Awareness, attitudes and perceptions of students towards leisure noise in Durban, South Africa.

BACKGROUND:  Young adults are exposed to high noise levels in leisure venues, which increases their risk of hearing loss, and can affect their quality of life. OBJECTIVES:  The aim of this study was to describe the young adults' awareness, attitudes and perceptions towards leisure noise at a university in South Africa. METHOD:  A descriptive cross-sectional study design with quantitative methods of data was considered for this study. Students from first to fourth years in the Education Department of a local university in Durban, South Africa, who were aged 18 years old - 25 years old were invited to participate in an online survey. RESULTS:  Of the 462 participants, most had a general awareness on noise and hearing loss but lacked knowledge on the negative effect of loud noise, with 95.2% using personal listening devices, followed by visiting restaurants and gyms, and 48.3% being unsure if noise can damage hearing permanently. They were unaware of methods to reduce their exposure to noise. A significant relationship between awareness of noise and attitudes (p = 0.029) indicated that the higher the level of awareness regarding leisure noise, the better their attitude and behaviour, thus the lower the risk of hearing loss. CONCLUSION:  The results highlight the need for implementing the World Health Organization (WHO) noise regulations and providing education for this age group to prevent irreversible hearing loss through exposure to leisure noise.Contribution: A national study is recommended to increase research evidence.

Leisure-time physical activity and the incidence of atrial fibrillation in senior adults: a prospective cohort study.

OBJECTIVE: Whether physical activity could reduce the risk of atrial fibrillation (AF) remains unclear. This study was to investigate the relationship of leisure-time physical activity (LTPA) with AF incidence among Chinese older adults. METHODS: A total of 3253 participants aged ≥60 years from the Guangzhou Heart Study were successfully followed between March 2018 and September 2019. LTPA was assessed using a modified Global Physical Activity Questionnaire. AF was ascertained by 12-lead electrocardiograms, 24-hour single-lead Holter and clinical examination. The Cox proportional hazards model was used to the estimate hazard ratio (HR) and 95% confidence interval (CI) after adjustment for confounders, and the population-attributable fraction (PAF) was estimated. RESULTS: A total of 76 (2.34%) new-onset cases of AF were identified during a median of 31.13 months of follow-up. After adjustment for confounders, subjects who had LTPA at least 10.0 metabolic equivalent (MET)-hours/week had a 55% lower risk of developing AF (HR: 0.45, 95%CI: 0.25-0.81), and at least 20 MET-hours/week reduced the risk by 45% (HR: 0.55, 95%CI: 0.34-0.92). At least 11% (PAF: 11%, 95%CI: 0%-20%) or 14% (PAF: 14%, 95%CI: 0%-26%) of AF cases could be avoided, respectively, if the subjects do LTPA at least 10 MET-hours/week or 20 MET-hours/week. A significant exposure-response trend was also observed between LTPA and AF risk (Plinear-trend = 0.002). For a specific LTPA, doing housework was associated with a 43% reduced risk, while engaging in ball games was associated with an increased risk. CONCLUSION: This prospective cohort study indicated that a higher LTPA volume was associated with a lower AF risk in Chinese older adults.

The causality between leisure sedentary behaviors, physical activity and obstructive sleep apnea: a bidirectional Mendelian randomization study.

Background: Previous observational studies have shown a correlation between leisure sedentary behaviors (LSB) and physical activity (PA) with the incidence of obstructive sleep apnea (OSA). However, the causal associations remain unknown. Therefore, our study used bidirectional two-sample Mendelian randomization (MR) to identify potential causal relationships between LSB/PA and OSA. Methods: We sourced genetic variation data for LSB and PA from the UK Biobank, while data on OSA were collected from the FinnGen study. The primary analysis method employed was the inverse variance weighted (IVW) approach, complemented by the weighted median and MR-Egger methods. For sensitivity analyses, we conducted Cochran's Q test, the MR-Egger intercept test, the MR-PRESSO global test, and the leave-one-out analysis. Results: IVW analyses showed that genetically predicted leisure television watching (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.09-1.75, p = 0.007) and computer use (OR = 1.48, 95% CI = 1.15-1.92, p = 0.002) significantly increased the risk of OSA. Conversely, self-reported vigorous physical activity (VPA) (OR = 0.33, 95% CI = 0.11-0.98, p = 0.046) may reduce the risk of OSA. No causal effects on OSA risk were observed for driving or self-reported moderate-to-vigorous physical activity. Furthermore, the reverse MR analysis indicated no significant causal relationship between OSA and any LSB/PA phenotype. Sensitivity tests showed no significant heterogeneity or horizontal pleiotropy. Conclusion: This study suggests that leisurely television watching and computer use are risk factors for OSA, while VPA may be a protective factor. Additionally, OSA does not affect PA or LSB levels. We recommend reducing sedentary activities, particularly television watching and computer use, and prioritizing VPA to reduce the risk of OSA. Further research in diverse populations and settings is needed to validate these findings.

Leisure Activity, Childhood Starvation, and Risk of Incident Diabetes in Older Adults: Evidence From a Chinese Nationwide Cohort Study.

OBJECTIVE: This study explores the impact of leisure activity and the association between childhood starvation and the risk of diabetes in older Chinese adults. DESIGN: Prospective cohort study based on the Chinese Longitudinal Healthy Longevity Study (CLHLS), a nationwide cohort study in China. SETTING AND PARTICIPANTS: A total of 4637 older adults aged ≥65 years, all with documented diabetes history, experiences of childhood starvation, and participation in leisure activities were recruited. METHODS: Childhood starvation exposure was assessed via self-reported responses from a structured questionnaire. The leisure activities were measured by 9 distinctive components and categorized into 3 distinct categories: productive activity, recreational activity, and sedentary activity. Diabetes status was determined by self-reported, physician-diagnosed cases during the follow-up period. Nonparametric survival models were employed for analysis. RESULTS: Over an average follow-up period of 4.3 years, 215 of 4637 participants (4.6%) reported a confirmed diagnosis of diabetes. Nonparametric survival models showed that those reporting childhood starvation had a higher risk of late-life diabetes [hazard ratio (HR) 1.72, 95% CI 1.21-2.44]. Engaging in productive activity (HR 0.90, 95% CI 0.83-0.99) and recreational activity (HR 0.88, 95% CI 0.77-1.00) was linked with a reduced risk of late-life diabetes. Sedentary activity did not show a significant effect. Further analysis highlighted the interactions effects of leisure activities on diabetes risk across different demographic and historical exposure subgroups. CONCLUSIONS AND IMPLICATIONS: Engaging in productive and recreational leisure activities was inversely associated with the risk of diabetes in older adults who experienced childhood starvation. Promoting such activities could be beneficial in mitigating long-term diabetes risk related to early-life nutritional deficiencies.

Are Middle- or Older-Aged Adults With a Spinal Cord Injury Engaging in Leisure-Time Physical Activity? A Systematic Review and Meta-Analysis.

Objectives: To investigate the amount of Leisure-Time Physical Activity (LTPA) that people over 45 years with a spinal cord injury (SCI) performed and to determine the frequency, duration, intensity, and modality of LTPA performed. Data Sources: We searched 5 major electronic databases (CINAHL, SCOPUS, EMBASE, MEDLINE, and PubMed) from inception to March 2023. Study Selection: Cross-sectional, longitudinal studies and control arm of controlled trials that assessed LTPA in participants over 45 years old, with a SCI. We included 19 studies in the review and 11 in the meta-analysis. Data Extraction: We followed the PRISMA checklist for Systematic Reviews. Two review authors independently assessed the risk of bias and extracted data on participants' demographics, injury characteristics, and LTPA participation of the included studies. Risk of bias was assessed using the Joanne Briggs Institute critical appraisal tool for cross-sectional studies. Any conflicts were resolved by a third author. Data Synthesis: We found considerable variability in LTPA participation in adults 45 years and older with SCI. An estimated 27%-64% of participants did not take part in any LTPA. A random effects meta-analysis model was completed for studies that reported total or moderate-to-heavy LTPA scores in minutes per week. Overall, participants (n=1675) engaged in 260 [205;329] (mean [95% CI]) mins/week of total LTPA. Those participating in moderate-heavy intensity LTPA (n=364) completed 173 [118; 255] (mean [95% CI]) mins/week. LTPA modalities included walking, wheeling, hand-cycling, basketball, and swimming, among others. Conclusions: While many older adults with SCI seem to be meeting the recommended weekly physical activity volume, many still remain sedentary. There was significant variation in reporting of frequency, intensity, and duration of LTPA and reporting on modality was limited. Because of differences in reporting, it was challenging to compare results across studies. Data constraints prevented subgroup analysis of LTPA disparities between paraplegia and tetraplegia.

Leisure-Time Physical Activity in Subjects with Metabolic-Dysfunction-Associated Steatotic Liver Disease: An All-Cause Mortality Study.

Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) affects 30% of adults worldwide and is associated with obesity and cardiovascular risk factors. If left untreated, it can progress to severe liver disease. Lifestyle changes such as physical activity and weight loss help to reduce the severity and risk of mortality. This study estimated the impact of MASLD and leisure-time physical activity (LTPA) on mortality and examined how gender mediates this effect in a Southern Italian population. Methods: This work is a population-based prospective cohort study of inhabitants of Castellana Grotte (>30 years old) in Southern Italy, which began in 1985. Participants provided general health information, underwent anthropometric measurements and ultrasonography, and completed a validated questionnaire on their food intake and LTPA. The vital status was tracked through local municipalities Results: In total, 1826 participants (39% with MASLD) were enrolled in this study, drawn from 2970 eligible subjects; the mean age was 51.91 (±14.76) years and 56.2% were men. Subjects with MASLD who practiced low LTPA had a significantly higher risk of death than those who did not have MASLD and practiced high LTPA. In addition, subjects with MASLD who practiced low LTPA were about 19% less likely to survive to the age of 82 years. As regards gender, both men and women with MASLD and low LTPA showed a significant risk of death, but this was higher in women. Conclusions: The presence of MASLD, especially in women, increases the risk of death from all causes. LTPA plays a key role in the disease and reduces mortality in these individuals.

Association between Physical Activity and Phase Angle Obtained via Bioelectrical Impedance Analysis in South Korean Adults Stratified by Sex.

This cross-sectional study aimed to examine the association of various aspects of physical activity, including intensity, duration, type, and purpose, with the phase angle (PhA), an objective indicator of health, in Korean adults after stratification by sex. Data from the 2022 Korean National Health and Nutrition Examination Survey, a nationwide, representative, population-based survey, were used. In total, 3996 participants were included in the study. Participants self-reported their weekly intensity, frequency, duration of engagement in physical activity. PhA was categorized into two groups on the basis of sex-specific averages. Multiple logistic regression analysis was used to investigate the relationship between physical activity and PhA, and proportional odds logistic regression analysis was performed to determine the association between physical activity and different subclasses of PhA. A positive association was found between sufficiently active aerobic physical activity and PhA compared with inactive physical activity (sufficiently active, male: odds ratio = 1.952, 95% confidence interval = 1.373-2.776; female: odds ratio = 1.333, 95% confidence interval = 1.019-1.745). This association was further strengthened when aerobic physical activity was accompanied by muscle-strengthening activity (sufficiently active with muscle-strengthening activity, male: aOR = 2.318, 95% CI = 1.512-3.554; female: aOR = 1.762, 95% CI = 1.215-2.556) and vigorous-intensity activities (sufficiently active with sufficient vigorous-intensity activity, male: aOR = 2.785, 95% CI = 1.647-4.709; female: aOR = 2.505, 95% CI = 1.441-4.356) and when there was more leisure-time physical activity than occupational physical activity (sufficiently active with more leisure-time physical activity, male: aOR = 2.158, 95% CI = 1.483-3.140; female: aOR = 1.457, 95% CI = 1.078-1.969). Furthermore, the inclusion of muscle-strengthening activity made a significant difference in the values of PhA for males with insufficiently active physical activity (aOR = 2.679, 95% CI = 1.560-4.602). For females with highly active physical activity (aOR = 1.521, 95% CI = 1.068-2.166), the inclusion of muscle-strengthening and vigorous-intensity activities were significantly associated with higher values for PhA. This study can be utilized to provide specific suggestions for better health programs and can change perception that only occupational physical activity is enough. This study also indicated that PhA can be used for personalized health assessments.

Motivation and Habits of a Wild Boar-Hunting Community.

The wild boar (Sus scrofa) is a widespread ungulate, the populations of which have recently increased throughout most of its range. This increase has caused negative impacts on ecosystems, biodiversity, and society. Nowadays, the wild boar is considered both a valuable game and a pest. Wildlife managers need to know the habits and motivations of wild boar hunters, a key stakeholder group, for effectively managing this controversial mammal. We carried out face-to-face interviews with 134 wild boar hunters in the Evros Prefecture, in the Region of Eastern Macedonia and Thrace, northern Greece to determine their hunting habits and their motivation for hunting. Most hunters owned a hunting dog (84.3%), hunted in groups of eight to nine people for 48 days, traveled 60 km, stayed outdoors for 4 nights, and spent weekly EUR 61 on average in each hunting season. Two motivations for wild boar hunting were prominent among the hunters (assessed on a 5-point scale; 1 = strongly disagree to 5 = strongly agree): a strong recreation motivation (hunting as a recreational activity; mean score 4.159 ± 1.144 SD) and a considerable utility motivation (hunting for its use values; 3.404 ± 1.11). Both recreation and utility motivations were positively associated with the preference for further increases in wild boar populations. Sociodemographic characteristics and hunting habits variously affected motivations and preferred future population trends. The findings revealed specific habits and strong motivations among hunters. Such findings will be useful for designing and implementing education and outreach programs for informing hunters about the negative impacts of wild boars and the need for their control. The participation of hunters in the management process will be critical for its success.

Tourism influences escape behavior of lizards in relationship with human clothing color.

Increased tourism pressure modifies animal behavior, including alterations in anti-predator responses and foraging activity. In areas with high tourist presence, animals may become accustomed to increased human activity and adjust the intensity of some defensive responses. An animal's anti-predation ability is usually estimated by measuring its Alert Initiation Distance (AID) and Flight Initiation Distance (FID). Both indexes are affected by multiple factors including the color of the observer's clothing. Animal behavior is also influenced by human presence, and individuals may become accustomed to increased human presence, e.g. in tourist areas. In this study, we analysed the escape behavior of the endemic Cyprus rock agama (Laudakia cypriaca) in relation to the observers clothing color. Our results showed that AIDs and FIDs of agamas in tourist areas were significantly shorter than those in non-tourist areas. Moreover, in non-tourist areas, AIDs and FIDs of agamas were significantly longer when the observer wore red clothes, compared to green and grey clothes. Our results may be helpful in planning research taking into account various colored clothing based on expected reptilian reactions. Furthermore, our results may determine the proximity at which humans interact with animals, considering clothing color, to prevent negative impacts especially on rare and protected lizard species.

Exploring the quality of participation and strategies to support meaningful engagement in an adapted paddleboard program among individuals with disabilities.

AIM: Adapted paddleboard provides an outdoor leisure-time physical activities (LTPA) opportunity with many health benefits (e.g., physical activity, reduced stress, social engagement). However, nearly 50% of individuals with disabilities do not participate in any LTPA. Quality of LTPA participation influences sustainable adherence, while optimizing participant experiences. An adapted paddleboard program is offered in Quebec City, for adults with physical disabilities, but little is known about how participants perceive their quality of participation. This study aimed to describe individuals with disabilities' perceived quality of participation in the adapted paddleboard program, and to explore their suggestions of strategies to support meaningful engagement in the program. METHODS: An ethnographic mixed-methods design was conducted, consisting of participant observations during the 13-week program and semi-structured interviews based on the Quality Parasport Participation Framework (QPPF). Measure of Experiential Aspects of Participation (MeEAP) questionnaire were collected. A mixed approach of data analysis was used for qualitative data and descriptive statistics were conducted for quantitative data. RESULTS: Nine participants (8F) with various disabilities (42±15 years old) participated in the study. Emergent dimensions of quality of participation included belongingness and autonomy. Facilitators to participation were identified, such as autonomy support through volunteers and provision of adaptive equipment. Barriers to participation included water access and level of individual challenge. Suggested strategies to improve engagement included water access closer to parking and multiple groups for variable skill levels. CONCLUSIONS: Participants expressed high-quality of participation in adapted paddleboarding. The study allows the development of knowledge about conditions that enhance the experience of participating in outdoor LTPA.

Adapted paddleboard is an increasingly popular activity that can be adapted with material and environmental accommodations for people with disabilities to enable and enhance participation in outdoor leisure-time physical activities (LTPA).Several facilitators, such as the safety of the site or the social support created by the group, enhance quality of experience in leisure-time physical activities (LTPA) including adapted paddleboard; therefore, support sustainable adherence in the practice of physical activities, well-being and social participation.Further opportunities to practice LTPA such as adapted paddleboard in a public space to promote social inclusion are necessary.

The effects of cultural engagement on health and well-being: a systematic review.

Purpose: This paper examines the effectiveness of culture-based activities in improving health-related outcomes among middle-aged and older adults. Based on the biopsychosocial model, this review aims to explore the impact of cultural engagement on health and well-being. Methods: We conducted a systematic literature review based on peer-reviewed articles retrieved from various electronic databases. In total, 11 studies were included in this review. Our study population consisted of healthy adults aged over 40 years. Results: The results provide evidence of positive association between cultural participation and better mental health (e.g., cognitive decline, depression, anxiety), frailty, resilience, well-being and social relations. Conclusion: This review suggests that cultural engagement serves as an effective means for individuals to maintain and enhance their health and well-being. The field is mostly limited by the heterogeneity of the studies and poor conceptualization of cultural activities. Thus, it is recommended that future research consider the effects of different cultural interventions in developing effective strategies for promoting healthy lifestyles and enhancing quality of life in later stages of life.

The role of hypertension in the relationship between leisure screen time, physical activity and migraine: a 2-sample Mendelian randomization study.

BACKGROUND: The relationship between lifestyle and migraine is complex, as it remains uncertain which specific lifestyle factors play the most prominent role in the development of migraine, or which modifiable metabolic traits serve as mediators in establishing causality. METHODS: Independent genetic variants strongly associated with 20 lifestyle factors were selected as instrumental variables from corresponding genome-wide association studies (GWASs). Summary-level data for migraine were obtained from the FinnGen consortium (18,477 cases and 287,837 controls) as a discovery set and the GWAS meta-analysis data (26,052 cases and 487,214 controls) as a replication set. Estimates derived from the two datasets were combined using fixed-effects meta-analysis. Two-step univariable MR (UVMR) and multivariable Mendelian randomization (MVMR) analyses were conducted to evaluate 19 potential mediators of association and determine the proportions of these mediators. RESULTS: The combined effect of inverse variance weighted revealed that a one standard deviation (SD) increase in genetically predicted Leisure screen time (LST) was associated with a 27.7% increase (95% CI: 1.14-1.44) in migraine risk, while Moderate or/and vigorous physical activity (MVPA) was associated with a 26.9% decrease (95% CI: 0.61-0.87) in migraine risk. The results of the mediation analysis indicated that out of the 19 modifiable metabolic risk factors examined, hypertension explains 24.81% of the relationship between LST and the risk of experiencing migraine. Furthermore, hypertension and diastolic blood pressure (DBP) partially weaken the association between MVPA and migraines, mediating 4.86% and 4.66% respectively. CONCLUSION: Our research findings indicated that both LST and MVPA in lifestyle have independent causal effects on migraine. Additionally, we have identified that hypertension and DBP play a mediating role in the causal pathway between these two factors and migraine.

Associations between leisure-time physical activity and the prevalence and incidence of osteoporosis disease: Cross-sectional and prospective findings from the UK biobank.

BACKGROUND: Previous studies underscore the protective role of physical activity (PA) in bone health, yet the relationship between different PA categories and osteoporosis risk remains less explored. Understanding the relationships helps tailor health recommendations and policies to maximize the effects of preventing osteoporosis. METHODS: The cross-sectional study involves 488,403 UK Biobank participants with heel quantitative ultrasound-estimated bone mineral density (eBMD) data. The longitudinal cohort involves 471,394 UK Biobank participants without initial osteoporosis and with follow-up records. PA exposure categories in our study included sedentary behavior (SB), total PA (TPA), and different category-specific PA including household, leisure, and work PA. The cases of osteoporosis were assessed using the International Classification of Diseases, 10th revision (ICD-10). The linear, logistic, and Cox proportional hazard regression models were used in our study. RESULTS: In the cross-sectional study, 15,818 (3.28 %) participants had osteoporosis. TPA levels have a positive correlation with eBMD and a negative correlation with osteoporosis prevalence. Among different categories of PA, higher levels of leisure PA were correlated with increased eBMD and a lower osteoporosis risk (leisure PA: OR: 0.83, 95 % CI: 0.79 to 0.86;). In the longitudinal study, 16,058 (17.6 % male, 82.4 % female) (3.41 %) individuals developed osteoporosis during an average follow-up of 13 years. We observed consistent protective effects of high levels of PA on osteoporosis incidence risk, particularly within the category of leisure PA (TPA: HR: 0.78, 95 % CI: 0.74 to 0.82; leisure PA:HR: 0.83, 95 % CI: 0.80 to 0.87). Such associations are independent of genetic predisposition, with no evidence of gene-PA interactions, and keep steady among individuals using drugs affecting bone-density. Moreover, among different leisure PA items, strenuous sports, other exercises, and walking for pleasure conferred a substantial protective effect against osteoporosis. Additionally, non-elderly individuals and males exhibited lower osteoporosis risk from PA. CONCLUSION: This study highlights activity categories differently associated with the risk of osteoporosis. Adherence to frequent leisure PA may have a protective effect against osteoporosis. Such associations are independent of genetic susceptibility to osteoporosis and keep steady among individuals using drugs affecting bone-density. This highlights that leisure PA could be suggested as a more effective intervention in the primary prevention of osteoporosis.

Perceived built environment as a mediator linking objective built environment and leisure-time physical activity in Chinese cities.

Numerous studies have suggested that the perceived built environment is shaped by the objective built environment and influences human physical activity. However, the empirical examination of this pathway remains scant. Addressing this gap, our study investigates whether the built environment affects leisure-time physical activity through its impact on the perceived built environment, utilizing data collected from 760 residents in Fuzhou, China. Structural Equation Modeling results reveal a modest correlation between objective and perceived built environment elements, with the objective built environment being a stronger predictor of leisure-time physical activity. Notably, perceived recreational facilities significantly mediate the relationship between objective recreational facilities and leisure-time physical activity, accounting for 15% of the variance in physical activity due to objective recreational facilities. This mediation effect is consistent across subpopulations, irrespective of residential self-selection biases. These results highlight the imperative for urban planning and policy to extend beyond mere spatial allocation of amenities to enhancing both the actual and perceived accessibility of these facilities, thus underlining the study's profound implications for public health and urban development strategies.

Leisure-Time Physical Activity Participation in Middle-Aged and Older Adults With a Spinal Cord Injury in Australia.

Objectives: Adults with spinal cord injury (SCI) are often sedentary, increasing their risk of cardiometabolic diseases. Leisure-time Physical Activity (LTPA) is physical activity completed during recreation time for enjoyment. We aimed to quantify LTPA in people ≥45 years with SCI and to explore its relationship with participants' characteristics. Methods: This is a secondary analysis on a subset of the Australian International SCI Survey in participants ≥45 years, at least 12 months post-injury. We described levels of LTPA and used multivariable regressions to estimate the associations between participant characteristics and LTPA. Results: Of 1,281 participants (mean age: 62.7 years, mean time since injury: 18.7 years; 74% males) 44% reported no participation in LTPA. The average LTPA participation was 197 (SD 352) minutes per week (median: 50). Females (ß = -62.3, 95% CI [-112.9, -11.7]), and participants with non-traumatic injuries (ß = -105.2, 95% CI [-165.9, -44.6]) performed less LTPA. Time since injury was not associated with moderate-to-heavy LTPA (LR: Probability > F = 0.785). Conclusion: LTPA promotion in the SCI population ≥45 years focusing on females and non-traumatic injuries is warranted.

Pickleball Participation and the Health and Well-Being of Adults-A Scoping Review.

BACKGROUND: Pickleball has grown tremendously in recent years, yet little evidence exists regarding pickleball-related injuries. This scoping review extends current work on pickleball participation by identifying positive and negative health effects associated with the sport. We summarize how pickleball impacts the health and well-being of adult participants. METHODS: Searches were conducted on MEDLINE, CINAHL, ProQuest Nursing, ERIC, SPORTDiscus, PsycINFO, Scopus, CBCA Complete, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses. Selected studies considered aspects of health and/or well-being of adult pickleball participants. Using the population/concept/context framework, participants were healthy, able-bodied adults 18 years of age or over, who had played pickleball at least once. The positive and negative outcomes of pickleball on participants' health and well-being (concept) within the context of pickleball participation were examined. Full-text articles written in English since 2013 were included. Extracted data were tabulated, and a descriptive summary with thematic analysis was completed. RESULTS: This scoping review comprised 27 articles that met the inclusion criteria. Pickleball is promising as an exercise intervention for all adults, and there is evidence of positive social and psychological effects, and health and fitness benefits to participating in pickleball by older adults. CONCLUSIONS: Although we are still in the early stages of studying pickleball, there have been some documented health benefits of using the sport as a physical exercise intervention for adults. More research is needed on the types, prevalence, and severity of pickleball injuries and the sport's impact on younger players.

'We may need some help; we are just parents who have chosen to engage in football': a qualitative study on amateur coaches' experiences of use of and support for injury prevention training in Sweden.

INTRODUCTION: Achieving sufficient adherence with injury prevention exercise programmes is a challenge. The aim was to explore how amateur football coaches experience the use of and support for injury prevention training using the Knee Control programmes as examples. METHODS: Semistructured interviews with 20 amateur football coaches around experiences of injury prevention training, facilitators and barriers, and perceived support, analysed with qualitative content analysis. Participants coached male and female, junior and senior teams. Experience of having used the Knee Control programmes was an inclusion criteria. RESULTS: Four main categories were developed: Why are we really doing this?, How do we make it work?, What are our drivers and challenges? and What could be improved? Coaches were motivated for injury prevention training but faced challenges such as limited access to football grounds and low player motivation. To make the prevention programme work for them, they integrated it and used exercises in the pauses during football-specific drills, or used as a warm-up. Many conducted prevention routines from an early player age. Coaches believed preventive training use could be further enhanced by education and practical support, and by football associations and clubs working together to reduce injuries. CONCLUSION: Coaches were motivated and creatively worked with the prevention programme to make it fit their team. Even coaches with long-term experience of using prevention programmes wanted support, indicating that present implementation strategies targeting those about to start using prevention programmes should be complemented by continuous support for maintained use. These strategies should preferably target both coaches and players.

Sleep duration and leisure activities are involved in regulating the association of depressive symptoms, muscle strength, physical function and mild cognitive impairment.

Background: In order to lessen the burden of Alzheimer's disease (AD), timely and efficient management and intervention methods for mild cognitive impairment (MCI) are crucial. MCI is seen as a transitional stage between normal aging and dementia. Although sarcopenia is an important risk factor for MCI, it is unclear what factors mediates and regulates the brain-muscle communication. Our objective was to investigate the indirect moderating effects of sleep duration and leisure activity on depressive symptoms, sarcopenia and MCI. Method: Panel data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) database was used in this investigation. we used Bootstrap sampling to determine the relationship between sleep duration, leisure activity, depressive symptoms, sarcopenia, and MCI in mediation and indirect moderation models. The outcome measurements were odds ratio (OR) and confidence interval (CI). Result: After adjusting for confounding variables, we discovered that sarcopenia and its traits, such as handgrip strength, gait speed, standing test, and muscle mass, were significantly correlated with MCI. Second, the results implied that depressive symptoms played a role in modulating the link between physical function, muscle strength, and MCI. This moderating effect was impacted by short sleep duration and moderate to high levels of leisure activities. Conclusion: We discovered that MCI was highly correlated not only with physical function and muscle strength but also with depressed symptoms, which acted as a partially mediating factor in this connection. Handgrip strength, gait speed, and standing test mediated the correction of MCI caused by depression symptoms. Importantly, leisure activities and sleep duration had indirect moderating effects on the above associations, and future management policies should take these factors into account.