Primary school children's health and its association with physical fitness development and health-related factors.

The health status (HS) of children is influenced by a variety of factors, including physical fitness (PF) or social and environmental characteristics. We present a 4-year longitudinal study carried out with 263 primary school children. PF was assessed yearly using the German Motor Performance Test 6-18. Demographic data, leisure time behavior and socioeconomic factors were collected using questionnaires for children and parents. Based on parents' ratings in year 4, children were categorized as either "very good health status" (VGHS) or "good health status or below" (GHSB). Children with VGHS (73%) showed a larger improvement of global PF (p < 0.001), a significantly higher proportion of being/playing outside (p < 0.001), significantly lower proportions of overweight (p < 0.001), of media availability in the bedroom (p = 0.011) and of daily media consumption > 2 h (p = 0.033) compared to children with GHSB. Regarding socio-economic factors, children with VGHS revealed significantly fewer parents with lower education (p = 0.002), lower physical activity levels (p = 0.030) and lower migration background (p < 0.001). Physical fitness (p = 0.019) and outdoors exercising (p = 0.050) were the only variables to provide significantly higher chances of perceiving one's own health as very good when tested within a complex model including all the variables studied in this work. Considering the little focus on PF in the current Austrian physical education curriculum and the favorable environmental features of the Tyrolean region, more emphasis should be given to promoting didactical and pedagogical approaches that allow schoolers to be active in the nature.

Sex-specific analysis of hiking accidents in the Austrian Alps: a follow-up from 2015 to 2021.

Background: Hiking is one of the most popular leisure sport activities practiced in the Alps during the summer season, but bears the risk of mountain emergencies, accidents, and fatalities. This paper provides an updated analysis of hiking accidents for the years 2015 to 2021 in the Austrian Alps, thereby outlining fatal and non-fatal accident characteristics. Methods: For this retrospective analysis, mountain hiking accidents documented by the Austrian Alpine Police during a 7-year period were screened for potential exclusion criteria. The final sample size consisted of 7368 accidents and 7552 victims. The outcome measures were mainly specified by sex, age, injury degree, injury location, pathophysiological characteristics, and cause of injury. Results: The overall annual number of accidents showed a continuous increase from 428 in 2015 to 544 in 2021. In total, 7.1% of the total victims died during the 7-year period, with male hikers being significantly more affected than female hikers (m: 80.8%, f: 19.2%; p ≤ 0.001). The sex specific distribution for non-fatal hiking accidents was 55.9% in women and 44.1% in men. Male victims showed significantly more frequent cardiovascular events (m: 78.5%, f: 21.5%), multiple injuries (m: 60.2%, f: 39.8%), and wounds/blood loss (m: 57.4%, f: 42.6%) than female victims, whereas women showed more fractures (m: 31.5%, f: 68.5%) than men (p ≤ 0.001). Additionally, men were more likely to injure their abdomen/chest (3.7%), head (14.1%), and multiple body parts (26.5%), whereas women were more likely to injure their ankle or foot (42.3%). Finally, men were more likely to have an accident during the ascent (24.1%), whereas women during the descent (69.0%) (p ≤ 0.001). Conclusion: This paper provides the latest data and a deeper insight into sex-specific characteristics of mountain hiking accidents in the Austrian Alps.

Validity, reliability, and invariance across sex of a German version of the Behavioral Regulation in Exercise Questionnaire.

Objective: Since there is no scientifically validated German version of the Behavioral Regulation in Exercise Questionnaire (BREQ-3), the aim of this study was to assess its psychometric parameters and invariance across sex in a sample of German-speaking young adults. The BREQ-3 is an instrument measuring the social and internal influences of motivation toward exercising. This tool is widespread within the scientific community and has been validated in several languages. Methods: A total of 271 participants (45% women; mean age = 20.67 ± 2.17 years; effect size ≥ 0.5) filled in the BREQ-3 at one time point, with a small sub-sample (n = 37) responding it a second time after 15 days. Confirmatory Factorial Analysis, Structural Modeling, and Intraclass Correlation Coefficient were used to examine the German version of the questionnaire. Results: Results highlighted a good fit of the six-dimensional model after the removal of two items (CFI = 0.912; SRMR = 0.0594; RMSEA = 0.064), as well as full invariance across sex (pχ2 = 0.218; ΔCFI < 0.01). Internal consistency and reliability were moderate to good. Conclusions: The 22-item German BREQ-3 is a scientifically valid instrument that can be used in cross-national studies dealing with social aspects of exercise behaviors.

Impact of Environmental Factors on the ACL Injury Risk in Recreational Alpine Skiing.

In recreational alpine skiing, an ACL injury represents the most common injury. Skiing is a complex activity where the skier interacts with the environment, such as weather, snow conditions, temperature, etc. Thus, the aim of this study was to evaluate the potential impact of environmental factors on ACL injury risk in recreational alpine skiers. Among a cohort of 392 ACL-injured skiers and 392 uninjured controls matched for sex and skiing skill, environmental factors were collected by questionnaire. Factors included weather conditions, snow conditions, perceived temperature, and slope difficulty at the time-point of the accident (ACL-injured skiers) or of questioning during the ski day (uninjured controls).Multiple logistic regression revealed that in addition to age, five environmental factors were significantly predictive of an ACL injury: fresh snow (OR 10.5), grippy snow (OR 7.8), icy slope condition (OR 12.4), very cold/cold perceived temperature (OR 1.6), and skiing on easy slopes (OR 6.9). In conclusion, besides age, environmental factors such as fresh and grippy snow, icy slope conditions, low temperatures, and flat slopes are associated with an increased ACL injury risk in recreational alpine skiing. Those factors are at least partly modifiable and should be taken into consideration for preventive strategies.

Health behavior of Austrian tertiary students focusing on diet type linked to sports and exercise-first glimpse of results from the "sustainably healthy-from science 2 high school and university" study.

Background: There is a strong association between lifestyle behavior and health status. While young adulthood is a critical period for adopting and stabilizing lifelong healthy behavior, university life is independently associated with psychological stressors that may further affect health and well-being. Objective: The present multidisciplinary study aimed to examine the health behavior of Austrian college and university students, differentiated based on diet types (vegan, vegetarian, and omnivorous) and physical activity (PA) habits. Methods: Following a cross-sectional study design, a total number of 6,148 students (65.3% females; 66.1% bachelor students, 67.0% from urban areas; mean age: 24.8 years) from 52 Austrian college/universities participated in an online survey and provided data on sociodemographic characteristics, dietary patterns, PA habits, and other lifestyle behavior characteristics, including alcohol intake and smoking. Results: Across the total sample, 74.0% had a normal weight (BMI = 18.5-25.0 kg/m2), while the prevalence of overweight/obesity (BMI ≥ 30.0 kg/m2) was lower in females than males and more in rural than urban students (p < 0.01). The general prevalence of vegetarian and vegan diets was 22.8 and 6.0%, respectively, with a predominance of females, graduates, and urban students compared to their peers (p < 0.01). The majority of students (79.3%) had a regular engagement in sport/exercise, with a predominance of vegetarian or vegan students compared to omnivores (p < 0.01). Vegans and vegetarians had a lower alcohol intake (p < 0.01) but no differences in smoking habits (p > 0.05) compared to omnivores. Students engaging in sport/exercise had a lower smoking rate and higher intake of fruits, vegetables, and fluids compared to inactive students (p < 0.01). Conclusion: The present findings suggest that diet type and PA habits of college/university students have an impact on other health behaviors, highlighting the interconnected nature of lifestyle habits and health behavior.

A glimpse of academic staff health behavior on diet type and physical activity at Austrian universities: first findings from the "Sustainably Healthy - From Science 2 Highschool & University" study.

Background: The association between lifestyle and health status highlights the importance of assessing health-related behavior in different populations. This multidisciplinary study aimed to examine the health behavior of academic staff of Austrian colleges and universities, with a specific focus on diet types (vegan, vegetarian, omnivorous) and physical activity (PA) reports. Methods: Following a cross-sectional study design incorporating an online survey, a sample of 1,041 academics from 52 institutes (mean age: 46.4 years) provided data on sociodemographic characteristics, dietary patterns, PA behavior, and other lifestyle behaviors (smoking, alcohol intake, etc.). Results: The prevalence of vegetarian and vegan diets was 13.2 and 2.0%, respectively, and 33.2% of participants had excess body weight (BMI ≥ 25). The majority of participants (88.5%) reported regularly engaging in leisure-time PA, but 18.6% were active members of sports clubs. No difference between females and males was observed in diet type and the type of sport participation (p > 0.05). Participants with a mixed diet had a higher BMI than vegetarians and vegans (p < 0.05). Leisure-time PA participation was associated with more frequent fruit and vegetable intake (p < 0.05). The prevalence of smoking and alcohol intake was 13.1 and 73.5%, respectively, without any difference between dietary or sports participation subgroups (p > 0.05). Conclusion: The present study provides an overview of the social trends in vegan and vegetarian diets linked to health behaviors in tertiary educational settings. Findings can be used by health scientists, decision-makers, and multipliers in health and education to improve public health.

Association of personal and equipment-related factors on ACL injury risk in alpine skiers with cautious or risk-taking behaviour: A case-control study.

Background: In recreational alpine skiing ACL injury risk depends on the interaction of individual characteristics and behaviours as well as on equipment-related factors. Aim: to evaluate if and to what extent personal characteristics and equipment-related parameters are associated with ACL injury risk in cautious and risk-taking recreational alpine skiers. Methods: A retrospective questionnaire-based, case-control study of ACL-injured and uninjured in a cohort of cautious as well as risk-taking recreational skiers was conducted. Participants self-reported their demographics, skiing skill level, and risk-taking behaviour. Ski length, side-cut radius, widths of the tip, waist, and tail were recorded from each participant's skis. Standing heights at the front and rear components of the ski binding were measured with a digital sliding caliper, and a standing height ratio between the front and rear components was calculated. Ski boot sole abrasion at the toe and heel pieces was also measured with the digital sliding caliper. Results: In total, 1068 recreational skiers (50.8% females) with a mean age of 37.8 ± 12.3 years participated, of whom 193 (22.0%) sustained an ACL injury, and 330 (30.9%) participants reported a risk-taking behaviour. Results of the multiple logistic regression analyses revealed that a higher age, a lower skill level, a higher standing height ratio, and greater ski boot sole abrasion at the toe as well as heel pieces were independently associated with an increased ACL injury risk in both the cautious and the risk-taking group. Among cautious skiers, a longer ski length was an additional significant risk factor for sustaining an ACL injury. In conclusion, the same personal and equipment related characteristics contribute to an increase in the ACL injury risk regardless of risk-taking behaviour, with the only difference that longer skis represent an additional risk factor in cautious skiers.

Skill-Specific Differences in Equipment-Related Risk Factors for ACL Injury in Male and Female Recreational Skiers.

Background: In recreational alpine skiing, the anterior cruciate ligament (ACL) is affected in approximately 50% of serious knee injuries. There are established sex-based and skill-based differences in ACL injury risk, but the potential impact of equipment used (eg, skis, bindings, and boots) has not been evaluated. Purpose: To evaluate individual and equipment-related risk factors for an ACL injury depending on sex and skill level. Study Design: Case-control study; Level of evidence, 3. Methods: This was a retrospective questionnaire-based, case-control study of female and male skiers with and without ACL injuries during 6 winter seasons (from 2014-2015 to 2019-2020). Demographic data, skill level, equipment specifications, risk-taking behavior, and ownership of ski equipment were recorded. Ski geometry (ski length; sidecut radius; and widths of the tip, waist, and tail) was taken from each participant's ski. The standing heights of the front and back part of the ski binding were measured using a digital sliding caliper, and the standing height ratio was calculated. Abrasion of the ski boot sole was also measured at the toe and heel. Participants were divided by sex into less and more skilled skiers. Results: A total of 1817 recreational skiers participated in this study, of whom 392 (21.6%) sustained an ACL injury. A greater standing height ratio and more abrasion at the toe of the boot sole were associated with increased ACL injury risk in both sexes, independent of the skill level. Riskier behavior increased the injury risk only in male skiers, independent of the skill level, and longer skis increased the injury risk only in less skilled female skiers. Older age, the use of rented/borrowed skis, and more abrasion at the heel of the boot sole were independent risk factors for ACL injury in the more skilled skiers of both sexes. Conclusion: Individual and equipment-related risk factors for an ACL injury partly differed according to skill level and sex. Consideration of the demonstrated equipment-related factors should be implemented in order to reduce ACL injuries in recreational skiers.

Assessment of a Novel Instrument Measuring Perceived Physical Education Teachers' In-Class Skills.

Physical Education (PE) teachers' professional and personal skills may not only affect the quality of the teaching-learning processes in PE, but also individuals' future active/inactive behaviors. The aim of this study is to examine the structure of a pool of items developed for measuring individuals' perception of such skills in PE teachers. Exploratory Factorial Analysis and a following structural modeling test on data collected from 660 participants suggest a two-factor structural model for the 10 items considered (χ2 = 191.155; df = 34; CFI = 0.953, and SRMR = 0.0529), with good internal consistency for both factors (factor 1: alpha = 0.879; omega = 0.878; factor 2: alpha = 0.850, and omega = 0.858) and the overall instrument (alpha = 0.892; omega = 0.895). The final "Teachers' Personal and Professional Skills Questionnaire" is a valid instrument that may be used alone or in combination with other instruments for the analysis of the quality of teaching-learning processes in PE environments and its impact on individuals' behaviors regarding physical activity in their adult life.

Improving Spatial Hearing when Wearing Ski Helmets in Order to Increase Safety on Ski Slopes.

This study investigated the effect of a new type of ear pads for ski helmets on the hearing performance of 13 young adults (mean age: 22 years). Free-field hearing thresholds and sound localization performance of the subjects were assessed in three conditions: without helmet, with a conventional helmet and with the modified helmet. Results showed that the modified helmet was superior to the conventional helmet in all respects, but did not allow for a performance level observed without a helmet. Considering the importance of precise hearing and sound localization during alpine skiing, acoustically improved ear pads of ski helmets, as demonstrated in this study, can essentially contribute to enhancing the safety on ski slopes.

Study Protocol of "Sustainably Healthy-From Science 2 Highschool & University"-Prevalence of Mixed, Vegetarian, and Vegan Diets Linked to Sports & Exercise among Austrian Tertiary Students and Lecturers/Academic Staff.

Healthy lifestyle is the major indicator of individual and public health especially in target populations (e.g., during emerging adulthood). Evidence indicates that unhealthy lifestyle behaviors are strongly associated with the increasing prevalence of chronic diseases. The dual approach of sustainable health (i.e., physical exercise tied to a healthy diet) is an effective lifestyle strategy to control and manage health-related disorders, including overweight/obesity. Based on the evidence on plant-based diets regarding health and considering the growing prevalence of vegans and vegetarians worldwide, limited data exist on the health-related behaviors of those who follow plant-based vs. mixed diets in young adulthood. This multidisciplinary study is the first to examine the association between diet type (mixed, vegetarian, and vegan diets) and various health-related behaviors (primarily physical activity, sport, & exercise) among college/university students and lecturers/academic staff in Austria nationwide. Following a cross-sectional study design and using online questionnaires, 4510 tertiary students and 1043 lecturers/academic staff provided data on sociodemographic characteristics, dietary patterns, physical exercise habits, and other lifestyle behaviors (sleep, alcohol intake, smoking, etc.) along with information on health status and quality of life. While the data will be analyzed based on differentiated sociodemographic and health-related categories, the influence of the COVID-19 pandemic on lifestyle behaviors will also be evaluated. As a study protocol, this article represents comprehensive details of the design, purposes, and associated analytical measures of the present study within the tertiary educational context.

Mortality in Recreational Mountain-Biking in the Austrian Alps: A Retrospective Study over 16 Years.

Despite recreational mountain-biking's growing popularity worldwide, the literature on mortality in this leisure sporting activity is scarce. Therefore, the aim of the present study was to investigate the characteristics of fatal accidents as well as resulting dead victims during recreational mountain-biking in the Austrian Alps over the past 16 years. For this purpose, a retrospective study based on Austrian institutional documentation from 2006 to 2021 was conducted. In total, 97 fatalities (1 woman) with a mean age of 55.6 ± 13.9 years were recorded by the Austrian Alpine Police. Of those, 54.6% died due to a non-traumatic (mostly cardio-vascular) and 41.2% due to a traumatic event. Mountain-bikers fatally accidented for non-traumatic reasons frequently belonged to older age classes (p = 0.05) and mostly (73.6%) died during the ascent, whereas traumatic events mainly (70.0%) happened during the descent (p < 0.001). Throughout the examined period, the absolute number of fatalities slightly increased, whereas the mortality index (proportion of deaths/accidented victims) did not (mean value: 1.34 ± 0.56%). Factors such as male sex in general, above average age and uphill riding for non-traumatic accidents, as well as downhill riding for traumatic events, seem to be associated with fatalities during recreational mountain-biking in the Austrian Alps. These results should be considered for future preventive strategies in recreational mountain-biking.

School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School.

The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.

Relation between Physical Fitness Components and the Occurrence and Subjective Intensity of Back Pain in Secondary School Adolescents.

Despite the well documented benefits of physical fitness (PF) on general health, its role in back pain (BP) is still unclear. The objective of this study was to assess the association between different PF profiles and BP in a sample of adolescents. The study assessed PF and BP in a sample of 919 youth (age = 15.5 ± 1.3 years) from North and South Tyrol. A total of 531 participants (57.8%) reported no BP, whereas 4.7% (n = 43) reported severe BP. A two-step cluster analysis detected three main groups: the "less fit", with significantly lower scores in all PF tests (p < 0.001); the "strong sprinters", with higher speed and muscular strength than the others (p < 0.001); and the "flexible marathoners", with higher flexibility and cardiorespiratory fitness (p < 0.001). The "flexible marathoners" showed significantly better BP scores than the "less fit" (p = 0.029). Cardiorespiratory fitness and trunk flexibility are potential preventive components of BP in adolescents. Since the decline in flexibility starts very early in life, it is recommended to put a particular emphasis on this component of PF. The role of other components of PF should be further investigated in the future.

Study protocol of "From Science 2 School"-prevalence of sports and physical exercise linked to omnivorous, vegetarian and vegan, diets among Austrian secondary schools.

The increasing prevalence of unhealthy lifestyle choices contribute to almost all chronic conditions negatively affecting individual and public health. As the most beneficial preventative solution, a healthy lifestyle focusing on the dual approach of physical activity (PA) and a healthful diet is highly recommended. Considering the growing number of people interested in sustainable, plant-based diets, it seems crucial to analyze lifestyle behaviors with a special focus on diet type to delve deeper into the unenthusiastic health status among young populations. Therefore, this multidisciplinary study aims to survey and scale health behaviors with a special focus on the prevalence of traditional and vegetarian diets in connection with PA levels among Austrian pupils (10-19 years), teachers and principals in secondary education levels I and II. Following a cross-sectional design, sociodemographic and school-related data along with a complete profile of lifestyle behaviors, including detailed information regarding diet, PA, sports & exercise, and other health-related behaviors, were collected using online-based questionnaires. A total number of 8,845 children/adolescents (~1.2% of the eligible 771,525 Austrian secondary school pupils) and 1,350 adults (~1.5% of total eligible 89,243 Austrian teachers/principals) participated in the study. As this is the first investigation to explore the prevalence of veganism/vegetarianism amongst a large group of pupils, the present study will add an important contribution to overcome the lack of knowledge on PA, sports & exercise linked to healthy alternative diets. With a sustainable healthy lifestyle, a healthy transition from childhood to adulthood occurs, which can result in growing healthier functioning generations at all social levels. As a study protocol, the present article is intended to present comprehensive details of the study design, objectives, and the associated analytical procedures of the "From Science 2 School" study.

A Comparison of ACL Injury Risk, Ski Geometry and Standing Height Parameters between Skiers with Rented and with Owned Skis.

AIM: to evaluate if ACL injuries are associated with recreational skiers using rented skis and whether individual factors, ski geometry parameters and standing heights differ between skiers who rented or owned skis. A retrospective questionnaire-based, case-control study of ACL-injured and uninjured recreational skiers was conducted during six winter seasons. Age, sex, body height, body weight, nationality, ownership of skis, skill level, risk-taking behavior, ski length, side-cut radius, widths of the tip, waist, and tail, and the standing heights at the front and rear components of the ski binding were assessed. Additionally, ratios between ski widths and a standing height ratio were calculated. Altogether, 1780 skiers (48.9% females) with a mean age of 39.2 ± 13.0 years participated, of whom 22.0% sustained an ACL injury and 32.3% rented skis. ACL injury risk was significantly associated with rented skis (OR 3.2, 95% CI 2.5-4.0). Compared to skiers using own skis, participants who rented skis were more likely female, smaller and lighter, tourists, less skilled and more cautious. In comparison to owned skis, rented skis showed significantly lower mean values in ski length, side-cut radius, ski widths, and for the three ski widths ratios. Additionally, standing heights were significantly lower while standing height ratio was higher for rented skis. Beside individual factors, equipment-related factors should be considered when renting skis in order to reduce ACL injury risk.

Editorial on the Research Topic the 2nd Edition of Mountain Sports Activities: Injuries and Prevention.

Mountain sports are continuously gaining popularity, currently fueled by the post-pandemic period expanding travel opportunities and the desire to escape the increasingly hot environmental conditions of urban areas-ambient temperature decreases by about 6 [...].

Unchanged Fatality Rate on Austrian Ski Slopes during the COVID-19 Lockdown.

Fatalities on ski slopes are very rare, with about one death per one million skier days. Whether the fatality rate is affected by substantial changes in the number of skier days and potentially associated alterations in the structure of the skier population is unknown. Thus, we compared the fatality rate on Austrian ski slopes in the winter season of 2020/21, when skiing activities were dramatically restricted during the COVID-19 lockdown, with those of the previous winter seasons. As a consequence of COVID-19 measures, the number of skier days dropped from over 50 million in previous years to 9.2 million skier days in the winter season of 2020/21. Still, the fatality rate (6.5 deaths/10 million skier days) was not different when compared to any of the seasons from 2011/12 to 2019/20. Despite the lack of international skiers and the reduction in skier days by more than 80%, the fatality rate remained surprisingly unchanged. The weather and snowfall conditions were on average comparable to those of previous winters, and, except for nationality, the composition of the skier population appears to have remained relatively unaltered. In conclusion, the fatality rate during downhill skiing is low and the absolute fatality numbers are primarily a function of the number of skier days.

Self-Rated Health Status of Upper Secondary School Pupils and Its Associations with Multiple Health-Related Factors.

Health is an essential part of any individual, and gains particular importance in youth, as a good health at this age is more likely to reduce health risks both in the short and long term. The aim of this study was to assess the impact of physical and contextual parameters on youths' perceived health. A total of 919 adolescents completed questionnaires on self-rated health status, electronic media use, leisure time and club physical activity, alcohol and tobacco consumption, and back pain, as well as performed the German Motor Performance Test. Participants with very good health had significantly higher physical fitness, leisure time exercise, and participated in sports clubs more often than those with poorer health. Electronic media use was significantly higher for those with poor/very poor health. Future intervention programs to improve youth health status should not only focus on active lifestyle but might also consider the impact of socioenvironmental factors, such as daily media use.