A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism.

This systematic review synthesized the literature on digital health interventions for the promotion of physical activity (PA) among people with intellectual disabilities and/or autism. From an initial screening of 553 records, 10 studies underwent full-text review. Data were extracted relating to study, intervention, and sample characteristics and PA-related findings. Methodological quality was evaluated using the Crowe Critical Appraisal Tool. There were mixed findings pertaining to the effectiveness of digital health interventions for promoting PA among these populations. Positive results were reported for three of five active-video-game interventions, two of three social-media-based interventions, and one of two e-learning/multicomponent interventions. Digital health interventions can potentially be effective for promoting PA among people with intellectual disabilities and/or autism. However, the large variation in the samples and intervention types and a reliance on pre- and quasi-experimental research designs suggest that inferences should be made with caution and additional research is needed.

Focus distance estimation from photographed faces: a test of PerspectiveX using 1709 frontal and profile photographs from DSLR and smartphone cameras.

As focus distance (FD) sets perspective, it is an important consideration for the forensic analysis of faces in photographs, including those used for craniofacial superimposition. In the craniofacial superimposition domain, the PerspectiveX algorithm has been suggested for FD estimation. This algorithm uses a mean value of palpebral fissure length, as a scale, to estimate the FD. So far, PerspectiveX has not been validated for profile view photographs or for photographs taken with smartphones. This study tests PerspectiveX in both front and profile views, using multiple DSLR cameras, lenses and smartphones. In total, 1709 frontal and 1709 profile photographs of 10 adult participants were tested at 15 ground truth FDs using three DSLR cameras with 12 camera/lens combinations, five smartphone back cameras and four smartphone front cameras. Across all distances, PerspectiveX performed with a mean absolute error (MAE) of 11% and 12% for DSLR photographs in frontal and profile views, respectively, while errors doubled for frontal and profile photographs from smartphones (26% and 27%, respectively). This reverifies FD estimation for frontal DSLR photographs, validates FD estimates from profile view DSLR photographs and shows that FD estimation is currently inaccurate for smartphones. Until such time that FD estimations for facial photographs taken using smartphones improves, DSLR or 35 mm film images should continue to be sought for craniofacial superimpositions.

Perspective distortion tolerances and skull-face registration in craniofacial superimposition: an analytical review.

Craniofacial superimposition requires the photographic registration of a skull at transparency to a photograph of an antemortem (AM) face so that anatomical concordance between the two can be assessed. When the camera vantage point of the AM photograph is exactly replicated for skull photography, the superimposition is a relatively straightforward process as the images are precisely comparable without complicating factors. In practice, however, focus distances are almost never exactly replicated because the focus distance for AM face photography is rarely known. Embedded differences in perspective, thereby, drive the images away from correspondence, raising questions as to how much difference can be tolerated and what image registration methods should be used. Recently, a ± 1% mismatch in facial height has been posited as an acceptable upper tolerance limit to differential perspective, but this proposition is speculative and has not yet been confirmed by tests on real-life images. In addition, the impact of image registration methods, though critically relevant, has received comparatively little consideration. This paper provides the first in-depth review of these intertwined perspective/registration matters and objective evaluation of tolerances by using real 2D photographic images and synthetic images generated from 3D CT data to demonstrate perspective impact on skull morphology. Taken together, the review confirms a ≤ 1% perspective difference in facial height to be a suitable criterion for craniofacial superimposition (at least as a starting point for method improvement), and that image registration should be point-based using a sellion/nasion combination to minimize anatomical misalignment in the principal region-of-interest (the mid-face).

Factors Related to Physical Activity in Adults With Intellectual Disabilities in Group Home Settings: A Systematic Literature Review.

This systematic review of literature aimed to synthesize the multilevel factors related to physical activity (PA) among adults (age 18-65) with intellectual disability living in group homes. Keyword searches were used to identify articles from electronic databases, resulting in the inclusion of 10 articles for full-text review. Data were extracted relating to study and sample characteristics and study findings. Methodological quality of the studies was also evaluated. Factors related to PA in group homes were identified at all levels of the social-ecological model. Intrapersonal factors (e.g., health and functional status, attitude to PA), interpersonal factors (e.g., staff attitude, encouragement for PA, and coparticipation in PA), and organizational factors (e.g., program offerings, staff education, and staff-client ratios) were prominent findings in the reviewed studies. The findings support a social-ecological approach for PA promotion in group homes that target intrapersonal, interpersonal, and organizational factors.

Irish Para Report Card on Physical Activity of Children and Adolescents With Disabilities.

For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D-), Sedentary Behaviors (D-), Family & Peers (C), School (C-), Community & Environment (B-), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.

U.S. Physical Activity Para Report Card for Children and Adolescents With Disabilities.

The U.S. Report Card on Physical Activity for Children and Youth has tracked 10 physical activity (PA) indicators common to the Active Healthy Kids Global Matrix since 2014. This article expands on the U.S. report cards by presenting PA indicator assessments among children and adolescents with disabilities. Grades for indicators were assigned based on a search of peer-reviewed articles presenting nationally representative data. The Global Matrix 3.0 benchmarks and grading framework guided the process. Grades for overall PA, sedentary behaviors, organized sports, and school were F, D+, D+, and D, respectively. Insufficient evidence existed to assign grades to the remaining six indicators. There is a need in the United States for targeted PA promotion strategies that are specific to children and adolescents with disabilities. Without a commitment to this effort across sectors and settings, the low grades identified in this para report card are expected to remain.

Craniofacial superimposition: a review of focus distance estimation methods and an extension to profile view photographs.

Craniofacial superimposition concerns the photographic overlay of skulls and faces, for skeletal identification. As a phased method that depends on photographic optics first and anatomical comparisons second, superimposition is strongly underpinned by the physics of light travel through glass lenses. So that the downstream (and dependent) anatomical evaluations are not thwarted or erroneous identification decisions risked, it is critical that the optical prerequisites for valid image comparisons are met. As focus distance sets the perspective, the focus distance used for skull photography must be matched to that used at face photography, so that anatomically comparable 1:1 images are obtained. In this paper, we review the pertinent camera optics that set these nonnegotiable fundamentals and review a recently proposed method for focus distance estimation. We go beyond the original method descriptions to explain the mathematical justification for the PerspectiveX algorithm and provide an extension to profile images. This enables the first scientifically grounded use of profile view (or partial profile view) photographs in craniofacial superimposition. Proof of concept is provided by multiple worked examples of the focus distance estimation for frontal and profile view images of three of the authors at known focus distances. This innovation (1) removes longstanding trial-and-error components of present-day superimposition methods, (2) provides the first systematic and complete optical basis for image comparison in craniofacial superimposition, and (3) will enable anatomical comparison standards to be established from a valid grassroots basis where complexities of camera vantage point are removed as interfering factors.

The Gatekeepers to Fitness: A Correspondence Study to Examine Disabling Practices Among Fitness Center Personnel.

Fitness centers may be an ideal setting for physical activity, yet qualitative findings suggest social-level barriers constrain access for people with disabilities. To further test this, I employed an online message correspondence study to investigate the effect of impairment status on the responsiveness of a national sample of fitness centers to requests for services. Email requests were sent to 800 fitness centers, of which 200 were tailored to each of the four investigative conditions (i.e., control, vision loss, spinal cord injury, or being autistic). The odds of receiving a positive response were 40.5% lower for individuals with vision loss (p = .011) and 33.3% lower for individuals with spinal cord injury (p = .055), as compared with individuals without an impairment. Specifically, the odds of receiving a positive response for personal training were 58.8% lower among individuals with vision loss (p = .003) and 41.1% lower for individuals with spinal cord injury (p = .065).

Impact of weight and disability status on bullying victimisation and perpetration among youth.

AIM: The purpose of this analysis was to examine the influence of weight and disability status on rates of bullying victimisation and perpetration among youth. METHODS: Data from the 2016 National Survey of Children's Health, which included 2716 youth (aged 10-17) with and 23 195 without disabilities in the USA were utilised. Parent-reported measures of height and weight, bullying perpetration and victimisation, and demographic covariates analysed. Descriptive statistics, and multivariable logistic regressions with outcomes of bullying perpetration and victimisation, were generated. RESULTS: In the multivariate analysis, overweight (adjusted odds ratio (aOR) = 1.26, 95% confidence interval (CI) 1.04-1.52), obesity (aOR = 2.25, 95% CI 1.83-2.77) and having a disability (aOR = 3.25, 95% CI 2.69-3.92) were related to greater odds of bully victimisation. Both obesity (aOR = 1.62, 95% CI 1.10-2.74) and disability (aOR = 2.74, 95% CI 2.00-3.75) were also related to greater odds of bully perpetration in the multivariate model; overweight status was not related to bully perpetration. CONCLUSIONS: Weight status was identified as a characteristic that may increase the risk of bullying victimisation, above and beyond disability. This analysis helps identify that youth with disabilities who are overweight or obese have greater risk factors for bullying and are in need of interventions to ameliorate bullying.

Effect of Rest Interval Duration on the Volume Completed During a High-Intensity Bench Press Exercise.

ABSTRACT: Hernandez, DJ, Healy, S, Giacomini, ML, and Kwon, YS. Effect of rest interval duration on the volume completed during a high-intensity bench press exercise. J Strength Cond Res 35(11): 2981-2987, 2021-Between-set rest intervals (RIs) are one of the most important variables in resistance training; however, no known research has investigated the effects of RIs greater than 5 minutes during high-intensity strength training. The purpose of this research was to examine the effects of 3 different RIs on repetition sustainability and training volume (sets × reps × resistance) during a high-intensity bench press exercise. Fifteen resistance-trained male subjects (mean ± SD, age = 25.5 ± 4.5 years, and bench press 1 repetition maximum [1RM] ratio [1RM/body mass] = 1.39 ± 0.1) completed 3 experimental sessions, during which 4 sets of the bench press were performed with 85% of 1RM load. Subjects performed the bench press using 3 different RIs in a random counterbalanced design. Data were analyzed using both a one- and two-way analysis of variance with repeated measures. As sets progressed, repetitions were significantly different (p < 0.05) between all RIs, and only the 8-minute RI (p < 0.05) allowed for the complete sustainability of repetitions over 4 consecutive sets. Subjects attained the greatest training volume (p < 0.05) using an 8-minute RI between sets compared with a 2- or 5-minute RI. Similarly, a significantly greater training volume was achieved using the 5-minute RI compared with the 2-minute RI. Resistance-trained men, with the goal of greater volume during strength training, would benefit from longer RIs, specifically using an 8-minute RI between 4 consecutive sets of a bench press exercise.

A Pilot Study of a Parent-Mediated, Web-Based Motor Skill Intervention for Children With Down Syndrome: Project SKIP.

To inform the development of scalable and sustainable fundamental motor skill interventions for children with Down syndrome, this study examined the feasibility and preliminary effectiveness of Project Skill Intervention Implemented by Parents (Project SKIP), a web-based, parent-mediated intervention intended to improve ball skills among children with Down syndrome. Twenty-four families enrolled in the study (including 13 boys and 11 girls; Mage = 4.92). Fourteen children were assigned to an experimental group and participated in the 6-week intervention, and 10 children served as the inactive comparison group. The Test of Gross Motor Development-3 was administered preintervention and postintervention. In addition, parents of children in the experimental group completed a postintervention survey to assess their perceptions of Project SKIP. Following the intervention, there was a significant improvement in ball skills (p = .023, d = 0.86) for children in the experimental group, whereas the comparison group did not show significant improvement. Moreover, parents perceived Project SKIP to be feasible and effective; all parents reported being satisfied with their overall experience in the program, and 11 parents indicated that their child's fundamental motor skills were positively influenced by the intervention. Engagement was high, with the majority of parents (n = 8, 57%) interacting with Project SKIP content three to four times a week.

Twenty-Four-Hour Movement Guidelines and Body Weight in Youth.

OBJECTIVE: To examine the prevalence of youth meeting the 24-hour healthy movement guidelines (ie, ≥60 minutes of moderate-to-vigorous physical activity, ≤2 hours of screen time, age-appropriate sleep duration), and which combination of meeting these guidelines was most associated with bodyweight status, in a nationally representative US sample. STUDY DESIGN: Cross-sectional data from the 2016-2017 National Survey of Children's Health were used. A multinomial regression model of body weight status was generated (underweight, overweight, obese vs healthy weight) and then stratified by sex. Analyses were adjusted for potential confounders. RESULTS: The sample (n = 30 478) was 50.4% female, 52.4% white, and the mean age was 13.85 ± 2.28 years; 15% percent were obese and 15.2% were overweight. Overall, 9.4% met all 3 of the 24-hour healthy movement guidelines, 43.6% met 2, 37.9% met 1, and 9.1% met none. Meeting zero guidelines (vs 3) was associated with the greatest likelihood of overweight (aOR, 1.85; 95% CI, 1.31-2.61), and obesity (aOR, 4.25; 95% CI, 2.87-6.31). Females (aOR, 4.97; 95% CI, 2.59-9.53) had higher odds of obesity than males (aOR, 3.99; 95% CI, 2.49-6.40) when zero (vs 3) guidelines were met. Meeting the moderate-to-vigorous physical activity guideline, either alone or in combination with screen time or sleep duration (vs all 3), was associated with the lowest odds for overweight and obesity in the full sample. CONCLUSION: Meeting all movement guidelines was associated with the lowest risk for obesity, particularly in females. Meeting the moderate-to-vigorous physical activity guideline may be a priority to prevent overweight and obesity in youth.

Extracurricular Activities and Bullying Among Children and Adolescents with Disabilities.

OBJECTIVES: The purpose of this study was to examine the relationship between participation in extracurricular activities and bullying perpetration and victimization among children and adolescents with disabilities. METHODS: A nationally representative sample of 1906 children with and 15,901 children without disabilities and 1782 adolescents with and 15,885 adolescents without disabilities from the 2016 National Survey of Children's Health was utilized. Parent-reported responses pertaining to bullying perpetration and victimization and extracurricular engagement were analyzed. Separate multilevel logistic regression analyses were conducted for children and adolescents, and separate analyses were conducted with a full sample of children as well as with a subset of children with disabilities. RESULTS: A nationally representative sample of 1906 children with and 15,901 children without disabilities and 1782 adolescents with and 15,885 adolescents without disabilities from the 2016 National Survey of Children's Health was utilized. Parent-reported responses pertaining to bullying perpetration and victimization and extracurricular engagement were analyzed. Results indicated that extracurricular engagement can reduce the likelihood of experiencing bullying victimization among adolescences with disabilities. However, extracurricular engagement was not associated with lower odds of bullying perpetration. CONCLUSIONS FOR PRACTICE: These findings contribute to our understanding of the role extracurricular engagement can play in bullying behaviors among youth with disabilities. Similar to children without disabilities, it appears that engagement in extracurricular activities is significantly associated with lower odds of experiencing bullying victimization among those with disabilities. Conversely, the positive effects of extracurricular involvement on bullying perpetration risk was not evident in this current study.

Proportions of youth with visual impairments meeting 24-hr movement guidelines.

BACKGROUND: Recent movement behaviour guidelines prescribe the optimal time spent in physical activity, screen time, and sleep across a 24-hr period. The proportion of youth with visual impairments meeting 0, 1, 2, or all 3 of these 24 movement guidelines is unknown. The primary purpose of this observational, cross-sectional analysis was to examine the proportions of youth with visual impairments in the United States who partially or fully meet the physical activity, screen time, and sleep duration guidelines. A secondary purpose of this analysis was to examine whether demographic variables were associated with the odds of youth with visual impairments meeting these guidelines. METHODS: This study included 561 youth with visual impairments from the 2016 to 2017 National Survey of Children's Health (NSCH). Accounting for the NSCH sampling plan, Complex Samples was used to estimate the prevalence of meeting 24-hr movement guidelines, and a multinomial logistic regression analysis was conducted to examine the odds ratio of guidelines met across different demographic factors. RESULTS: Of the participants in this study, 18.7%, 50.7%, and 73.2% met physical activity, sleep, and screen time guidelines, respectively. Just 5.8% of the sample met all three of the 24-hr movement guidelines, whereas 10.6% did not meet any of the three guidelines. CONCLUSIONS: The proportion of the sample meeting of all three guidelines was low, thus depriving the majority of this population of the physiological and psychological health benefits of meeting each guideline. Moreover, the study identifies physical inactivity as a key risk factor that requires attention in this population.

Weight management interventions for youth with autism spectrum disorder: a systematic review.

BACKGROUND AND OBJECTIVE: In response to the elevated levels of overweight and obesity among children with autism spectrum disorder (ASD), this article provides a systematic review of the extant empirical literature reporting the effect of weight management interventions (including exercise, diet, and medication) for youth with ASD. DESIGN: A systematic review of published studies. The databases CINAHL, Web of Science, ERIC, Pubmed, and PsychINFO were searched, revealing 12 studies that were eligible for review. RESULTS: Of the included studies, half (n = 6) demonstrated significant weight loss; including comprehensive (n = 3), pharmaceutical (n = 2), and exercise (n = 1) interventions. Of relevance, and concern, was that only one of the included studies was determined to be of strong research quality, with the majority (n = 8) determined as being of weak study quality. Furthermore, studies included highly heterogeneous treatment approaches, study designs, and sample characteristics. CONCLUSIONS: This review demonstrates the potential of interventions (particularly individualized, comprehensive, and multidisciplinary team- based interventions) to effectively impact on weight among youth with ASD. It is imperative to rigorously test these interventions in individuals with ASD given the rates of obesity in this population and complications that ensue.

Prevalence of Meeting Physical Activity, Screen-Time, and Sleep Guidelines Among Children and Adolescents With and Without Visual Impairments in the United States.

The purpose of this study was to compare the degree to which children and adolescents with and without visual impairments (VIs) met national physical activity, screen-time, and sleep guidelines. This observational, cross-sectional analysis of the 2016 National Survey of Children's Health focused on children (age 6-12 yr) and adolescents (age 13-17 yr) with and without VIs. The sample included 241 (weighted n = 472,127) and 17,610 (weighted n = 28,249,833) children, and 255 (weighted n = 505,401) and 17,417 (weighted n = 20,071,557) adolescents with and without VIs, respectively. Chi-square statistics were computed to examine the degree to which participants with and without VIs met health-behavior guidelines. Children (p = .02) with VIs were less likely to meet screen-time guidelines, but adolescents with VIs were not (p = .87). VI status was not associated with the likelihood of meeting physical activity or sleep guidelines (p < .05). Low numbers of children and adolescents with and without VIs meeting health-behavior guidelines warrant targeted interventions aimed at enhancing engagement.

Circulating Progenitor Cells Identify Peripheral Arterial Disease in Patients With Coronary Artery Disease.

RATIONALE: Peripheral arterial disease (PAD) is a clinical manifestation of extracoronary atherosclerosis. Despite sharing the same risk factors, only 20% to 30% of patients with coronary artery disease (CAD) develop PAD. Decline in the number of bone marrow-derived circulating progenitor cells (PCs) is thought to contribute to the pathogenesis of atherosclerosis. Whether specific changes in PCs differentiate patients with both PAD and CAD from those with CAD alone is unknown. OBJECTIVE: Determine whether differences exist in PCs counts of CAD patients with and without known PAD. METHODS AND RESULTS: 1497 patients (mean age: 65 years; 62% men) with known CAD were identified in the Emory Cardiovascular Biobank. Presence of PAD (n=308) was determined by history, review of medical records, or imaging and was classified as carotid (53%), lower extremity (41%), upper extremity (3%), and aortic disease (33%). Circulating PCs were enumerated by flow cytometry. Patients with CAD and PAD had significantly lower PC counts compared with those with only CAD. In multivariable analysis, a 50% decrease in cluster of differentiation 34 (CD34+) or CD34+/vascular endothelial growth factor receptor-2 (VEGFR2+) counts was associated with a 31% (P=0.032) and 183% (P=0.002) increase in the odds of having PAD, respectively. CD34+ and CD34+/VEGFR2+ counts significantly improved risk prediction metrics for prevalent PAD. Low CD34+/VEGFR2+ counts were associated with a 1.40-fold (95% confidence interval, 1.03-1.91) and a 1.64-fold (95% confidence interval, 1.07-2.50) increases in the risk of mortality and PAD-related events, respectively. CONCLUSIONS: PAD is associated with low CD34+ and CD34+/VEGFR2+ PC counts. Whether low PC counts are useful in screening for PAD needs to be investigated.

'He who helps the guilty, shares the crime'? INGOs, moral narcissism and complicity in wrongdoing.

Humanitarian organisations often work alongside those responsible for serious wrongdoing. In these circumstances, accusations of moral complicity are sometimes levelled at decision makers. These accusations can carry a strong if unfocused moral charge and are frequently the source of significant moral unease. In this paper, we explore the meaning and usefulness of complicity and its relation to moral accountability. We also examine the impact of concerns about complicity on the motivation of humanitarian staff and the risk that complicity may lead to a retreat into moral narcissism. Moral narcissism is the possibility that where humanitarian actors inadvertently become implicated in wrongdoing, they may focus more on their image as self-consciously good actors than on the interests of potential beneficiaries. Moral narcissism can be triggered where accusations of complicity are made and can slew decision making. We look at three interventions by Médecins Sans Frontières that gave rise to questions of complicity. We question its decision-guiding usefulness. Drawing on recent thought, we suggest that complicity can helpfully draw attention to the presence of moral conflict and to the way International Non-Governmental Organisations (INGOs) can be drawn into unintentional wrongdoing. We acknowledge the moral challenge that complicity presents to humanitarian staff but argue that complicity does not help INGOs make tough decisions in morally compromising situations as to whether they should continue with an intervention or pull out.

Taming a tiger in the city: comparison of motorized backpack applications and source reduction against the Asian tiger mosquito, Aedes albopictus.

We evaluated 2 strategies to manage Aedes albopictus: 1) motorized backpack applications and 2) source reduction (coupled with hand-applied applications of larvicide). Backpack applications used a water-dispersible granular formulation (VectoBac WDG) of Bacillus thuringiensis var. israelensis (Bti), whereas source reduction used granular formulations of the insect growth regulator methoprene (Altosid) combined with a monomolecular film surfactant (Agnique). Six subplots (total 8.02 ha) were selected for backpack applications, source reduction, and control groups. The experiments were blind with applications conducted randomly and independently. Efficacy was determined through placement of bioassay cups with larvae within experimental plots 1 day before treatment. Backpack applications resulted in 76% (+/- 8.2% SE) and source reduction resulted in 92% (+/- 4.1% SE) larval mortality. Backpack applications required 50 times less labor than source reduction (0.25 versus 0.005 ha/h). The cost of backpack applications, including labor, was $159.88/ha, compared with $659.65/ha for source reduction. Although overall efficacy was slightly lower, motorized backpack applications of Bti were more efficient and cost-effective than source reduction methods to control Ae. albopictus in urban settings at the community level.

The Critical Photographic Variables Contributing to Skull-Face Superimposition Methods to Assist Forensic Identification of Skeletons: A Review.

When an unidentified skeleton is discovered, a video superimposition (VS) of the skull and a facial photograph may be undertaken to assist identification. In the first instance, the method is fundamentally a photographic one, requiring the overlay of two 2D photographic images at transparency for comparison. Presently, mathematical and anatomical techniques used to compare skull/face anatomy dominate superimposition discussions, however, little attention has been paid to the equally fundamental photographic prerequisites that underpin these methods. This predisposes error, as the optical parameters of the two comparison photographs are (presently) rarely matched prior to, or for, comparison. In this paper, we: (1) review the basic but critical photographic prerequisites that apply to VS; (2) propose a replacement for the current anatomy-centric searches for the correct 'skull pose' with a photographic-centric camera vantage point search; and (3) demarcate superimposition as a clear two-stage phased procedure that depends first on photographic parameter matching, as a prerequisite to undertaking any anatomical comparison(s).