Physical activity in primary and secondary prevention of cardiovascular disease:Overview updated

Although the observed progress in the cardiovascular disease treatment, the incidence of new and recurrent coronary artery disease remains elevated and constitutes the leading cause of death in the developed countries. Three-quarters of deaths due to cardiovascular diseases could be prevented with adequate changes in lifestyle, including increased daily physical activity. New evidence confirms that there is an inverse dose-response relationship between physical activity and cardiovascular disease and mortality risk. However, participation in moderate to vigorous physical activity may not fully attenuate the independent effect of sedentary activities on increased risk for cardiovascular diseases. Physical activity also plays an important role in secondary prevention of cardiovascular diseases by reducing the impact of the disease, slowing its progress and preventing recurrence. Nonetheless, most of eligible cardiovascular patients still do not benefit from secondary prevention/cardiac rehabilitation programs. The present review draws attention to the importance of physical activity in the primary and secondary prevention of cardiovascular diseases. It also addresses the mechanisms by which physical activity and regular exercise can improve cardiovascular health and reduce the burden of the disease.

Physically active primary care physicians consult more on physical activity and exercise for patients: A public teaching-hospital study

Physical activity and exercise(PAE)improve quality of life and reduce the effects of chronic diseases.Primary care physicians(PCPs)play an important role to encourage PAE in patients.We aim to assess PCPs'current PAE consultation practices and their enablers/barriers in daily clinical practice.We had 64 PCPs(age[35.3±4.7]y,47 women)that completed self-administered questionnaires on PAE consultation practices,training,and confidence levels.PCPs(n=42)also completed the International Physical Activity Questionnaire-Short Form to assess their physical activity(PA)levels.We conducted correlation,one-way analysis of variance and a linear regression to assess the associations between enablers,barriers and PA levels to PAE consultation practices.On average,PCPs consulted on PAE in 49.7%of their daily clinical appointments.Majority of PCPs(70%)strongly agreed that more PAE knowledge were needed to increase consultation practices.Top three barriers related(p<0.001)to practices were lack of PAE education(r=0.47),patients’preference of pharmaceutical interventions(r=0.45)and lack of continuing education in PAE for PCPs(r=0.37).Physically active PCPs(health-enhancing PA levels,n=6)gave significantly more daily consultations in PAE,73.2%±21.9%,compared to inactive PCPs(n=13),37.4%22.8%(p=0.013).In our regression output,PCPs who had higher PA levels consulted more on PAE daily(R^(2)=0.38,p<0.001)while controlling for age.Conclusion,PCPs require more knowledge on PAE and need be physically active themselves to increase PAE consultation for patients in their daily practice.Medical education should consider including more PA and exercise topics that may benefit both physicians and their patients.

Antenatal physical activity counseling among healthcare providers

Objective: Pregnant women often report a lack of knowledge concerning the safety of exercising during pregnancy. Healthcare providers play an integral role in providing pregnant women with the necessary knowledge to promote antenatal physical activity. Thus, the objective of this study was to assess healthcare providers’ beliefs, attitudes, knowledge and practices related to antenatal physical activity counseling. Study Design: 188 Providers (i.e. obstetricians, midwives, and family medicine physicians) completed a 39 closed-item survey. Characteristics among healthcare providers’ physical activity counseling practices as well as belief, attitudes and knowledge were explored. Results: The majority of all providers agreed that physical activity during pregnancy will result in numerous improved health outcomes for mother and baby. Approximately half of the providers (48%, n = 89) were not familiar with the current national guides recommending that women free of obstetric complications should engage in at least 150 minutes of exercise per week. Only 43% of providers believed their patients followed the advice they are given about physical activity. Over half of the providers reported that they provide in-office physical activity counseling, and FMs provide individualized counseling less often than OBs and CNMs (i.e. 33%, 60%, and 65%, respectively;p = 0.0014). Importantly, 17% (n = 31) of providers reported that they never received professional training in antenatal physical activity counseling and of those that did receive training, 69% (n = 107) claimed their training was “fair” or “poor”. Conclusion: Findings from the pre- sent study demonstrate a need for further continuing education opportunities on the current national guide- lines on antenatal physical activity.

瑞典体医融合服务模式经验及启示

运用文献资料,逻辑分析等方法,阐述瑞典体医融合服务模式概况、经验,并提出对我国的启示。从形成动因、指导思想、流程内容三方面阐述了瑞典体医融合服务模式概况。经验:国家战略推动,提供方向指导;多方共同参与,倡导资源整合;基于循证实践,提供循证建议;以个人为中心,重视社区基础。启示:强化支撑体系,健全制度保障;强调循证依据,落实运动处方;夯实社区基础,提升健康服务;强调随访追踪,完善持续监督。

医改再出发背景下“体+医+养”融合服务模式探索——以三明市为例

运用SWOT分析法,从“体+医+养”服务资源配置的价值导向、现实条件和机制创新三个维度,深入分析三明市探索实施“体育+医疗+康养”公共服务模式的优势、劣势、机遇和挑战。在此基础上,对“体+医+养”融合服务资源配置、部门利益平衡等问题进行了阐释和分析,找出三明市“体医养融合”关键影响因素,取长补短,协作发挥各自优势,为居民提供一种集锻炼、医疗、康养为一体综合健康服务模式。

英国运动转介计划的发展经验对我国体医融合的启示

梳理英国运动转介计划的发展经验,旨在为我国体医融合提升身体活动水平、促进健康从宏观远景细化为具体行动策略提供方法借鉴。英国运动转介计划的形成是一个不断探寻优化的过程,改变生活方式是英国运动转介计划形成的主要原因。英国运动转介计划在患者筛选、转介流程、计划设计等方面建立了完善的指导体系,并从参与主体、人员责任、准入及培训、效果评估等方面提供了保障机制。当下我国体医融合推动存在参与主体不全、资源整合不够、从业人员责任不明晰、准入及培训机制不健全、效果评估缺失等问题。英国运动转介计划对于我国的启示是:厘清相关参与人员在体医融合过程中的责任,建立健全准入和培训机制,完善评估体系,制定体医融合干预后的后续措施,搭建数据信息共享平台。

生命关怀视域下青少年身体素养教育需求及路径分析

生命关怀是教育促进学生全面发展的必由之路,身体素养是教育落实生命关怀的基础和途径。通过文献资料调研、逻辑分析方法,从生命关怀的角度出发,对身体素养落实生命关怀的可行性进行探究发现,其身心一体的理论基础是生命关怀的哲学原理,健康第一的指导思想是生命关怀的根本任务,具身性的身体实践是感知生命关怀的途径,生态和谐的活动目的是生命关怀的价值取向。但由于功利教育下的重智轻体,技术主义下的身体静态规训,过度量化的体育追求和社会环境的改变等因素的影响,导致了学生身体主体的离场,身体活动缺乏,身体素养教育亟待落实。基于此,研究建构了青少年身体素养的培养路径:以体育教育为核心,坚持生成性教育思维和以人为本的教育原则,开齐开足体育课,保证学生的身体主体在场活动,注重教师、学生与环境间的多重交流互动,将运动嵌入身体,将身体嵌入环境,促进学生的身心发展,并将身体活动拓展到生活世界中,推动学生社会适应能力的提升和精神意识的塑造,保障学生的生命完整和全面发展,实现生命的和谐相处。

体力活动纳入生命体征与运动转介制度:国外经验与中国路径

对国外体力活动纳入生命体征和运动转介这两项体卫融合的实务操作制度进行综合分析,并探讨二者在“Exercise Is Medicine”解决方案中的具体应用,为我国体卫融合的行动策略与实施路径提供借鉴。结果显示:将体力活动纳入生命体征并确定简捷有效的测评工具,推动在卫生保健和临床诊疗工作中常规进行体力活动的评估,可实现“融体于卫”;为了使运动处方/建议得以实施,卫生保健/医疗工作者将有锻炼需求者转介到经专门资质认证的社区体育锻炼资源中,从而做到“联卫于体”。通过上述关键环节形成体卫融合从启动到落实的完整闭环。建议:我国应基于运动促进健康理念,设计制订体卫融合的完整实施路线;在体力活动评估和运动转介制度这两项关键环节注重操作性与资源建设;在卫生健康领域拓展运动健康促进的覆盖范围。

体智融合课程:基本原理、域外经验与本土启示

体智融合课程是将身体活动与相关学科知识进行整合性学习的一种新型课程。经欧美部分小学实践,已积累了较为丰富并具有指导价值的实践经验。此类课程旨在应对小学生身体活动水平持续降低造成的肥胖及相关健康风险,通过综合活泼的课堂组织形式和多通道并举的学习方法,进一步调动学生的学习兴趣,从而提升教学效率。通过对TAKE 10!®、A+PAAC、TWM-E 3个大型国际体智融合课程项目的实践过程进行回溯,分析其施用原理,总结得失,为我国体育与健康课程中知识类内容的落实、校园环境中学生运动机会的挖掘、校园运动干预方案的推广应用提供可借鉴的经验。

基于PTA量表的物理化学综合实践活动的实施与评价

物理化学作为一门化学理论课程,以抽象和繁杂的知识为主,成为学生学习生涯中的拦路虎.随着课程综合化在时代变迁中日益凸显的重要性,拟将综合实践活动引入物理化学的教学中,采用合作学习来组织教学,以期让学生能够在活动中轻松又高效地学习物理化学知识,并培养自身的综合能力.同时,尝试应用PTA量表法来评定学生在活动过程中的表现,方便教师对学生的学习情况进行科学有效的评价.

体医融合服务模式的国外经验与启示

体医融合是实施健康中国战略的重要举措,体医融合服务模式作为体医融合政策落实到个体的具体实践途径,关系着体医融合实施的具体成效。运用文献资料法、逻辑分析法等归纳美国、德国和日本3个发达国家的体医融合服务模式的主要类型、运行现状以及基本特征并总结成功经验,在此基础上,发现我国体医融合服务模式的发展困境,并提出解决策略。研究得出:我国体医融合服务模式存在顶层设计有待完善,保障政策存在空缺;观念传播有待提高,融合壁垒依存;人才培养有待加强,培养体系存在短板等问题。建议要以优化顶层设计为立足点,保障政策执行力;以强化融合理念为切入点,激发群众主动性;以加强人才培养为基本点,提供服务源动力。

通过基本医疗服务促进身体活动国外研究进展

身体活动不足是当前重大的公共卫生问题。医疗卫生工作者能够接触广大的就诊人群,并通过身体活动的评估,建议人们有效增加身体活动水平。英、美等发达国家和巴西等发展中国家都已经开展了通过基本医疗卫生服务促进国民身体活动的实践。本文综述近期国外对该问题的研究报道,分析上述国家所采取的实施措施和模式,为我国提供借鉴。提出在医疗卫生服务体系中开展身体活动促进、开展常规身体活动的检查和建议、实行锻炼转介制度、加强运动医学发展等措施,有效促进国民身体活动,增进大众体质健康水平,减少疾病负担。