Examining the role of knowledge and trust on vaccine confidence in North Dakota among university students, faculty, and staff.

BACKGROUND: Vaccination is one of the greatest tools for individuals to stay healthy. Individuals are, however, often exposed to misinformation via digital and social media, and thus, may miss the opportunity to develop scientific knowledge about vaccines and trust in relevant stakeholders. This has a damaging impact on vaccine confidence. Understanding vaccine confidence is particularly important in North Dakota, where vaccination rates are lower than national averages. OBJECTIVES: The objectives of this research are to examine the association between vaccine confidence and three potential sources of it, namely, trust, vaccine knowledge, and vaccine information sources and to investigate the relative strength of three vaccine confidence sources, while accounting for covariates. METHODS: Students (n = 517, 56.6%) and staff and faculty (n = 397, 43.4%) at the University of North Dakota (n = 914) completed an online survey. Logistic regressions estimated odds ratios (OR) and 95% confidence intervals (CI) for associations among trust in doctors, family/friends, government health agencies, charitable organizations, and religious organizations, vaccine knowledge, vaccine information sources as well as vaccine confidence, accounting for gender, race, marital status, age, religion, political ideology, education, and health status. RESULTS: The mean age of participants was 29.43 years (SD = 13.48). Most were females (71.6%) and white (91.5%). Great trust in doctors (OR = 3.29, p < 0.001, 95%CI 1.89, 5.73) government health agencies (OR = 2.95, p < 0.001, 95%CI 2.13, 4.08) and vaccine knowledge (OR = 1.28, p < 0.001, 95%CI 1.18, 1.38) had higher odds of vaccine confidence. Using Internet Government source as the primary source of vaccine information (OR = 1.73, p < 0.05, 95%CI 1.22, 2.44) showed higher odds of vaccine confidence before all independent variables were introduced, but it became non-significant after they were introduced. Trust in government health agencies showed strongest associations with vaccine confidence. CONCLUSION: Multiple stakeholders are necessary to ensure verified, accessible, and accurate information in order to advance vaccine confidence in rural, conservative areas.

Comparable Levels of Objectively Measured Physical Activity and Cardiorespiratory Fitness in Firefighters From Two Midwest Fire Departments.

OBJECTIVE: The aim of the study is to objectively assess if firefighters are meeting the National Fire Protection Association (NFPA) cardiorespiratory fitness (CRF) and American College of Sports Medicine/American Heart Association physical activity (PA) guidelines. METHODS: Two independent fire departments from the Midwest participated in the study. Firefighters wore an accelerometer to track PA and associated intensities. In addition, firefighters completed a stage-graded exercise test TO determine their maximal oxygen uptake (V˙O 2max ). RESULTS: A total of 43 career firefighters completed the study (fire department 1 [FD1]: n = 29, FD2: n = 14). Almost half (44.8% FD1 and 42.9% FD2) met the NFPA CRF guidelines. Compared with the American College of Sports Medicine PA Guidelines of 30 min/d of moderate-to-vigorous PA, more than half of FD2 (57.1%) met the recommended amount of PA, whereas FD1 had less than half (48.3%). CONCLUSIONS: These data demonstrate the need to improve firefighters' PA levels, CRF, and overall health.

Customized Occupational-Specific Graded Exercise Test for Structural Firefighters: An Update.

OBJECTIVE: The aim of the study is to validate a customized V˙O 2max Graded Exercise Test (GXT) protocol specifically to accommodate firefighters with different cardiovascular fitness levels. METHODS: Career male firefighters (N = 15) completed 3 customized GXTs on a treadmill: 1 in athletic clothes and 2 in their bunker gear to determine maximal oxygen uptake (V˙O 2max ). RESULTS: The on-duty task protocol was reliable, V˙O 2max values of 40.2 ± 4.6 mL·kg·min -1 and 40.3 ± 5.3 mL·kg·min -1 between trials yielded an interclass correlation of 0.911 with a typical error of 1.48 mL·kg·min -1 and a coefficient of variation of 4.0%. The validity analysis indicated consistent maximal V˙O 2 values for the GXTs yielding mean interclass correlation of 0.94 with typical error of 1.16 mL·kg·min -1 and a coefficient of variation of 2.9%. CONCLUSIONS: The customized GXT for structural firefighters has shown to be a reliable, valid, and applicable method of testing cardiovascular fitness in firefighters.

The glue that keeps everybody together: Peer support in mothers of young children with special health care needs.

BACKGROUND: The first years following diagnosis may be particularly challenging for parents and peer support from other parents of children with special health care needs may buffer their stress. METHODS: This qualitative interview study sought to explore the impact of early access to parental peer support and whether it leads to positive adaptation and improved family well-being. RESULTS: Five mothers of young children with special health care needs from peer support organizations in two northern US states participated in interviews by telephone or Zoom. Themes of interest included professional scrutiny, going through the motions, someone who understands, learning and sharing, and one size does not fit all. Although most participants attributed positive changes in their emotional well-being to the support they received, they were wary of extending the impact of peer support to their child and family. CONCLUSIONS: Implications for practice include embedding peer support programmes in neonatal care units and children's hospitals, as well as the addition of mindfulness practices to facilitate parental adaptation to disability and promote family well-being.

Vitamin D Awareness and Intake in Collegiate Athletes.

ABSTRACT: Leitch, BA, Wilson, PB, Ufholz, KE, Roemmich, JN, Orysiak, J, Walch, TJ, Short, SE, and Fitzgerald, JS. Vitamin D awareness and intake in collegiate athletes. J Strength Cond Res 35(10): 2742-2748, 2021-Poor vitamin D status is a risk factor for negative health and performance outcomes in athletes, but little is known about how athletes' awareness and beliefs about vitamin D affect their consumption of vitamin D. This observational study investigated awareness of vitamin D for health and performance among collegiate athletes and evaluated the association of vitamin D awareness with its dietary intake. Fifty-two female and 29 male Division I collegiate athletes completed an online vitamin D awareness and dietary intake questionnaire between November 1, 2015, and January 30, 2016. Median intake of vitamin D was 330 International Units (IU), which is below the recommended daily allowance (RDA) of 600 IU, but was greater in male athletes (693 IU) than female athletes (263 IU, p < 0.01). The RDA for vitamin D was met by 62% of men and 30% of women. Athletes responded that vitamin D "probably" or "definitely" will play a role in their health (88.9%) and athletic performance (71.6%). However, only 23.4 and 28.4% of athletes reported concern for their vitamin D levels or believed that they were at risk for deficiency, respectively. Results showed small-to-moderate, positive correlations (r = 0.28-0.495, p < 0.05) between aspects of vitamin D awareness and vitamin D intake, particularly with supplemental forms of vitamin D. Given the lack of awareness concerning risk of vitamin D deficiency, and the links between aspects of vitamin D awareness and vitamin D intake, nutritional education programs designed to increase vitamin D awareness in athletes may be an effective strategy to reduce deficiency.

Temporal Trends in the Standing Broad Jump Performance of United States Children and Adolescents.

Purpose: To estimate temporal trends in broad jump performance for United States youth, a marker of muscular fitness and health. Method: Electronic databases, topical systematic reviews, and personal libraries were systematically searched for studies reporting descriptive standing broad jump data for apparently healthy United States youth (age 10-17 years). Temporal trends at the sex-age level were estimated using sample-weighted regression models associating the year of testing to mean jump performance, with national trends standardized to the year 1985 using a post-stratified population-weighting procedure. Results: Collectively, there was a small increase of 12.6 cm (95%CI: 12.5 to 12.7) or 7.9% (95%CI: 7.1 to 8.6) in 65,527 United States youth between 1911 and 1990. Increases were greater for girls (change in means [95% CI]: 17.1 cm [16.9 to 17.3]; 11.4% [10.7 to 12.2]) compared to boys (change in means [95% CI]: 8.5 cm [8.3 to 8.7]; 4.6% [3.8 to 5.4]), but did not differ between children (10-12 years) and adolescents (13-17 years). Increases in broad jump performance were not always uniform across time, with steady and progressive increases observed for boys and children, respectively, and a diminishing rate of increase observed for girls and adolescents. Conclusions: Muscular fitness is a good marker of health, so greater broad jump performance from 1911 to 1990 may reflect corresponding changes in health. Routine assessment of broad jump performance may be useful to monitor trends in health and muscular fitness of United States youth due to its practicality, scalability, and predictive utility.

Effects of Exercise Training on Resting Testosterone Concentrations in Insufficiently Active Men: A Systematic Review and Meta-Analysis.

ABSTRACT: Potter, NJ, Tomkinson, GR, Dufner, TJ, Walch, TJ, Roemmich, JN, Wilson, PB, and Fitzgerald, JS. Effects of exercise training on resting testosterone concentrations in insufficiently active men: a systematic review and meta-analysis. J Strength Cond Res 35(12): 3521-3528, 2021-The anabolic hormone testosterone plays a pivotal role in the healthy aging of men and tends to decline with age. The aims of this systematic review and meta-analysis were 2-fold: (a) to evaluate the effect of exercise training on resting total testosterone concentration in insufficiently active, apparently healthy men and (b) to determine whether the effects of exercise training differed by training mode, age, body mass status, or testosterone measure. Electronic databases (MEDLINE, Scopus, CINAHL, and SPORTDiscus) were systematically searched (up to and including October 22, 2020) for peer-reviewed randomized controlled trials (RCTs) meeting the following criteria: population (insufficiently active, apparently healthy men aged ≥18 years), intervention (exercise training [any modality at intensity of ≥4 metabolic equivalents] lasting a minimum of 4 weeks), control (insufficiently active men), and outcome (resting total testosterone concentration). Intervention effects, weighted by the inverse of the pooled variance, were calculated relative to the control group as standardized mean differences (SMDs). Eleven RCTs, representing 421 insufficiently active, apparently healthy men aged 19-75 years across 16 intervention groups who participated in aerobic, resistance, or combined training lasting a median of 12 weeks, were included in the analysis. Overall, exercise training had a negligible effect on resting total testosterone concentration (mean SMD [95% CI]: 0.00 [-0.20 to 0.20]). Subgroup analyses indicated that the effect of exercise training was not significantly affected by training mode, age, body mass status, or testosterone measure. Exercise training does not seem to affect resting total or free testosterone concentration in insufficiently active, eugonadal men.

Firefighters Are More Physically Active On-Duty Compared to Off-Duty.

Physical inactivity, coupled with increasing obesity levels, in firefighters plays a key role in aggregated cardiovascular events. The purpose of this study was to investigate device-measured physical activity (PA) for firefighters while on- and off-duty to have a clearer understanding of their overall PA level. METHODS: Twenty-nine career firefighters participated in this non-experimental, within-subjects study by wearing an accelerometer to assess PA intensities and step-count. Obesity was classified using body mass index (BMI). Dependent t-tests were used to examine mean differences in PA intensities when on- and off-duty. Pearson product-moment correlations were used to assess the association between PA intensities when on and off-duty. RESULTS: According to the World Health Organization BMI categorizations, 20 firefighters were overweight, 9 were obese, and, thus, none were normal weight. Only light PA (LPA) was statistically significant (p = 0.026) for on- and off-duty days with a small-to-medium effect size (d = 0.47), meaning that on average, firefighters performed more minutes of LPA when on-duty compared to off. There was a significant difference between on- (9060.2 ± 2636.4) and off-duty (7495.3 ± 2835.8) daily step counts (p = 0.011). CONCLUSION: As the results demonstrate, there is a dire need for increased PA levels in firefighters while on- and off-duty.

Temporal trends in the sit-ups performance of 9,939,289 children and adolescents between 1964 and 2017.

We estimated international/national temporal trends in sit-ups performance for children and adolescents, and examined relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. Data were obtained by systematically searching studies reporting on temporal trends in sit-ups performance for apparently healthy 9-17 year-olds, and by examining nationally representative fitness datasets. Trends at the country-sex-age level were estimated by sample-weighted regression models relating the testing year to mean sit-ups performance. International/national trends were estimated by a post-stratified population-weighting procedure. Pearson's correlations quantified relationships between national trends in sit-ups performance and national trends in health-related/sociodemographic indicators. A total of 9,939,289 children and adolescents from 31 countries/special administrative regions between 1964 and 2017 collectively showed a large improvement of 38.4% (95% CI: 36.8 to 40.0) or 7.1% per decade (95% CI: 6.8 to 7.4). Large international improvements were experienced by all age and sex groups, with the rate of improvement slowing from 1964 to 2000, stabilizing near zero until 2010, before declining. Trends differed between countries, with national trends in vigorous physical activity a strong, positive correlate of national trends in sit-ups performance. More sit-ups data are needed from low- and middle-income countries to better monitor trends in muscular fitness. PROSPERO REGISTRATION NUMBER: CRD42013003657.

Parent adoption and implementation of obesity prevention practices through building children's asking skills at family child care homes.

BACKGROUND: Early childhood education programs provide a setting to reach children and parents to modify home environments to prevent obesity. The Healthy Opportunities for Physical Activity and Nutrition Home (HOP'N) Home project was a novel approach that linked Family Child Care Homes (FCCH) to home environments by developing children's asking skills for healthful home environmental change through curricular activities. OBJECTIVE: To evaluate the feasibility of engaging parents in obesity prevention practices through building children's asking skills at FCCH. METHODS: FCCHs (n = 5 settings) and children (n = 25; aged 3-5 years; female = 36 %; non-Hispanic white = 91 %; low socioeconomic status = 28 %; overweight/obese = 52 %) and parents (n = 25) participated in a pre-post cohort design. We assessed children's body mass index and self-report variables at three time points. HOP'N Home included continuous staff training, group time, dramatic play, meal prompts, songs, and home activities. RESULTS: FCCH providers implemented 83%-100% of intervention activities. All parents (100 %) adopted the program, most (87 %) returned completed homework activities to FCCHs, and over 90 % implemented changes in the home. Percent of overweight/obese children decreased from pre-intervention (50 %) to post-intervention (29 %,p = 0.06) and follow-up (38 %,p = 0.06). CONCLUSIONS: It is feasible to build children's asking skills and pair this strategy with home activities to engage parents to prevent obesity.

A Systematic Analysis of Temporal Trends in the Handgrip Strength of 2,216,320 Children and Adolescents Between 1967 and 2017.

OBJECTIVE: To estimate national and international temporal trends in handgrip strength for children and adolescents, and to examine relationships between trends in handgrip strength and trends in health-related and sociodemographic indicators. METHODS: Data were obtained through a systematic search of studies reporting temporal trends in the handgrip strength for apparently healthy 9-17-year-olds, and by examining large national fitness datasets. Temporal trends at the country-sex-age level were estimated by sample-weighted regression models relating the year of testing to mean handgrip strength. International and national trends were estimated by a post-stratified population-weighting procedure. Pearson's correlations quantified relationships between national trends in handgrip strength and national trends in health-related/sociodemographic indicators. RESULTS: 2,216,320 children and adolescents from 13 high-, 5 upper-middle-, and 1 low-income countries/special administrative regions between 1967 and 2017 collectively showed a moderate improvement of 19.4% (95% CI 18.4-20.4) or 3.8% per decade (95% CI 3.6-4.0). The international rate of improvement progressively increased over time, with more recent values (post-2000) close to two times larger than those from the 1960s/1970s. Improvements were larger for children (9-12 years) compared to adolescents (13-17 years), and similar for boys and girls. Trends differed between countries, with relationships between national trends in handgrip strength and national trends in health-related/sociodemographic indicators negligible-to-weak and not statistically significant. CONCLUSIONS: There has been a substantial improvement in absolute handgrip strength for children and adolescents since 1967. There is a need for improved international surveillance of handgrip strength, especially in low- and middle-income countries, to more confidently determine true international trends. PROSPERO REGISTRATION NUMBER: CRD42013003657.

Firefighters' Physical Activity and Waist Circumference as Predictors of VO2max.

OBJECTIVE: To examine associations among objectively measured physical activity (PA), body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) in firefighters. METHODS: Career firefighters (n = 29; male = 100%) wore accelerometers to assess PA. BMI and WC classified obesity. Each participant completed a stage-graded exercise test to determine maximal oxygen uptake ((Equation is included in full-text article.)). RESULTS: Two linear regression models were used to investigate whether PA intensities, step count, BMI, or WC were predictive of "true" (Equation is included in full-text article.). Vigorous physical activity (VPA) was predictive of "true" (Equation is included in full-text article.)(F[1,27] = 7.89, R = 0.23, P < 0.01). Additionally, when BMI and WC were added, only WC was predictive of "true" (Equation is included in full-text article.)(F[1,27] = 11.76, R = 0.30, P < 0.01). CONCLUSION: Fire departments should be cognizent of ways to increase PA levels, decrease excess weight gain, and maintain CRF to adequately perform job-specific tasks.

An Occupational-Specific O2max Protocol for Structural Firefighters.

OBJECTIVE: The aim of this study was to validate a (Equation is included in full-text article.)O2max protocol designed specifically for the occupational demands of firefighters by incorporating the use of personal protective equipment (PPE). METHODS: Career firefighters completed a stage-graded exercise test (GXT) with submaximal square-wave verification bout while wearing PPE (pants and boots) to determine (Equation is included in full-text article.)O2max. Using the self-reported Physical Activity-Rating (PA-R) scale and an estimated nonexercise regression equation of (Equation is included in full-text article.)O2max for comparison to measured. RESULTS: Twenty-eight male, career firefighters performed the GXT and square-wave bout. (Equation is included in full-text article.)O2 values (mean ±â€ŠSD) from the GXT and the square-wave verification bout were 41.04 ±â€Š6.98 and 39.74 ±â€Š6.42 mL/kg/min, respectively (ICC = 0.98, typical error = 0.96 mL/kg/min, CV = 2.4%). CONCLUSION: Our data suggest an incremental treadmill protocol that incorporates PPE and square-wave verification as an occupational-specific tool to measure cardiovascular fitness in firefighters.

The elite young athlete: strategies to ensure physical and emotional health.

This article presents a current review of the risk of physical and psychological injury associated with participation in elite youth sport, and suggests strategies to ensure the physical and emotional health of these young athletes. Although there is lack of epidemiological data, especially with regard to psychological injury, preliminary data suggest that the risk of injury is high in this population. While there is lack of incident and follow-up data, there is also concern regarding burnout, disordered eating, and the long-term consequences of injury. Modifiable injury risk factors identified include postural control, competition anxiety, life events, previous injury, and volume of training. There are presently no studies designed to determine the effectiveness of injury prevention measures in elite youth sports. However, there is adequate evidence arising from injury prevention studies of youth sports participants - including neuromuscular training, protective equipment, mental training to enhance self-esteem, and sport rules modification - to prevent injuries in elite youth sports settings. Although not tested, psychosocial prevention strategies such as adoption of task-oriented coping mechanisms, autonomous support from parents, and a proactive organizational approach also show promise in injury prevention.

Excess Gestational Weight Gain in Low-Income Overweight and Obese Women: A Qualitative Study.

OBJECTIVE: Examine factors implicated in gestational weight gain (GWG) in low-income overweight and obese women. DESIGN: Qualitative study. SETTING: Community-based perinatal center. PARTICIPANTS: Eight focus groups with women (black = 48%, white non-Hispanic = 41%, and Hispanic = 10%) in the first half (n = 12) and last half of pregnancy (n = 10) or postpartum (n = 7), 2 with obstetrician-gynecologists (n = 9). PHENOMENON OF INTEREST: Barriers and facilitators to healthy eating and GWG within different levels of the Social Ecological Model: for example, intrapersonal, interpersonal, and organizational. ANALYSIS: Coding guide was based on the Social Ecological Model. Transcripts were coded by 3 researchers for common themes. Thematic saturation was reached. RESULTS: At an intrapersonal level, knowledge/skills and cravings were the most common barriers. At an interpersonal level, family and friends were most influential. At an organizational level, the Special Supplemental Nutrition Program for Women, Infants, and Children and clinics were influential. At the community level, lack of transportation was most frequently discussed. At a policy level, complex policies and social stigma surrounding the Special Supplemental Nutrition Program for Women, Infants, and Children were barriers. There was consensus that ideal intervention approaches would include peer-facilitated support groups with information from experts. Obstetrician-gynecologists felt uncomfortable counseling patients about GWG because of time constraints, other priorities, and lack of training. CONCLUSIONS AND IMPLICATIONS: There are multilevel public health opportunities to promote healthy GWG. Better communication between nutrition specialists and obstetrician-gynecologists is needed.