Concussion response and recovery in men and women's rugby union: A reflexive thematic analysis of player interviews.

Numerous concussion-management protocols have been developed in rugby, though little is known about player's personal experiences of concussion. Specifically, research typically refers to clinical recovery, with social and psychological sequelae post-concussion gaining little attention. This study aimed to explore the experiences of rugby players in relation to being concussed and recovering from concussion. UK-based rugby players (10 men, 9 women and 1 non-binary person) from school, university, club, military and semi-professional teams took part in semi-structured interviews (36 ± 12 minutes). Interviews were transcribed verbatim, and a reflexive thematic analysis was conducted. Players considered pitch-side healthcare a necessity, though amateur players highlighted the difficulty in consistently accessing this resource. In the absence of medical staff, players were reliant on the goodwill of volunteers, but their response to concussion did not always align with current concussion guidance. Players highlighted that concussion recovery could be socially isolating and that current return-to-play programmes did little to restore lost confidence, resulting in retirement from the game in some instances. Participants expressed a desire for more in-person concussion education and for greater coverage of holistic methods to support their recovery. This study highlights a need for further investigation of the post-concussion social and psychological changes that players may experience during their recovery. Greater focus on information relating to concussion recovery and return-to-contact in education programmes would likely benefit player welfare.

Combining diaries and accelerometers to explain change in physical activity during a lifestyle intervention for adults with pre-diabetes: A PREVIEW sub-study.

Self-report and device-based measures of physical activity (PA) both have unique strengths and limitations; combining these measures should provide complementary and comprehensive insights to PA behaviours. Therefore, we aim to 1) identify PA clusters and clusters of change in PA based on self-reported daily activities and 2) assess differences in device-based PA between clusters in a lifestyle intervention, the PREVIEW diabetes prevention study. In total, 232 participants with overweight and prediabetes (147 women; 55.9 ± 9.5yrs; BMI ≥25 kg·m-2; impaired fasting glucose and/or impaired glucose tolerance) were clustered using a partitioning around medoids algorithm based on self-reported daily activities before a lifestyle intervention and their changes after 6 and 12 months. Device-assessed PA levels (PAL), sedentary time (SED), light PA (LPA), and moderate-to-vigorous PA (MVPA) were assessed using ActiSleep+ accelerometers and compared between clusters using (multivariate) analyses of covariance. At baseline, the self-reported "walking and housework" cluster had significantly higher PAL, MVPA and LPA, and less SED than the "inactive" cluster. LPA was higher only among the "cycling" cluster. There was no difference in the device-based measures between the "social-sports" and "inactive" clusters. Looking at the changes after 6 months, the "increased walking" cluster showed the greatest increase in PAL while the "increased cycling" cluster accumulated the highest amount of LPA. The "increased housework" and "increased supervised sports" reported least favourable changes in device-based PA. After 12 months, there was only minor change in activities between the "increased walking and cycling", "no change" and "increased supervised sports" clusters, with no significant differences in device-based measures. Combining self-report and device-based measures provides better insights into the behaviours that change during an intervention. Walking and cycling may be suitable activities to increase PA in adults with prediabetes.

Moving together: Increasing physical activity in older adults with an intergenerational technology-based intervention. A feasibility study.

Robust evidence supports the role of physical activity and exercise in increasing longevity, decreasing morbidity and helping older adults maintain the highest quality of life attainable. However, the majority of older adults are not sufficiently physically active and interventions are needed to change their behaviors. Familial or intergenerational contact has been positively linked to health and well-being in older adults. Therefore, this study aimed to i) establish acceptability and test the functionality and useability of a novel technology-driven intergenerational intervention targeting physical activity and age stereotypes, and ii) identify any potential issues with recruitment and retention. Four familial dyads (adult ≥ 65 and child 7-11 years) engaged with the intervention. Working collaboratively during a four-week trial, they combined daily step-counts (acquired via any activity of their choice, using PA trackers) to complete a virtual walk route using online platform World Walking. Thematic analysis of three post-intervention focus groups (one older adult; one child; one additional parental cohort) identified eight subthemes: Engagement; Provision of a Positive Experience; Participant Stimuli; Generated Outcomes; Operationality; Limitations; Mediators; Facilitators, and Perceptions. Participants enjoyed and successfully engaged with the intervention; when designing behaviour change interventions for older adults, flexibility within pre-established routines, individual choice, and avoiding rigidly imposed structures, is important. Strategies to challenge negative perceptions of older adults' engagement with technology and PA should be integrated into recruitment processes.

Association of Recess Provision With Accelerometer-Measured Physical Activity and Sedentary Time in a Representative Sample of 6- to 11-Year-Old Children in the United States.

PURPOSE: To assess the association between the amount of recess provision and children's accelerometer-measured physical activity (PA) levels. METHODS: Parents/guardians of 6- to 11-year-olds (n = 451) in the 2012 National Youth Fitness Survey reported recess provision, categorized as low (10-15 min; 31.9%), medium (16-30 min; 48.0%), or high (>30 min; 20.1%). Children wore a wrist-worn accelerometer for 7 days to estimate time spent sedentary, in light PA, and in moderate to vigorous PA using 2 different cut points for either activity counts or raw acceleration. Outcomes were compared between levels of recess provision while adjusting for covariates and the survey's multistage, probability sampling design. RESULTS: Children with high recess provision spent less time sedentary, irrespective of type of day (week vs weekend) and engaged in more light or moderate to vigorous PA on weekdays than those with low recess provision. The magnitude and statistical significance of effects differed based on the cut points used to classify PA (eg, 4.7 vs 11.9 additional min·d-1 of moderate to vigorous PA). CONCLUSIONS: Providing children with >30 minutes of daily recess, which exceeds current recommendations of ≥20 minutes, is associated with more favorable PA levels and not just on school days. Identifying the optimal method for analyzing wrist-worn accelerometer data could clarify the magnitude of this effect.

The Effect of Sex, Maturity, and Training Status on Maximal Sprint Performance Kinetics.

PURPOSE: The development of sprint running during youth has received renewed interest, but questions remain regarding the development of speed in youth, especially the influences of sex, training, and maturity status. METHODS: One hundred and forty-seven team sport trained (69 girls; 14.3 [2.1] y) and 113 untrained (64 girls; 13.8 [2.7] y) youth completed two 30-m sprints separated by 2-minute active rest. Velocity was measured using a radar gun at >46 Hz, with power and force variables derived from a force-velocity-power profile. RESULTS: Boys produced a significantly higher absolute peak power (741 [272] vs 645 [229] W; P < .01) and force (431 [124] vs 398 [125] N; P < .01) than girls, irrespective of maturity and training status. However, there was a greater sex difference in relative mean power and peak velocity in circa peak height velocity adolescents (46.9% and 19.8%, respectively) compared with prepeak height velocity (5.4% and 3.2%) or postpeak height velocity youth (11.6% and 5.6%). CONCLUSIONS: Sprint development in youth is sexually dimorphic which needs considering when devising long-term training plans. Further research is needed to explore the independent, and combined, effects of sex, training, and maturity status on sprint performance kinetics in youth.

The Influence of Motor Competence on Broader Aspects of Health: A Systematic Review of the Longitudinal Associations Between Motor Competence and Cognitive and Social-Emotional Outcomes.

BACKGROUND: Motor competence has important developmental associations with aspects of physical health, but there has been no synthesis of longitudinal associations with cognitive and social-emotional health. OBJECTIVES: The first aim was to present a conceptual model that positions motor competence as a mediator between physical activity and cognitive and social-emotional outcomes. The second aim was to synthesize the association of motor competence and cognitive and social-emotional development using longitudinal observational and experimental evidence, in particular to (i) identify the role of task, individual, and environmental characteristics in moderating the association between motor and cognitive and social-emotional outcomes and (ii) synthesize the strength of evidence pertaining to domain-specific relationships. METHODS: This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analyses. Five electronic databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were systematically searched. Following study screening and risk-of-bias assessment by two authors, 49 eligible studies were identified for inclusion and grouped by study design. Evidence for domain-specific paths between motor competence and cognitive and social-emotional outcomes was synthesized by calculating the significant analyses in the hypothesized direction, divided by the total number of analyses for that path. These percentages were then collated for each domain outcome. This collated influence was classified as either no association (0-33%), written as '0', or indeterminate/inconsistent (34-59%), written as '?' If there were fewer than three studies in the domain, the strength of evidence was classified as insufficient (I). RESULTS: Of the 49 studies, 35% were able to satisfy six or more of the seven risk-of-bias criteria. Longitudinal observational evidence about domain-specific and global associations of motor competence and cognitive and social-emotional development is indeterminate. The included studies also did not provide evidence for a consistent moderating role of age and sex. Some preliminary experimental evidence does support the role of motor competence in moderating the influence of cognitively enriched physical activity on cognitive outcomes, especially working memory and social-emotional skills. However, too few studies were appropriately designed to acknowledge the moderating role of contextual mechanisms. CONCLUSIONS: Between-study heterogeneity means it was not possible to identify definitive domain- and construct-specific relationships between motor competence and cognitive and social-emotional outcomes. To further develop our understanding, it is important that researchers acknowledge the complexity of these relationships within rigorous study designs.

Perceptions surrounding the possible interaction between physical activity, pollution and asthma in children and adolescents with and without asthma.

A cornerstone of asthma management is maintaining physical activity (PA), but this may lead to increased exposure to, and deeper inhalation of, pollutants. Furthermore, children and adolescents may be more susceptible to the deleterious impacts of such exposures. Despite the recent air quality campaigns and media coverage surrounding the dangers of air pollution to respiratory health, few target children and their understanding of such issues.Using semi structured interviews, understanding of PA, air pollution and their interaction was explored with 25 youth aged 7-17 years. Utilising NVIVO 12 software, an atheoretical, inductive thematic analysis was conducted to identify key themes which were subsequently presented as pen profiles with the number of common responses within a theme indicative of its strength.The majority (88%) of youth's indicated traffic-related air pollution and global manufacturing as key sources of air pollution. Whilst all youths were aware of outdoor pollution, only 52% were aware of indoor air pollutants, of which 62% had asthma. Despite some uncertainty, all youths described pollution in a negative fashion, with 52% linking air pollution to undesirable effects on health, specifically respiratory health. PA in a polluted area was thought to be more dangerous than beneficial by 44%, although 24% suggested the benefits of PA would outweigh any detriment from pollution.Youth are aware of, and potentially compensate for, the interaction between air pollution and PA. Strategies are needed to allow youth to make more informed decisions regarding how to promote PA whilst minimising exposure to air pollution.

Adaptation of Left Ventricular Twist Mechanics in Exercise-Trained Children Is Only Evident after the Adolescent Growth Spurt.

BACKGROUND: The extent of structural cardiac remodeling in response to endurance training is maturity dependent. In adults, this structural adaptation is often associated with the adaptation of left ventricular (LV) twist mechanics. For example, an increase in LV twist often follows an expansion in end-diastolic volume, whereas a reduction in twist may follow a thickening of the LV walls. While structural cardiac remodeling has been shown to be more prominent post-peak height velocity (PHV), it remains to be determined how this maturation-dependent structural remodeling influences LV twist. Therefore, we aimed to (1) compare LV twist mechanics between trained and untrained children pre- and post-PHV and (2) investigate how LV structural variables relate to LV twist mechanics pre- and post-PHV. METHODS: Left ventricular function and morphology were assessed (echocardiography) in endurance-trained and untrained boys (n = 38 and n = 28, respectively) and girls (n = 39 and n = 34, respectively). Participants were categorized as either pre- or post-PHV using maturity offset to estimate somatic maturation. RESULTS: Pre-PHV, there were no differences in LV twist or torsion between trained and untrained boys (twist: P = .630; torsion: P = .382) or girls (twist: P = .502; torsion: P = .316), and LV twist mechanics were not related with any LV structural variables (P > .05). Post-PHV, LV twist was lower in trained versus untrained boys (P = .004), with torsion lower in trained groups, irrespective of sex (boys: P < .001; girls: P = .017). Moreover, LV torsion was inversely related to LV mass (boys: r = -0.55, P = .001; girls: r = -0.46, P = .003) and end-diastolic volume (boys: r = -0.64, P < .001; girls: r = -0.36, P = .025) in both sexes. CONCLUSIONS: A difference in LV twist mechanics between endurance-trained and untrained cohorts is only apparent post-PHV, where structural and functional remodeling were related.

Motor Competence between Children with and without Additional Learning Needs: A Cross-Sectional Population-Level Study.

The aim of this study was to examine associations in motor competence between children with additional learning needs (ALN) and typically developing children. This cross-sectional study involved a nationally representative cohort of 4555 children (48.98% boys; 11.35 ± 0.65 years) from sixty-five schools across Wales (UK). Demographic data were collected from schools, and children were assessed using the Dragon Challenge assessment of motor competence, which consists of nine tasks completed in a timed circuit. A multi-nominal multi-level model with random intercept was fitted to explore the proficiency between children with ALN and those without. In all nine motor competence tasks, typically developing children demonstrated higher levels of proficiency than their peers with ALN, with these associations evident after accounting for age, sex, ethnicity, and socioeconomic status. This study highlights motor competence inequalities at a population level and emphasises the need for policymakers, practitioners, and researchers to prioritise motor competence development, particularly for children with ALN.

The Role of Multi-Sensor Measurement in the Assessment of Movement Quality: A Systematic Review.

BACKGROUND: Movement quality is typically assessed by drawing comparisons against predetermined movement standards. Movements are often discretely scored or labelled against pre-set criteria, though movement quality can also be evaluated using motion-related measurements (e.g., spatio-temporal parameters and kinematic variables). Wearable technology has the potential to measure and assess movement quality and offer valuable, practical feedback. OBJECTIVES: A systematic approach was taken to examine the benefits associated with multi-sensor and multiple wearable-device usage, compared with unimodal applications, when assessing movement quality. Consequently, this review considers the additional variables and features that could be obtained through multi-sensor devices for use in movement analyses. Processing methods and applications of the various configurations were also explored. METHODS: Articles were included within this review if they were written in English, specifically studied the use of wearable sensors to assess movement quality, and were published between January 2010 and December 2022. Of the 62,635 articles initially identified, 27 papers were included in this review. The quality of included studies was determined using a modified Downs and Black checklist, with 24/27 high quality. RESULTS: Fifteen of the 27 included studies used a classification approach, 11 used a measurement approach, and one used both methods. Accelerometers featured in all 27 studies, in isolation (n = 5), with a gyroscope (n = 9), or with both a gyroscope and a magnetometer (n = 13). Sampling frequencies across all studies ranged from 50 to 200 Hz. The most common classification methods were traditional feature-based classifiers (n = 5) and support vector machines (SVM; n = 5). Sensor fusion featured in six of the 16 classification studies and nine of the 12 measurement studies, with the Madgwick algorithm most prevalent (n = 7). CONCLUSIONS: This systematic review highlights the differences between the applications and processing methods associated with the use of unimodal and multi-sensor wearable devices when assessing movement quality. Further, the use of multiple devices appears to increase the feasibility of effectively assessing holistic movements, while multi-sensor devices offer the ability to obtain more output metrics.

Profiling Hormonal Contraceptive Use and Perceived Impact on Training and Performance in a Global Sample of Women Rugby Players.

PURPOSE: The potential impact of hormonal contraceptives (HCs) on player health and performance in women's rugby union (rugby) is not well understood, despite rugby's growing popularity worldwide. This study investigated the prevalence of HC use and reported associations with training and performance in a global sample of women rugby players. METHOD: A globally distributed online survey, seeking to explore experiences in women's rugby, was completed by 1596 current or former adult women 7s or 15s rugby players (mean age 27 [6] y; 7 [5] y playing experience) from 62 countries. The survey included a section of questions about reported HC use, including the type, reason for use, symptoms, and experiences relating to rugby training and performance. RESULTS: A total of 606 (38%) participants from 33 of the 62 (53%) countries reported using HCs, with the combined oral contraceptive pill reported as the most frequently used (44%). Almost half of participants using HCs (43%) tracked HC-related symptoms. Over 10% reported altered rugby performance due to HC-related symptoms, 22% required medication to manage symptoms, and 11% used HCs to control or stop their menstrual periods for rugby training and performance. CONCLUSIONS: The current study highlights the prevalence of HC use in women's rugby, identifying practices that may negatively affect performance, health, and well-being. Thus, there is an urgent need to better understand the motivations for such practices and knowledge of potential side effects among women rugby players across all levels and countries.

Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome.

PURPOSE: The objective of this study is to investigate whether heterogeneous treatment effects occur for changes in inspiratory muscle strength, perceived dyspnea, and health-related quality of life after 8 wk of unsupervised home-based inspiratory muscle training (IMT) in adults with postacute coronavirus disease 2019 (COVID-19) syndrome. METHODS: In total, 147 adults with self-reported prior COVID-19 either completed an 8-wk home-based IMT intervention ( n = 111, 92 females, 48 ± 11 yr, 9.3 ± 3.6 months postacute COVID-19 infection) or acted as "usual care" wait list controls ( n = 36, 34 females, 49 ± 12 yr, 9.4 ± 3.2 months postacute COVID-19 infection). RESULTS: Applying a Bayesian framework, we found clear evidence of heterogeneity of treatment response for inspiratory muscle strength: the estimated difference between standard deviations (SD) of the IMT and control groups was 22.8 cm H 2 O (75% credible interval (CrI), 4.7-37.7) for changes in maximal inspiratory pressure (MIP) and 86.8 pressure time units (75% CrI, 55.7-116.7) for sustained MIP (SMIP). Conversely, there were minimal differences in the SD between the IMT and the control group for changes in perceived dyspnea and health-related quality of life, providing no evidence of heterogeneous treatment effects. Higher cumulative power during the IMT intervention was related to changes in MIP ( ß = 10.9 cm H 2 O (95% CrI, 5.3-16.8) per 1 SD) and SMIP ( ß = 63.7 (32.2-95.3) pressure time units per 1 SD), clearly indicating an IMT dose response for changes in inspiratory muscle strength. Older age (>50 yr), a longer time postacute COVID-19 (>3 months), and greater severity of dyspnea at baseline were also associated with smaller improvements in inspiratory muscle strength. CONCLUSIONS: Heterogeneous individual responses occurred after an 8-wk home-based IMT program in people with postacute COVID-19 syndrome. Consistent with standard exercise theory, larger improvements in inspiratory muscle strength are strongly related to a greater cumulative dose of IMT.

Investigating the kinetics of repeated sprint ability in national level adolescent hockey players.

Repeated sprint ability (RSA) is more closely related to match performance outcomes than single-sprint performance, but the kinetic determinants in youth athletes remain poorly understood. Therefore, the aim of the study was to explore the kinetic determinants of RSA in youth athletes. Twenty trained adolescents (15 girls; 14.4 ± 1.0 years) completed five 15 m repetitions interspersed with 5-s rest. Velocity was measured during each trial using a radar gun at >46 Hz, following which the force-velocity-power (F-v-P) profile was fitted to a velocity-time curve and instantaneous power and force variables calculated. The mechanical efficiency of force application (DRF) was the primary predictor of both single and repeated sprint performance in adolescents. Secondly, hierarchical analyses revealed the percentage reduction in peak velocity, DRF, and allometrically scaled peak force explained 91.5% of the variance in 15 m sprint time from sprints 1-5. Finally, declines in allometrically scaled peak power were more closely related to declines in peak force than reductions in velocity. In conclusion, given DRF was the primary predictor of both single and repeated sprint performance training programmes targeting RSA need to include technique, and skill acquisition, components.

Battling the unknown: Using composite vignettes to portray lived experiences of COVID-19 and long-COVID.

Understanding the day-to-day lived experiences of individuals who have had or are still recovering from Coronavirus Disease-19 (COVID-19), whilst a complex challenge, presents the opportunity to listen and learn. Composite vignettes provide a novel approach to explore and present descriptive portrayals of the most commonly derived experiences and recovery journeys. The thematic analysis of 47 shared accounts (semi-structured interviews with adults aged ≥18 years; 40 females; 6-11 months post-COVID-19 infection) produced a series of four intricate character stories written through the lens of a single individual. Each vignette gives a voice to and captures a different experience trajectory. From the point of initial symptom development onwards, the vignettes depict how COVID-19 has affected everyday lives, focusing on the secondary non-biological socio-psychological effects and implications. The vignettes highlight in participants' own words: i) the potential negative implications of not addressing the psychological effects of COVID-19; ii) the lack of symptom and recovery linearity; iii) the ongoing 'lottery' of access to healthcare services; and iv) the highly variable, yet generally devastating, impacts that COVID-19 and consequent long-COVID has had across multiple facets of daily living.

A Global Women's Rugby Union Web-Based Survey.

Rugby Union (rugby) is a full-contact team sport characterised by frequent collision events. Over one third (2.7 million) of global rugby participants are women and girls. Yet, most rugby research, laws, and regulations are derived from the men's game with limited transferability to the women's game. This includes research focused on injury and concussion management. Greater insights are urgently required to enable appropriate adaptations and support for all rugby participants. Therefore, this paper presents the protocol for a project that sought to gather insights into the understanding, experiences, and attitudes of players and coaches in women's rugby regarding key issues of concussion, injury, and training for injury prevention, as well as the implications of the menstrual cycle for training and performance. From August 2020 to November 2020, online, open, cross-sectional surveys for players and coaches were distributed globally through rugby governing bodies and women's rugby social media platforms using snowball sampling. Survey responses were recorded anonymously via a GDPR-compliant online survey platform, JISC (jisc.ac.uk, Bristol, England). Participant eligibility included being ≥18 years and either actively playing or coaching women's rugby 15s and/or sevens, or having done so in the past decade, at any level, in any country. To enhance the number and accuracy of responses, the survey was professionally translated into eight additional languages. A total of 1596 participants from 62 countries (27 ± 6 years; 7.5 ± 5.1 years of playing experience) and 296 participants from 37 countries (mean age = 36.64, SD = 9.09, mean experience = 6.53 years, SD = 3.31) completed the players' and coaches' surveys, respectively. Understanding women's participation in and experiences of rugby is important to enable lifelong engagement and enjoyment of the sport and health during and following participation.

The associations of physical activity, sedentary time, and sleep with V˙O2max in trained and untrained children and adolescents: A novel five-part compositional analysis.

The benefits of physical activity (PA) and the negative impacts of sedentary time (SED) on both short- and long-term health in youth are well established. However, uncertainty remains about how PA and SED jointly influence maximal oxygen uptake ([Formula: see text]). Therefore, the aim of this study was to determine the joint influence of PA and SED on [Formula: see text] using compositional analyses. 176 adolescents (84 girls, 13.8 ± 1.8 years) completed an incremental ramp test and supramaximal validation bout on a cycle ergometer, with PA and SED recorded for seven consecutive days on the right hip using a ActiGraph GT3X accelerometer. Time spent in Sleep, SED, light, moderate and vigorous PA was analysed using a compositional linear regression model. Compositions with 10 minutes more time in vigorous PA (> 27.5 mins⋅day-1) compared to the average 17.5 mins⋅day-1 were associated with a + 2.9% - 11.1% higher absolute and scaled [Formula: see text] whilst compositions with less (> -10 mins⋅day-1) VPA were associated with a reduced absolute and allometrically scaled [Formula: see text] (-4.6% - 24.4%). All associations were irrespective of sex, maturity, and training status. The proportion of time spent sedentary had little impact on absolute and scaled [Formula: see text] (0.01-1.98%). These findings therefore highlight that intensity of PA may be of greater importance for increases in [Formula: see text] than reductions in SED and should be incorporated into future intervention designs.

3D-Printing Physical Activity in Youth: An Autotopographical Approach to Behaviour Change.

The conceptualisation and visualisation of physical activity through 3D-printed objects offers a unique means by which to elicit positive behaviour change. This study aimed to explore whether 3D-printed models of physical activity obtain autotopographical meaning in youths and the influence of such models on their sense of personal and social identity. Following participation in a seven-week faded intervention, whereby habitual physical activity was measured and used to create individual 3D models, the views of 61 participants (36 boys; 10.9 ± 3.0 years) were explored via semi-structured focus groups. Within the over-arching theme of '3D-Printed Models', key emergent sub-themes were structured around 'Autotopography', 'Reflection', 'In-group norms', and 'Significant others'. Investing meaning in the material representations facilitated social activation and self-reflection on their own behaviour, both of which are key elements of identity formation. The influential role of significant others (familial and peers) within initial model interpretation and their potential long-term efficacy as a behaviour change approach was highlighted. 3D-printed models present a novel concept and intervention approach and may represent a useful component within behaviour change engagement strategies in children and adolescents.

Experiences of adults living with a kidney transplant-Effects on physical activity, physical function, and quality of life: A descriptive phenomenological study.

BACKGROUND: Although kidney transplantation is the best treatment for kidney failure, scarce research has examined its effects on physical activity, physical function and quality of life. OBJECTIVES: To investigate the experiences of a group of adults living with advanced kidney disease focusing on quality of life, physical activity and function and to see how findings differ in a group of kidney transplant recipients. APPROACH: Individual semi-structured interviews were conducted with adults with advanced kidney disease (n = 10; 70.5 ± 8.9 years) and adults who had received a kidney transplant (n = 10; 50.7 ± 11.5 years; transplant age: 42.7 ± 20.9 months). Interviews were transcribed verbatim, thematically analysed and composite vignettes developed. FINDINGS: Individuals with advanced kidney disease described a sense of loss and alteration to their life plans. Kidney transplant recipients reported increased freedom, independence and a return to near normality, with improved quality of life, physical activity and function compared with their pre-transplant lives. However, transplant recipients also described living with anxiety about the health of their transplant and fear it may fail. CONCLUSION: Whilst adults living with advanced kidney disease often experience a reduced quality of life, physical activity and function, kidney transplantation can help facilitate a return to pre-disease levels of physical activity, physical function and quality of life. However, transplant recipients also reported living with anxiety around their new kidney failing. This study demonstrates the variability in the lived experiences of adults living with advanced kidney disease or a kidney transplant and highlights the need for patient-centred care.

Clusters of Activity-Related Social and Physical Home Environmental Factors and Their Association With Children's Home-Based Physical Activity and Sitting.

PURPOSE: Understanding which physical activity (PA) and sedentary behavior correlates cluster in children is important, particularly in the home, where children spend significant time. Therefore, this study aimed to assess clustering of physical and social activity-related factors at home, and whether these clusters are related to home-based sitting and PA in children. A secondary aim was to explore whether the clusters were associated with child, parent, and family characteristics. METHODS: Altogether, 235 children (55% girls, mean age = 10.2 [0.7] y) and their parents took part. Physical (eg, PA and electronic media equipment, house and garden size, layout) and social (eg, activity preferences, priorities, parental rules) home environmental factors were obtained via the HomeSPACE-II audit and self-report, respectively. Principal component analysis was used to identify clusters of physical and social environmental factors. Backward regression analysis and partial correlations were used to examine relationships between clusters, children's device-measured home-based activity behaviors, and background characteristics. RESULTS: The findings show that physical and social environment activity-related factors at home cluster. The clusters were associated with several background characteristics, with socioeconomic factors appearing to be particularly influential. The clusters were also associated with home-based activity behaviors in the hypothesized directions. CONCLUSION: Interventions which target clusters of social and physical factors at home, especially among low-socioeconomic status families, are warranted.

Exploring patients' experiences of the impact of dialysis therapies on quality of life and wellbeing.

BACKGROUND: When people with chronic kidney disease reach kidney failure, renal replacement therapy is usually required to improve symptoms and maintain life. Although in-centre haemodialysis is most commonly used for this purpose, other forms of dialysis are available, including home haemodialysis and peritoneal dialysis. OBJECTIVES: We aimed to explore the experiences of adults living with chronic kidney disease who were either approaching the need for dialysis or had reached kidney failure and were receiving a form of dialysis. In particular, we explored how different forms of dialysis affect their quality of life, wellbeing, and physical activity. METHODS: Individual semistructured interviews were conducted with 40 adults with kidney failure, comprising four groups (n = 10 each): those receiving in-centre haemodialysis, home haemodialysis or peritoneal dialysis, or predialysis. Interviews were transcribed verbatim, thematically analysed, and then composite vignettes were subsequently developed to present a rich narrative of the collective experiences of each group. FINDINGS: Compared with adults who were predialysis, quality of life and wellbeing improved upon initiation of their home haemodialysis or peritoneal dialysis. Conversely, minimal improvement was perceived by those receiving in-centre haemodialysis. Low physical activity was reported across all four groups, although those receiving home haemodialysis and peritoneal dialysis reported a greater desire and ability to be physically active than those in-centre. CONCLUSION: These findings highlight that dialysis modalities not requiring regular hospital attendance (i.e., home haemodialysis and peritoneal dialysis) improve independence, quality of life, wellbeing, and can facilitate a more physically active lifestyle.