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Purpose: To determine whether perceived changes (i.e. perception of engagement during the pandemic relative to pre-pandemic) in specific health behaviors differ by weight status (i.e. healthy weight, overweight, obese). Design: Cross-sectional. Recruitment took place between June-August 2020, via social media posts and Qualtrics online panels. Setting: Participants completed the survey online through the Qualtrics platform. Sample: Analyses included N = 502 participants (≥18 years); 45.2% healthy weight (n = 227), 28.5% overweight (n = 143), and 26.3% obese (n = 132). Measures: Study-specific survey items included questions about demographics and perceived changes in health behaviors. Analysis: Logistic regression models, adjusted for age, race, ethnicity, gender, education, and COVID-19 diagnosis, assessed the odds of perceiving changes in health behaviors considered a risk for weight gain. Results: Participants with obesity, but not overweight, were significantly more likely to report deleterious changes to health behaviors compared to healthy weight peers, including: (1) decreased fruit/vegetable consumption [adjusted odds ratio (AOR) = 1.92; 95% confidence interval (CI): (1.13, 3.26)]; (2) increased processed food consumption [AOR = 1.85; 95%CI: (1.15, 3.00)]; (3) increased caloric intake [AOR = 1.66; 95% CI: (1.06, 2.61)]; (4) decreased physical activity [AOR = 2.07; 95%CI: (1.31, 3.28)]; and (5) deterioration in sleep quality [AOR = 2.07; 95%CI: (1.32, 3.25)]. Conclusion: Our findings suggest that adults with obesity may be at greater risk for unhealthy behaviors during a period of prolonged social distancing, potentially exacerbating the obesity epidemic. © The Author(s) 2021.

Context: The Athletic Training Locations and Services (ATLAS) Annual Report suggested that athletic trainer (AT) employment status differed based on geographic locale. However, the influence of geographic locale and school size on AT employment is unknown. Objective: To determine if differences existed in the odds of having AT services by locale for public and private schools and by student enrollment for public schools. Design: Cross-sectional study. Setting: Public and private secondary schools with athletics programs. Patients or Other Participants: Data from 20 078 US public and private secondary schools were obtained. Main Outcome Measures(s): Data were collected by the ATLAS Project. Athletic trainer employment status, locale (city, suburban, town, or rural) for public and private schools, and school size category (large, moderate, medium, or small) only for public schools were obtained. The employment status of ATs was examined for each category using odds ratios. Logistic regression analysis produced a prediction model. Results: Of the 19 918 public and private schools with available AT employment status and locale, suburban schools had the highest access to AT services (80.1%) with increased odds compared with rural schools (odds ratio = 3.55 [95% CI = 3.28, 3.85]). Of 15 850 public schools with known AT employment status and student enrollment, large schools had the highest rate of AT services (92.1%) with nearly 18.5 times greater odds (odds ratio = 18.49 [95% CI = 16.20, 21.08]) versus small schools. The logistic model demonstrated that the odds of access to an AT increased by 2.883 times as the school size went up by 1 category. Conclusions: Nationally, suburban schools and large public schools had the greatest access to AT services compared with schools that were in more remote areas and with lower student enrollment. These findings elucidate the geographic locales and student enrollment levels with the highest prevalence of AT services. Ó by the National Athletic Trainers’ Association, Inc

Objective: Even healthy college students are vulnerable to severe complications associated with seasonal influenza (flu). Despite national directives to increase influenza vaccination compliance, college campuses remain woefully below national goals. This study aimed to identify factors correlated with the decision to voluntarily receive an influenza vaccine. Additionally, students’ reasons for non-vaccination were also examined. Participants: 1021 undergraduate students across four professional schools. Methods: A representative cross-sectional survey was conducted at a public, urban university. Results: The survey measured self-reported influenza vaccination: an overall influenza vaccination rate of 38% was identified. Student characteristics associated with increased influenza vaccination included students’ enrollment in academic health disciplines; being female; human papillomavirus (HPV) vaccination; and no marijuana use in the last month. Barriers to influenza vaccination included contraindications, mistrust issues, and personal reasons. Conclusion: Universities that can identify facilitators and barriers to voluntary influenza vaccination can assist with program initiatives to improve influenza vaccination compliance rates. © 2021 Taylor & Francis Group, LLC.

Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.’s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

The periodized resistance-training model has not been well documented in the literature. Further research is needed to determine if periodized resistance training in conjunction with creatine supplementation can cause changes in strength, performance, total body weight, girth, and lean muscle mass. Therefore, the purpose of this investigation was to determine the effects of periodized resistance training in conjunction with low-dose (LD) and high-dose (HD) creatine supplementation on strength, body composition, and anaerobic muscular endurance. Subjects were divided into 3 groups: LD, HD, and placebo (P). Testing took place pre-, mid-, and postsupplementation for the following: weight, body composition (fat-free mass and fat mass), 1 repetition maximum squat, and anaerobic muscular endurance testing. Results revealed no significant differences in either creatine group when compared with the P group. However, significant differences were noted over time. These data suggest that 10 weeks of periodized resistance training was effective for causing changes in strength, body composition, and anaerobic muscular endurance.

The purpose of this study was to determine the effect of supramaximal sprint interval training (SIT), body weight reduction, and a combination of both treatments on peak and average anaerobic power to weight ratio (PPOan:Wt, APOan:Wt) by manipulating peak and average anaerobic power output (PPOan, APOan) and body weight (BW) in experienced cyclists. Participants (N = 34, age = 38.0 +/- 7.1 years) were assigned to 4 groups for a 10-week study. One group performed twice-weekly SIT sessions on a cycle ergometer while maintaining body weight (SIT). A second group did not perform SIT but intentionally reduced body weight (WR). A third group simultaneously performed SIT sessions and reduced body weight (SIT+WR). A control group cycled in their normal routine and maintained body weight (CON). The 30-second Wingate Test assessed pretest and posttest POan:Wt scores. There was a significant mean increase (p < 0.05) from pretest to posttest in PPOan:Wt and APOan:Wt (W x kg(-1)) scores in both SIT (10.82 +/- 1.71 to 11.92 +/- 1.77 and 8.05 +/- 0.64 to 8.77 +/- 0.64, respectively) and WR (10.33 +/- 2.91 to 11.29 +/- 2.80 and 7.04 +/- 1.45 to 7.62 +/- 1.24, respectively). PPOan and APOan (W) increased significantly only in SIT (753.7 +/- 121.0 to 834.3 +/- 150.1 and 561.3 +/- 62.5 to 612.7 +/- 69.0, respectively). Body weight (kg) decreased significantly in WR and SIT + WR (80.3 +/- 13.7 to 75.3 +/- 11.9 and 78.9 +/- 10.8 to 73.4 +/- 10.8, respectively). The results demonstrate that cyclists can use SIT sessions and body weight reduction as singular training interventions to effect significant increases in anaerobic power to weight ratio, which has been correlated to enhanced aerobic cycling performance. However, the treatments were not effective as combined interventions, as there was no significant change in either PPOan:Wt or APOan:Wt in SIT + WR.

OBJECTIVE: Describe a multilevel model of decontamination capacity for hospitals., DESIGN: Descriptive model., SETTING: Acute care hospitals with decontamination responsibilities., PATIENTS, PARTICIPANTS: None., INTERVENTIONS: None., MAIN OUTCOME MEASURE(S): None., RESULTS: This multilevel model of defining decontamination capacity would allow more realistic assessment of current capacity, allow for fluctuating service levels depending on time of day, incorporate realistic ramp-up and ramp-down of decontamination services, allow for a defined fall-back decontamination model should decontamination processes fail, allow hospitals to define long-term decontamination service level goals, and allow better understanding of when and why to focus on low-risk/low-resource patients rather than high-risk/high-resource patients., CONCLUSIONS: This multiple-level model would allow for more realistic and effective hospital-based decontamination service models and should become part of the national decontamination paradigm.

A cross-sector collaboration among a community-based organization, a prison arts program, and state departments of Public Health, Education, and Correction was established to address critical health education prevention efforts for at-risk high school-aged youth. The Tell Me What You See initiative utilizes artwork and poetry created by incarcerated youth to promote sexually transmitted disease (STD), HIV, and hepatitis prevention with students in public high schools and juvenile justice facilities. This innovative intervention integrates functional health knowledge and skills-based education through an art-based interdisciplinary approach reaching various populations of youth in multiple settings across a state. Evaluation results indicated that the materials effectively engage youth and open up a critical dialogue among peers and adults by addressing the role personal behavior can have in the prevention of STDs, hepatitis, and HIV. Lessons learned and recommendations are provided., (C)2021Sage Publications

Background: Adolescents with obesity are less likely to flourish and be academically engaged in comparison to their healthy weight peers. However, it is unknown how participation in physical activity influences flourishing and academic engagement in adolescents with obesity. The current study examined engagement in varying levels of physical activity and the likelihood of flourishing and academic engagement in adolescents with obesity. Methods: Analyses included 26 764 adolescents, ages 10–17 years, from the parent-reported, combined 2016–2017 National Survey of Children's Health. Participants were grouped by physical activity levels (none, low, moderate, daily). Outcome variables included flourishing (finishing tasks, staying calm when faced with a challenge and showing interest in new things) and academic engagement (completing all required homework and caring about doing well in school). Logistic regression models, adjusted for age, sex, race, household income, highest level of education in the household, behavioural conduct problems and depression assessed the likelihood of each outcome comparing physical activity levels among adolescents with obesity. Results: Adolescents with obesity who participated in any amount of physical activity (low, moderate and daily) or sports had significantly greater likelihood of flourishing and academic engagement compared those that did not engage in any physical activity (p's ¡ 0.05). Conclusions: Participation in even low amounts of physical activity or participation in sports increases the likelihood of flourishing and academic engagement in adolescents with obesity, which expands on previous findings that adolescents with obesity are less likely to flourish and be academically engaged in comparison to their healthy weight peers. © 2021 World Obesity Federation

Purpose: This study examined effects of fat-free chocolate milk (MILK) consumption on kinetic and cellular markers of protein turnover, muscle glycogen, and performance during recovery from endurance exercise. Methods: Male runners participated in two trials separated by 1 wk and consumed either MILK or a nonnitrogenous isocaloric carbohydrate (CHO) control beverage (CON) after a 45-min run at 65% of V̇O 2peak. Postexercise muscle protein fractional synthetic rate (FSR) and whole-body protein turnover were determined during 3 h of recovery using muscle biopsies and primed constant infusions of L-[ring-H5]phenylalanine and L-[1-C]leucine, respectively. Phosphorylation of translational signaling proteins and activity of proteolytic molecules were determined using Western blotting and enzymatic activity assays. Muscle glycogen was quantified, and treadmill time to exhaustion was determined after the recovery period. Results: Consuming MILK after exercise resulted in higher mixed muscle FSR with lower whole-body proteolysis and synthesis compared with CON (P ≤ 0.05). Phosphorylation of eIF4E-BP1 and FOXO3a was higher for MILK (P &lt; 0.01), whereas Akt phosphorylation was lower during recovery regardless of dietary treatment (P &lt; 0.05). Enzymatic activity assays indicated lower caspase-3 activity during recovery for MILK (P &lt; 0.01) and higher 26S proteasome activity for CON (P &lt; 0.01). Muscle glycogen was not affected by either dietary treatment; however, time to exhaustion was greater for MILK than for CON (P &lt; 0.05). Conclusions: The effects of consumption of MILK after endurance exercise on FSR, signaling molecules of skeletal muscle protein turnover, leucine kinetics, and performance measures suggest unique benefits of milk compared with a CHO-only beverage. © 2012 by the American College of Sports Medicine.

The primary purpose of this study was to determine if a difference existed between peak speed attained when performing a sprint with maximal acceleration versus from a gradual build-up. Additionally, this investigation sought to compare the actual peak speed achieved when instructed to reach 75% and 90% of maximum speed. Field sport athletes (n = 21) performed sprints over 60 m under the experimental conditions, and the peak speed was assessed with a radar gun. The gradual build-up to maximum speed (8.30 +/- 0.40 m.s-1) produced the greater peak speed (effect size = 0.3, small) than the maximum acceleration run (8.18 +/- 0.40 m.s-1), and the majority of participants (62%) followed this pattern. For the sub-maximum runs, the actual mean percentage of maximum speed reached was 78 +/- 6% for the 75% prescribed run and 89 +/- 5% for the 90% prescription. The errors in attaining the prescribed peak speeds were large (~15%) for certain individuals, especially for the 75% trial. Sprint training for maximum speed should be performed with a gradual build-up of speed rather than a maximum acceleration. For sub-maximum interval training, the ability to attain the prescribed target peak speed can be challenging for field sport athletes, and therefore where possible, feedback on peak speeds reached should be provided after each repetition.

Screening for social determinants of health allows health care teams to assess and address social factors that influence one's health, mental health, and access to care. These social factors include poverty, health literacy, social support, exposure to trauma, food insecurity, and housing instability. The objective of this study was to examine what screening tools for social determinants of health are being used, in what contexts, and with what populations. Findings suggest that health literacy is the most commonly screened for, followed by trauma history, social support, food insecurity and housing across diverse contexts and populations. Results from this study can be used to inform providers of available screening tools and resources that can be readily utilized in practice.