perceived benefits/barriers of exercise and FC membership resignation. Sub-analyses were then conducted, stratifying by gender and age group.ResultsãA total of 2,065 participants were included in the analyses. The mean (standard deviation) age was 39.0 (15.0) years and 28.8% were male. Over 10.1 (4.4) months of newly-joined member follow-up, the FC membership drop-out rate was 24.6 instances per 1000 person-months. Multivariable analyses revealed no significant factors associated with FC membership drop-out. However, men aged 40-59 years who had a high physical benefit score and who perceived improving physical fitness as a benefit, were less likely to resign their memberships (hazard ratio [HR], 95% confidence interval [CI], 0.72 [0.52-1.00]). However, women aged <40 years with a high discomfort score and who saw discomfort as a barrier were more likely to resign membership (HR, 1.10 [1.01-1.19]). Women aged 40-59 years with high social benefit scores and who perceived social interaction as a benefit were less likely to resign their memberships, as were women with higher lack of motivation to exercise scores and who perceived lack of motivation as a barrier to exercise (HR for social benefit, 0.84 [0.74-0.97]; HR for lack of motivation, 0.85 [0.73-0.99]). Among both male and female participants aged ≥60 years, higher self-improvement scores, indicating that peer recognition was perceived as a benefit of exercise, was associated with higher HR for drop-out (men, 2.52 [1.10-5.81]; women, 1.31 [1.00-1.72]).ConclusionsãThe results revealed gender and age differences in the association between the perceived benefits/barriers of exercise and FC membership dropout. Implementing programs based on enrollees' characteristics and psychological factors may contribute to preventing FC dropout in the future.
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Actitud Frente a la Salud , Ejercicio Físico/psicología , Centros de Acondicionamiento/estadística & datos numéricos , Conductas Relacionadas con la Salud , Motivación , Aptitud Física/psicología , Adulto , Factores de Edad , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores Sexuales , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
OBJECTIVE: To examine the prevalence, and the demographic, socio-economic, and health correlates to Outdoor Gyms (OGs) use for adults from a southern Brazilian city. STUDY DESIGN: Population-based cross-sectional study. METHODS: A total of 431 adults (66.8% women) aged 18-87 years living in the surroundings of four OGs distributed in different regions of the city were randomly selected. Information about OG use for physical activity (PA) practice, and demographic, socio-economic, and health variables were collected by household interviews. Associations between independent variables and OG use were analyzed with results expressed as odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: About one-third of participants (30.4%; 95% CI: 26.1-34.7) informed using OGs for PA practice, and 20.4% (95% CI 16.8-24.4) informed using it twice or more times a week (≥2x/week). Adjusted analysis indicated that the OG use ≥2x/week is higher for women (OR: 1.93; 95% CI: 1.11-3.35) and for those with lower family income (OR: 2.13; 95% CI: 1.03-4.13) than men and those with higher family income, respectively. CONCLUSION: About 30% of the population uses OGs for PA practice. Women and low-income people are those who more commonly use OGs for PA practice. The installation of these facilities in public spaces may reduce social inequities related to leisure-time PA.
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Ejercicio Físico , Centros de Acondicionamiento/estadística & datos numéricos , Pobreza , Características de la Residencia , Equipo Deportivo/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Ciudades , Estudios Transversales , Planificación Ambiental , Composición Familiar , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Actividad Motora , Vigilancia de la Población , Prevalencia , Factores Socioeconómicos , Adulto JovenRESUMEN
In line with the Sustainable Development Goals (SDGs) and the target for achieving Universal Health Coverage (UHC), state level initiatives to promote health with "no-one left behind" are underway in India. In Kerala, reforms under the flagship Aardram mission include upgradation of Primary Health Centres (PHCs) to Family Health Centres (FHCs, similar to the national model of health and wellness centres (HWCs)), with the proactive provision of a package of primary care services for the population in an administrative area. We report on a component of Aardram's monitoring and evaluation framework for primary health care, where tracer input, output, and outcome indicators were selected using a modified Delphi process and field tested. A conceptual framework and indicator inventory were developed drawing upon literature review and stakeholder consultations, followed by mapping of manual registers currently used in PHCs to identify sources of data and processes of monitoring. The indicator inventory was reduced to a list using a modified Delphi method, followed by facility-level field testing across three districts. The modified Delphi comprised 25 participants in two rounds, who brought the list down to 23 approved and 12 recommended indicators. Three types of challenges in monitoring indicators were identified: appropriateness of indicators relative to local use, lack of clarity or procedural differences among those doing the reporting, and validity of data. Further field-testing of indicators, as well as the revision or removal of some may be required to support ongoing health systems reform, learning, monitoring and evaluation.
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Reforma de la Atención de Salud/organización & administración , Atención Primaria de Salud/organización & administración , Indicadores de Calidad de la Atención de Salud , Desarrollo Sostenible , Cobertura Universal del Seguro de Salud/organización & administración , Instituciones de Atención Ambulatoria/organización & administración , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Centros de Acondicionamiento/organización & administración , Centros de Acondicionamiento/estadística & datos numéricos , Reforma de la Atención de Salud/estadística & datos numéricos , Implementación de Plan de Salud/organización & administración , Implementación de Plan de Salud/estadística & datos numéricos , Promoción de la Salud/organización & administración , Promoción de la Salud/estadística & datos numéricos , Humanos , India , Atención Primaria de Salud/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Cobertura Universal del Seguro de Salud/estadística & datos numéricosRESUMEN
Many athletic governing bodies are adopting on-site measurement of the wet-bulb globe temperature (WBGT) as part of their heat safety policies. It is well known, however, that microclimatic conditions can vary over different surface types and a question is whether more than one WBGT sensor is needed to accurately capture local environmental conditions. Our study collected matched WBGT data over three commonly used athletic surfaces (grass, artificial turf, and hardcourt tennis) across an athletic complex on the campus of the University of Georgia in Athens, GA. Data were collected every 10 min from 9:00 a.m. to 6:00 p.m. over a four-day period during July 2019. Results indicate that there is no difference in WBGT among the three surfaces, even when considered over morning, midday, and afternoon practice periods. We did observe microclimatic differences in dry-bulb temperature and dewpoint temperature among the sites. Greater dry-bulb and lower dewpoint temperatures occurred over the tennis and artificial turf surfaces compared with the grass field because of reduced evapotranspiration and increase convective transfers of sensible heat over these surfaces. The lack of difference in WBGT among the surfaces is attributed to the counterbalancing influences of the different components that comprise the index. We conclude that, in a humid, subtropical climate over well-watered grass, there is no difference in WBGT among the three athletic surfaces and that, under these circumstances, a single monitoring site can provide representative WBGTs for nearby athletic surfaces.
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Centros de Acondicionamiento/clasificación , Pisos y Cubiertas de Piso/clasificación , Termografía/instrumentación , Pesos y Medidas/instrumentación , Centros de Acondicionamiento/estadística & datos numéricos , Georgia , Humanos , Termografía/métodosRESUMEN
ObjectivesãComprehensive community sports clubs (CCSCs), of which more than 3,500 exist in Japan, have the potential to contribute to healthy aging in older adults, but their effect on this population has not, thus far, been well explored. This study aimed to investigate the current environment affecting seniors at Japanese CCSCs and to examine issues identified by the analysis.MethodsãData were collected from the FY 2016 Survey Results on Comprehensive Community Sports Clubs, conducted by the Japan Sports Agency. A total of 2,444 clubs were divided equally into four groups after calculating the proportion of senior members (ages 60 and over) per total number of members in each club. The groups were then ranked from lowest to highest according to proportion of senior members: Groups A, B, C and D. Additionally, the 2,444 clubs were classified into six regions according to location. Group designation (A to D) and regional classification were used as independent variables. The dependent variables were categorized as follows: basic information (e.g. total number of members), crisis management and accident prevention measures (13 specific items in total), and each club's compliance with legal obligations.ResultsãStudy results revealed that Group D, containing the highest proportion of senior members, had fewer total members, lower monthly membership fees, lower annual club income, less annual club budget apportioned to each member, and fewer instructors than other groups. Regarding crisis management and accident prevention measures, Group D had lower completion rates on 6 items (health certificate submissions, liability insurance enrollment, safety workshop implementation, heatstroke prevention, liaison with healthcare professionals, and AED availability). Group D also showed a lower rate of compliance with legal obligations than other groups. In comparisons between the six regions, the median proportion of senior members was found to be highest in Chugoku-Shikoku and lowest in Chubu, although each median ranged from only 20% to 30%. Regarding crisis management and accident prevention measures, clubs in Kanto region had the highest completion rates for 10 items, whereas clubs in Kinki region had the lowest completion rates for 8 items.ConclusionãThe CCSCs with higher proportions of senior members had smaller budgets, fewer members and staff, and delayed implementation of crisis management and accident prevention measures. Regional disparities were also observed both in club scale and management of medical and safety issues. Although our study identified several shortcomings in this area, medical and safety management implementation is an important consideration for CCSCs with high proportions of senior members, as these members are at higher risk for disease and frailty. Affected CCSCs and relevant authorities should therefore acknowledge and address this issue cooperatively.
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Centros de Acondicionamiento/estadística & datos numéricos , Prevención de Accidentes , Factores de Edad , Anciano , Interpretación Estadística de Datos , Femenino , Centros de Acondicionamiento/economía , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Riesgo , Administración de la Seguridad , Deportes , Encuestas y CuestionariosRESUMEN
BACKGROUND: Indoor tanning (IT) in fitness facilities encourages a misleading positive relationship between tanning and health. While IT in Canadian fitness facilities has been studied, American literature regarding this topic is lacking. OBJECTIVES: The objective of this study is to evaluate availability, cost, reported risks, and adherence to legislation of IT in American fitness clubs. METHODS: This was a cross-sectional study utilizing a telephone questionnaire to survey gyms across all 50 states. The key term "fitness club" was searched in the Yellow Pages and 20 facilities from each state were randomly included into the study. Data were described descriptively and Pearson χ2 tests were used to compare IT prevalence and rates of noncompliance between population groups. Regression analysis examined potential relationship between cost and prevalence of IT. RESULTS: Of the 1000 fitness clubs surveyed, 44.4% (444/1000) offered IT. The overall noncompliance rates for age, rest time, and eye protection were 13.8% (54/390), 26.0% (20/77), and 27.8% (85/225), respectively. The most common risk reported was skin cancer (61.6%), but many facilities were unsure of risks (27.0%) and some described no risk associated with IT (3.2%). The average cost for monthly unlimited tanning was 33 ± 13.96 USD. A state-to-state comparison showed a statistically significant inverse relationship between mean cost and prevalence of IT (P = .013, [r]= -0.35). CONCLUSION: The prevalence and noncompliance rates of IT in fitness clubs contradict the healthy lifestyles they are working to promote. To limit harms, legislations should be standardized and more strictly enforced. Additionally, public education on IT risks and the use of higher costs may help minimize IT use.
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Centros de Acondicionamiento/estadística & datos numéricos , Neoplasias Cutáneas/epidemiología , Baño de Sol/legislación & jurisprudencia , Baño de Sol/estadística & datos numéricos , Rayos Ultravioleta/efectos adversos , Adolescente , Estudios Transversales , Centros de Acondicionamiento/economía , Centros de Acondicionamiento/legislación & jurisprudencia , Conocimientos, Actitudes y Práctica en Salud , Humanos , Baño de Sol/economía , Encuestas y Cuestionarios , Estados UnidosRESUMEN
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.
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Terapia por Ejercicio/estadística & datos numéricos , Centros de Acondicionamiento/estadística & datos numéricos , Dolor de la Región Lumbar/terapia , Dimensión del Dolor/métodos , Anciano , Análisis Costo-Beneficio , Evaluación de la Discapacidad , Terapia por Ejercicio/métodos , Estudios de Seguimiento , Humanos , Dolor de la Región Lumbar/psicología , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Ausencia por Enfermedad/economía , Ausencia por Enfermedad/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Factores de Tiempo , Resultado del TratamientoRESUMEN
It is well-documented that fitness trainers could play an important role in the nutrition-related behaviour of their clients based on their personalised nutrition-related counselling activities, but there are considerable concerns all over the world about the level of their knowledge to become nutritional coaches. In the framework of the current study based on qualitative (focus-group interviews) and quantitative (questionnaire and analysis of responses by multivariable methods, as well as structural equation modelling) methods, it has been proven that (1) theoretically, both the trainers and the dietitians acknowledge the importance of cooperation in the optimisation of coaching efficiency and advisory work due to some "professional jealousness" and differences in professional background, as well as in culture, so it is hard to find a common platform for cooperation, especially in market segments characterised by relative low levels of purchasing power; (2) due to lack of regulation, there is a high heterogeneity of professional competences of trainers in general and their nutritional competences, in particular; (3) the majority of trainers do not have an objective picture on his/her effective nutritional knowledge, and they often offer a much wider scope of services (e.g., nutritional counselling for clients with chronic diseases) which are well beyond their professional knowledge and (4) the dietary guidelines have not become an integral part of professional knowledge, even at the level of specialists. To improve the current-in some cases, dangerous-situation, the following steps should be taken: (1) enhancement of the level of professional qualification of future trainers, integrating the practice-oriented approaches and emphasising the role of teamwork by simulation-based practices; (2) highlighting in a clear way the professional and ethical boundaries of the activities of trainers and (3) working out an efficient incentive system for the continuous professional development of trainers.
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Conducta Alimentaria/fisiología , Conocimientos, Actitudes y Práctica en Salud , Tutoría/estadística & datos numéricos , Educación y Entrenamiento Físico/estadística & datos numéricos , Competencia Profesional/estadística & datos numéricos , Adulto , Consejo/estadística & datos numéricos , Ejercicio Físico , Femenino , Centros de Acondicionamiento/estadística & datos numéricos , Grupos Focales , Humanos , Hungría , Masculino , Persona de Mediana Edad , Aptitud Física/fisiología , Investigación Cualitativa , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: To evaluate the prevalence and severity of urinary incontinence (UI) in women who participate in CrossFit classes compared with women who participate in non-CrossFit group fitness classes. METHODS: The authors conducted a cross-sectional study of women who participate in either CrossFit or non-CrossFit group fitness classes using an online survey. Participants provided demographic information and completed the Incontinence Severity Index and Urinary Distress Inventory. Participants were recruited from local CrossFit and non-CrossFit gyms, online via social media, and an electronic CrossFit Newsletter. Associated comorbidities, exercises associated with UI, and coping mechanisms for urinary leakage were also assessed. RESULTS: Four hundred twenty-three women meeting inclusion criteria completed the survey, including 322 CrossFit participants and 101 non-CrossFit participants. We found that CrossFit participants were older than non-CrossFit participants and more likely to self-identify as non-Hispanic white. CrossFit participants more commonly reported UI (84% vs 48%, P = <0.001), higher severity of UI (Urinary Distress Inventory score: 20.8 vs 12.5, P < 0.001), and specifically more stress UI (73% vs 47%, P < 0.001). Weightlifting and jumping movements were the most common exercises associated with UI in CrossFit participants. Age and participation in CrossFit are significant and independent predictors of UI. CONCLUSIONS: More than 80% of CrossFit participants reported UI and half of these reported moderate-severe UI, as compared with women who participate in non-CrossFit classes, less than half of whom reported UI with a small minority reporting moderate-severe UI. Exercises most associated with UI were jumping and weightlifting.
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Entrenamiento de Intervalos de Alta Intensidad , Calidad de Vida , Incontinencia Urinaria de Esfuerzo , Adaptación Psicológica , Adulto , Factores de Edad , Comorbilidad , Estudios Transversales , Femenino , Centros de Acondicionamiento/estadística & datos numéricos , Entrenamiento de Intervalos de Alta Intensidad/efectos adversos , Entrenamiento de Intervalos de Alta Intensidad/métodos , Humanos , Aptitud Física/fisiología , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Incontinencia Urinaria de Esfuerzo/diagnóstico , Incontinencia Urinaria de Esfuerzo/epidemiología , Incontinencia Urinaria de Esfuerzo/etiología , Incontinencia Urinaria de Esfuerzo/psicologíaRESUMEN
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.
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Monitoreo Epidemiológico , Centros de Acondicionamiento/estadística & datos numéricos , Conductas Relacionadas con la Salud , Higiene , Evaluación de Procesos, Atención de Salud/estadística & datos numéricos , Salud Pública/estadística & datos numéricos , Femenino , Grupos Focales , Humanos , RwandaRESUMEN
ABSTRACT This paper analyses the main results of Timemania as a sports public policy based on the efficiency, efficacy and social effectiveness principles. A descriptive-analytical research with qualitative approach was conducted through the analysis of contents from laws and official reports. Results suggest that the Timemania lottery was neither efficacious nor efficient, as it did not achieve the initial goals as to its revenues and debt payment for clubs. Timemania was not effective and did not significantly impact sports development. Finally, it is possible to conclude that Timemania, as a regulatory policy, fulfills the sole role of ensuring financial injection for major Brazilian football clubs.
RESUMO O artigo analisa os principais resultados da Timemania como política pública de esporte a partir dos princípios da eficiência, eficácia e efetividade social. Realizou-se uma pesquisa descritivo-analítica, com abordagem qualitativa, a partir da análise de conteúdos de leis e relatórios oficiais. Os resultados indicam que a Timemania não foi eficaz e eficiente, por não atender os objetivos iniciais de arrecadação e pagamento das dívidas dos clubes. A Timemania não foi efetiva e não impactou de forma significativa no desenvolvimento do esporte. Por fim, conclui-se que a Timemania, como uma política regulatória, cumpre o papel apenas de garantir um aporte financeiro para os clubes de futebol de maior destaque no Brasil.
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Política Pública/legislación & jurisprudencia , Deportes/legislación & jurisprudencia , Fútbol/legislación & jurisprudencia , Cambio Social , Financiación del Capital/legislación & jurisprudencia , Eficacia , Legislación , Centros de Acondicionamiento/estadística & datos numéricos , EficienciaRESUMEN
BACKGROUND: Few anabolic-androgenic steroid (AAS) users disclose their performance enhancing drug (PED) use with their healthcare providers. AAS users practice polypharmacy with prescription medications to counter adverse effects of AAS, to further their muscular gains, or to lose weight. OBJECTIVES: To compare and contrast AAS using and non-AAS using gym clients regarding PED use, in particular prescription drugs. METHODS: The CASTRO (Castro Anabolic Steroid Research Observation) study was a 108-item cross-sectional survey that took place at four gyms in San Francisco, California between August 2015 and January 2016. 40 AAS users and 179 non-AAS users completed the survey. RESULTS: The prevalence of AAS use in the study cohort was 18.3%. AAS users reported using a greater number of total PEDs (8.7⯱â¯4.2 vs. 3.7⯱â¯2.1, pâ¯<â¯0.001) than non-AAS users. AAS users were more likely to misuse the following prescription drugs: antiestrogens (tamoxifen, anastrazole), fertility agents (clomiphene, human chorionic gonadotropin), erectile dysfunction drugs (tadalafil, sildenafil), anabolic drugs (clenbuterol, recombinant human growth hormone), and weight loss drugs (liothyronine). CONCLUSIONS: AAS users practice polypharmacy and misuse multiple prescription drugs. These findings allow researchers and clinicians to be more knowledgeable and to anticipate potential misuse of prescription medications that traditionally are not thought to be abused.
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Anabolizantes/administración & dosificación , Centros de Acondicionamiento/estadística & datos numéricos , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Congéneres de la Testosterona/administración & dosificación , Adulto , Humanos , Masculino , Persona de Mediana Edad , San Francisco , Encuestas y CuestionariosRESUMEN
In common with other countries in the World Health Organization South-East Asia Region, disease patterns in India have rapidly transitioned towards an increased burden of noncommunicable diseases. This epidemiological transition has been a major driver impelling a radical rethink of the structure of health care, especially with respect to the role, quality and capacity of primary health care. In addition to the Pradhan Mantri Jan Arogya Yojana insurance scheme, covering 40% of the poorest and most vulnerable individuals in the country for secondary and tertiary care, Ayushman Bharat is based on an ambitious programme of transforming India's 150 000 public peripheral health centres into health and wellness centres (HWCs) delivering universal, free comprehensive primary health care by the end of 2022. This transformation to facilities delivering high-quality, efficient, equitable and comprehensive care will involve paradigm shifts, not least in human resources to include a new cadre of mid-level health providers. The design of HWCs and the delivery of services build on the experiences and lessons learnt from the National Health Mission, India's flagship programme for strengthening health systems. Expanding the scope of these components to address the expanded service delivery package will require reorganization of work processes, including addressing the continuum of care across facility levels; moving from episodic pregnancy and delivery, newborn and immunization services to chronic care services; instituting screening and early treatment programmes; ensuring high-quality clinical services; and using information and communications technology for better reporting, focusing on health promotion and addressing health literacy in communities. Although there are major challenges ahead to meet these ambitious goals, it is important to capitalize on the current high level of political commitment accorded to comprehensive primary health care.
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Atención Integral de Salud/métodos , Centros de Acondicionamiento/tendencias , Cobertura Universal del Seguro de Salud/normas , Atención Integral de Salud/tendencias , Centros de Acondicionamiento/organización & administración , Centros de Acondicionamiento/estadística & datos numéricos , Humanos , India , Atención Primaria de Salud/métodos , Atención Primaria de Salud/normas , Cobertura Universal del Seguro de Salud/estadística & datos numéricosRESUMEN
INTRODUCTION: In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements. METHODS: A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements. RESULTS: Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08). CONCLUSIONS: This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals.