The feasibility of using the Körperkoordinationstest fur Kinder (KTK) in a U.S. elementary physical education setting to assess gross motor skills specific to postural balance.

Introduction: For the past ten years, falls have been the leading cause of nonfatal injuries for all age groups less than 15 years old. A significant rise in childhood sedentary behavior in schools and limited opportunities to be outside has led to motor coordination deficits which have contributed to fall injuries. Method: A German assessment tool, the Körperkoordinationstest fur Kinder (KTK), which has been used for decades in Western European countries, allows researchers and physical education teachers to evaluate typical and atypical children's motor coordination competencies related to dynamic postural balance successfully. No research has been published on the use of this assessment tool in the United States. If its use were found to be feasible in this country for identifying motor coordination deficits in typical and atypical children, it would close the gap in determining motor coordination. Therefore, this study sought in Phase 1 to determine the feasibility of using the KTK assessment in U.S. children and Phase 2 sought to determine the adaptability of the scoring protocol from use in other countries to the United States. Results: The Phase 1 results revealed the KTK assessment was feasible to administer in U.S. physical education class by addressing three challenges for U.S. schools: 1) KTK implementation, 2) time to assess each skill, and 3) the equipment availability and cost to implement the test in a physical education setting. In Phase 2, the researchers were able to determine the raw scores and motor quotient scores in this population and then were able to show similar scoring trends between U.S. children and Flemish children from a previous study. Conclusion: This assessment tool was deemed feasible and adaptable which is the first step to use the KTK in U.S. physical education elementary school settings.

Development of the Movement Pattern Observation Tool (MPOT)-An Observational Tool to Measure Limb Movements during Elementary School Recess.

BACKGROUND: The US Center for Disease Control estimates that only 24% of American elementary-aged children participate in the recommended 60 min of daily physical activity. As activity levels decline, elementary schools should consider increasing movement opportunities. Activity-driven school days, where children can move their limbs freely, may increase memory retention performance, behavioral impulse control, as well as bone density, and muscle strength. Unstructured, outdoor play (recess) may provide an opportunity for the brain, bone, and muscle-stimulating limb movements to be utilized. To date, no research has focused on whether the modern child actively uses limb movements during recess, nor to what degree. The purpose of this study was to develop a reliable assessment tool (Movement Pattern Observation Tool, MPOT) to observe and record limb movements (unilateral, bilateral, and contralateral movements) of elementary children during recess, defined in this study as unstructured, outdoor play. METHODS: Three observers used the MPOT to complete thirty-five observations at one elementary school during kindergarten through fifth-grade recess breaks. RESULTS: Interrater reliability approached excellent, being that excellent is above 0.90. The ICC of the master observer and observer 3 value was 0.898 (95% CI 0.757-0.957), and the ICC of the master observer and observer 2 was 0.885 (95% CI 0.599-0.967), p < 0.03. CONCLUSION: Inter-rater reliability was achieved through a three-phase process. This reliable recess observation tool will contribute to the body of research linking recess to physical and cognitive health.

A Pilot Study Examining Body Composition Classification Differences Between Body Mass Index and Bioelectrical Impedance Analysis in Children With High Levels of Physical Activity.

Background: Body mass index (BMI) is frequently labeled as "flawed" in assessing obesity since it cannot differentiate between muscle and fat leading to misclassifications of healthy individuals. Bioelectrical impedance analysis (BIA) may be a more accurate indicator of obesity since it can distinguish the difference between muscle and fat in children. This pilot study investigated discrepancies between BMI and BIA body composition classifications in children with high levels of physical activity. Methods: Participants were selected from three elementary schools (N = 380, K = 76, 1st = 64, 2nd = 62, 3rd = 61, 4th = 83, and 5th = 34) receiving 60 min of outdoor, unstructured play daily. BIA scales were used to collect each child's body fat percentage and BMI score, then those numbers were categorized by BIA and BMI normative values as either underweight, healthy, overweight, or obese. Results: Overall, 26% of the students were classified differently when using the normative classifications for BMI and BIA, with the largest discrepancy found in the overweight category at 38%. Similar inconsistencies were found when students were divided as younger (42%) vs older students (36%), and males (40%) vs. females (35%). Conclusions: This pilot study demonstrated that there is a significant difference in how BMI and BIA discriminate between the different body composition categories. BIA consistently shows to be a more accurate tool in assessing obesity rates in children since it directly measures body fat.

The Preliminary Effects of a Multi-Recess School Intervention: Using Accelerometers to Measure Physical Activity Patterns in Elementary Children.

This pilot study used accelerometers to investigate the effectiveness of a multiple recess school intervention on physical activity patterns in younger elementary children using a post-test only with nonequivalent groups design. First and second grade students (N = 157) participating in a larger study, the LiiNK Project® (Let's inspire innovation 'N Kids), wore accelerometers for the duration of the school day for two weeks to measure physical activity intensity and number of steps taken daily. Students attended either an intervention school (N = 90), participating in four 15-min unstructured, outdoor recesses and one 15-min character development lesson daily, or a control school (N = 67), participating in two 15-min unstructured, outdoor recesses daily and no character development program. The intervention students, grades 1 and 2, took more steps (p < 0.001) and time spent in moderate (p < 0.001) and vigorous (p < 0.001) physical activity (MVPA) than the control school students. Intervention students averaged approximately 900 more steps per day than the control school students. These results show young children given 60 min of recess daily continue to increase physical activity patterns over those with 30 min of recess daily. Next steps are to evaluate if children demonstrate healthier body fat levels as a result of these higher patterns of MVPA daily.

Ethnicity, ethnic identity, self-esteem, and at-risk eating disordered behavior differences of urban adolescent females.

The purpose of this study was two-fold: to determine the relationship between ethnic identity and self-esteem as dimensions of one's self-concept; and to determine if differences exist among one's ethnicity, ethnic identity, and/or self-esteem when examining at-risk eating disordered behaviors. A total of 893 urban adolescent females completed three behavioral subscales: the Eating Disorder Inventory, Rosenberg's Self-Esteem Scale, and Phinney's Multigroup Ethnic Identity Measure. As hypothesized, ethnic identity was significantly associated with self-esteem to form one's self-concept. When compared to Mexican American and White females, only Black females who were in the higher ethnic identity and self-esteem categories had significantly lower at-risk eating disordered scores. Our findings suggest eating disorder status in Mexican American and White females may not be associated as much with ethnic identity as with other acculturation and self-concept factors. Further, this study demonstrated ethnicity, self-esteem, and ethnic identity play significant roles in eating disorder risks.

Adults surviving lung cancer two or more years: A systematic review.

BACKGROUND: Lung cancer has had a low survival rate throughout the years. Some studies have shown that psychological variables such as hardiness and resiliency may play a role in the meaningfulness of survival among lung cancer patients. OBJECTIVE: The objective of this systematic review was to synthesize the best available evidence on the experiences of surviving lung cancer (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) in adults over the age of 18, two or more years after diagnosis. INCLUSION CRITERIA: The review considered adults (18 years and older) who have survived lung cancer two or more years post diagnosis.The review included studies that examined the experiences (including psychological/affective well-being dimensions such as resiliency, optimism, quality of life, and coping strategies) of surviving lung cancer two or more years post diagnosis.The review considered patients' experiences of surviving lung cancer post two years diagnosis, including the examination of specific psychological/affective well-being aspects such as resiliency, optimism, quality of life and coping strategies.The review included quantitative descriptive studies and qualitative studies. SEARCH STRATEGY: A search for published and unpublished studies in English language from January 1999 through December 2010 was undertaken in multiple databases including MEDLINE, CINAHL, ProQuest and Psyc INFO. METHODOLOGICAL QUALITY: Assessment of methodological quality of studies was undertaken using critical appraisal tools from the Joanna Briggs Institute. DATA COLLECTION: Data was extracted using the Joanna Briggs Institute Data Extraction forms. DATA SYNTHESIS: Results were presented in a narrative format as the synthesis of qualitative or quantitative data was not appropriate. RESULTS: 13 studies were included in the review: one mixed methods study (including a qualitative research component) and 12 quantitative studies.The qualitative component of the included mixed methods study identified five findings related to the meaningfulness of surviving lung cancer post two years. The central themes that emerged were existential issues, health and self-care, physical ability, adjustment, and support.Quantitative studies identified that distressed groups had less meaningful experiences related to lung cancer survival than not distressed groups. The studies also found that emotional states and style of coping were related to the meaningfulness of lung cancer survival. CONCLUSIONS: With less emotional distress, seeing the good in everything, adjusting life to fit the changes from lung cancer, and adding physical activity to the daily routine, the life of a lung cancer survivor can be more meaningful. IMPLICATION FOR PRACTICE: Healthcare providers must assess lung cancer survivors for potential symptom clusters affecting key patient outcomes such as quality of life. Consider introducing interventions to promote light to moderate physical activity in older patients and moderate to vigorous physical activity in younger patients, and ceasing smoking. Teach active coping strategies. IMPLICATIONS FOR RESEARCH: There is a need for qualitative research studies exploring the experiences of lung cancer survivors. Further research is recommended on symptom clusters that might impact outcomes such as quality of life.

Weight control beliefs, body shape attitudes, and physical activity among adolescents.

BACKGROUND: Relatively little is known about how perceived weight controllability influences important psychological health factors among adolescents. Thus, the purpose of this study is to explore adolescents' weight controllability beliefs and how those beliefs influence weight-related attitudes and behaviors. METHODS: Adolescents (N = 369, mean age = 13.14, SD = 0.95) enrolled in physical education completed a survey packet, which included demographic questions and items targeting obesity, body shape, and weight controllability beliefs. RESULTS: Participants believed that fat children have weight problems because they consume too many calories, are lazy, have access to junk food, and lack self-control. Those who endorsed high weight controllability beliefs were more likely to indicate that a thin person, as compared to a fat person, would enjoy physical activity and be coordinated, have higher levels of personal weight and body shape satisfaction, and engage in vigorous physical activity more days per week. CONCLUSIONS: Perceived weight controllability may be an important construct to study further, particularly in relationship to health- and weight-related attitudes and behaviors.

Division I athletes' attitudes toward and preferences for male and female strength and conditioning coaches.

The purpose of this study was to examine whether male and female Division I team sport athletes prefer same-sex or opposite-sex strength and conditioning coaches. Participants included 476 (male = 275, female = 201) National Collegiate Athletic Association Division I collegiate football, soccer, and volleyball athletes; the men were from football programs and the women were from soccer and volleyball programs. The Attitudes of Athletes toward Male versus Female Coaches Questionnaire was used to assess the attitudes and feelings of male and female athletes toward the gender of their strength coach (29). The results of a 2 x 2 multivariate analysis of variance (athlete gender x coach gender) revealed that the male athletes (all football players) were less comfortable with a female strength coach in all regards and preferred to have a male strength coach (p < 0.05). Female athletes did not have a gender preference, nor did they have any negative attitudes toward a strength coach. The women would be productive training with any qualified strength coach, whereas the men would prefer working with a male strength coach no matter how qualified the female coach might be. As a result of this study, one suggestion is for male athletes to be exposed to female strength coaches much earlier in their sport experience. This might help reduce gender bias later in their athletic careers.

Weight stereotypes and behavioral intentions toward thin and fat peers among White and Hispanic adolescents.

PURPOSE: This study examined weight stereotypes among White and Hispanic youth. Specific objectives were to: (a) document stereotyped beliefs about fat vs. thin peers; (b) examine the extent to which stereotyped beliefs contribute to behavioral intentions toward fat vs. thin peers; and (c) explore potential differences in weight stereotypes and behavioral intentions in White and Hispanic youth. METHODS: Participants, 157 Hispanic and 117 White middle school students, completed a demographic and background survey, the Fat Stereotypes Questionnaire (FSQ), Adjective Checklist, and Shared Activities Questionnaire (SAQ). RESULTS: Participants endorsed weight-related stereotypes, which were predictive of their social, academic, and recreation behavioral intentions. Participants indicated greater willingness to engage in social (p < .001), academic (p < .05), and recreational (p < .001) activities with thin vs. fat peers. Few differences were found between White and Hispanic adolescents. CONCLUSIONS: The results of this study highlight the ubiquitous nature of stereotyped beliefs about fat youth. Fat youth are considered unhealthy, lazy, and socially inept by their peers. Such stereotypes influence a variety of behavioral intentions and may contribute to discriminatory behaviors and difficult peer relationships. Additional research focused on weight stereotypes and peer relationships is needed.

Eating attitudes, exercise identity, and body alienation in competitive ultramarathoners.

This study examined the relationships among eating attitudes, exercise identity, and body alienation in ultramarathoners. Eighty-seven competitive ultramarathoners (73 males, 14 females) completed the Eating Attitudes Test-26, Exercise Identity Scale, and Body Alienation Scale as part of their pre-race registration. Correlation coefficients revealed that eating attitudes were positively related to exercise identity (R = 0.31) and injury tolerance (R = 0.43), and that exercise identity was positively related to injury tolerance (R = 0.33). MANOVA further indicated that subjects with high exercise identity reported more eating disorder behaviors [F(2, 80) = 7.73, P <0.001] and higher injury tolerance [F(2, 80) = 3.69, P <0.05] than persons with low exercise identity. Female ultramarathoners scoring high on exercise identity were more likely to report aberrant eating behaviors [F(2, 80) = 3.39, P <0.05] and higher training intensity levels [F(2, 80) = 3.91, P <0.02] than were average males and the low- or moderate-exercise identifying females.

Muscle dysmorphia in elite-level power lifters and bodybuilders: a test of differences within a conceptual model.

The purpose of this study was to determine if associated characteristics of muscle dysmorphia (MD) were different between elite-level competitive bodybuilders and power lifters. Elite-level competitive bodybuilders (n = 100) and power lifters (n = 68) completed the muscle dysmorphia inventory (MDI) at the time of or immediately before competition. A 2 x 6 (group x MDI subscales) multivariate analysis of variance indicated that bodybuilders were significantly more likely to report body size-symmetry concerns (F(1, 167) = 10.31, p < 0.001), physique protection (F(1, 167) = 10.27, p < 0.001), dietary behavior (F(1, 167) = 28.38, p < 0.001), and pharmacological use (F(1, 167) = 19.64, p < 0.001) than were power lifters. These results suggest that elite-level bodybuilders are significantly more likely to engage in characteristics associated with MD than are elite-level power lifters.