Relations of change in fruit and vegetable intake with overall energy reduction and physical activity with weight change:Assessing theory-based psychosocial mediators

Background'.Increased physical activity and fruit and vegetable(FV)intake are typically suggested to counter obesity.Sustained behavior change in those areas has,however,been poor,possibly because of a lack of understanding of the effects of psychosocial factors.Using data from previous research,this study aimed to better define the role of physical activity and FV intake in short;and long-term weight loss via changes in malleable psychosocial mediators and moderators.Methods:Women who were obese(n=183;age=50.0±7.9 years;body mass index=35.2±3.2 kg/m2,mean±SD)and who previously participated in 3 different community-based behavioral weight-loss treatments were assessed over 2 years.Changes in FV intake,physical activity,sei^regulation of physical activity and eating(aggregated),negative mood,and weight were measured over 6 and 24 months.Results'.Changes in each variable over both 6 and 24 months were significant(all p values<0.001).The FV intake to the weight-related caloric intake relationship(β=.0.30,p<0.001)was significantly mediated by selfregulation change over 6 months.The physical activity to weightchange relationship(β=.0.46,p<0.001)was significantly mediated by both sei±regulation and mood change over 24 months.Physical activity,itself,accounted for only 16%of weight-related caloric expenditure differences.Changes in physical activity and FV intake were each independent predictors of weight change over 24 months(overall R2=0.50,p<0.001).Conclusion-.Findings clarified theory-based targets for weight-management treatments and suggested that future weight-loss treatments strongly focus on developing self-regulatory skills to address barriers to behavioral changes.

Health through martial arts training: Physical fitness and reaction time in adolescent Taekwondo practitioners

Taekwondo (TKD) is a popular sport among adolescents, but the potential benefits of TKD training to young individuals are not well understood. The objectives of this cross-sectional exploratory study were to compare flexibility, muscular endurance, body composition, and simple reaction time between TKD-trained adolescents and controls. Twenty TKD-trained adolescents aged between 10 and 14 and 20 age-matched healthy controls were asked to perform five physical fitness tests: a sit-and-reach test, leg split test, skinfold measurement, one-minute curl-up test, and ruler-drop reaction time test. The results revealed no significance differences between the two groups in sit-and-reach distance (p = 0.690), leg split angle (p = 0.789), percentage of body fat (p = 0.342), or number of repetitions in the one-minute curl-up test (p = 0.250). However, the TKD group had significantly faster reaction times in the rulerdrop test than the control group (p = 0.005). The results thus suggest that although TKD training may improve reaction times in adolescents, it may have little effect on flexibility, muscular endurance, and body composition (percentage of fat). TKD may be a suitable exercise for improving simple reaction time, but it may not be suitable for improving general physical fitness in adolescents.

Chinese-translated Behavioral Regulation in Exercise Questionnaire-2： Evidence from university students in the Mainland and Hong Kong of China

Purpose： The purpose of the study was to examine the psychometric properties of the Chinese-translated Behavioral Regulation in Exercise Questionnaire-2 （C-BREQ-2） among Chinese university students from the Mainland and Hong Kong of China. Methods： University students from the Mainland （n = 191） and Hong Kong （n=194） of China participated in this study. Factorial validity, discriminant validity, nomological validity, internal reliability, and measurement invariance across sample of the C-BREQ-2 were examined. Results： Confirmatory factor analysis provided support for the factorial validity of the 18-item, 5-factor structure C-BREQ-2. Examination of the 95% confidence interval of the inter-factor correlations suggested that the C-BREQ-2 assesses related but distinct constructs, which provided support for its discriminant validity. The internal consistency reliability of the C-BREQ-2 was found acceptable. Examination of the pattern of inter-factor correlations between different regulations suggested that a simplex-like pattern was displayed, which provided evidence for the nomological validity of C-BREQ-2. The results from multi-group confirmatory factor analysis suggested that the factor loadings and variances/ covariances of the C-BREQ-2 measurement model were invariant across the Chinese university students in the Mainland and Hong Kong of China. Conclusion： The current study provided further psychometric evidence for the C-BREQ-2, which makes the further application and research of self-determination theory （SDT） based motivation in relation to exercise and physical activity in the Mainland of China context possible.

Assessing acceptance in mindfulness with direct-worded items:The development and initial validation of the Athlete Mindfulness Questionnaire

Purpose:The purpose of the current study was to develop and validate a sport-specific mindfulness measure,the Athlete Mindfulness Questionnaire(AMQ),through 5 related studies using 4 separate samples of Chinese athletes.The AMQ is a 3-factor measure designed to assess mindfulness that reflects present-moment attention,awareness,and acceptance in a sport context.Methods:In Study 1,an initial pool of items was generated based on previous literature,existing mindfulness scales,as well as interviews with and feedback from the athletes,coaches,and mindfulness experts.Initial support for the 3-factor structure of the AMQ was established via exploratory factor analysis in Study 2,and cross-validated through confirmatory factor analysis in Studies 3 and 4.In Study 5,a modified 3-factor AMQ with direct-worded acceptance items was examined in a fourth independent sample.Results:Convergent and concurrent validities of the acceptance subscale failed to be established in Studies 3 and 4 which may be due to the inattention and confusion of the athletes whilst interpreting the reverse-worded items.A modified 16-item AMQ in Study 5 displayed satisfactory model fit and acceptable internal consistencies.Most importantly,convergent and concurrent validities of the 16-item AMQ were supported.The3 subscales showed significant positive associations with mindfulness,flow,well-being,and positive affect and significant negative associations with experiential avoidance,burnout,and negative affect.Conclusion:The AMQ is a psychometrically sound measure of mindfulness in a sport context.The importance of using direct-worded acceptance items is discussed.

Normative reference of standing long jump indicates gender difference in lower muscular strength of pubertal growth

Background: Although the standing long jump (SLJ) is a popular physical fitness assessment, it lacks an updated criterion-reference standard. This study generated the first normative SLJ test data for Chinese aged 8 - 18. Methods: From September 2005 to December 2011, comprehensive physical fitness assessments were conducted on 12,712 school students. The SLJ performances were significantly different between boys and girls (all age groups, p < 0.01). Results: The boys performed better than the girls in each age group. The mean difference increased as the age increased, depicting a prominent variance in muscular strength between boys and girls at age 12, and the variances became larger at age 18. Girls in the 70th percenttile performed similarly to boys performing in the 10th percentile. The onset of muscle strength for boys found in this study corresponded to the onset age of testosterone maturation of Chinese boys investigated in previous studies. Linear regression found age and BMI predicting SLJ significantly for boys and girls, explaining better SLJ results in older boy and the effect of their heavy body size. Conclusions: This study indicated a muscular strength difference between genders during growth and added supporting evidence to the hormonal influence of muscle growth during puberty.

Effects of resistance training on cardiovascular health in non-obese active adolescents

AIM:To determine the benefits of a 10-wk resistance training programme on cardiovascular health in nonobese and active adolescents.METHODS:This is a pragmatic randomised controlled intervention.The study was carried out in a Hong Kong Government secondary school.Thirty-eight lean and active boys and girls were randomised to either the resistance training group or the control group.Students in the resistance training group received in-school 10-wk supervised resistance training twice per week,with each session lasting 70 min.Main outcome measures taken before and after training included brachial endothelial dependent flow-mediated dilation,body composition,fasting serum lipids,fasting glucose and insulin,high sensitive C-reactive protein,24-h ambulatory blood pressure and aerobic fitness.RESULTS:The only training related change was in endothelial dependent flow-mediated dilation which increased from 8.5%to 9.8%.A main effect of time and an interaction(P<0.005) indicated that this improvement was a result of the 10-wk resistance training.Main effects for time(P<0.05) in a number of anthropometric,metabolic and vascular variables were noted;however,there were no significant interactions indicating the change was more likely an outcome of normal growth and development as opposed to a training effect.CONCLUSION:Ten weeks of resistance training in school appears to have some vascular benefit in active,lean children.

Effects of Ving Tsun sticking-hand training on upper-limb sensorimotor performance in community-dwelling middle-aged and older adults: A randomized controlled trial

Objective:To evaluate the effects of Ving Tsun(VT)sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older adults.Methods:Thirty-three adults were randomly allocated to either a VT group or a control group.The VT group received VT sticking-hand training twice per week for 3 months.Measurements were taken before and after the intervention period.The primary outcome was elbow-joint repositioning error,which was measured by an elbow-joint passive positioning and active repositioning test using a universal goniometer.Secondary outcomes were upper-limb muscles'peak force and time taken to reach peak force as measured by a hand-held dynamometer.Results:No significant time,group or time-by-group interaction effects were found for elbow-joint repositioning error or upper-limb muscle peak force outcomes.Shoulder flexor time to peak force decreased by 33.8%from pre-test to post-test in the VT group(P=0.007).Shoulder abductor,internal and external rotator,and elbow extensor times to peak force decreased by 30.0%-35.9%in the VT%roup(P<0.05)and by 30.4%-37.1%in the control group(P<0.05).Conclusions:VT sticking-hand training does not improve elbow-joint position sense or the maximum strength of upper-limb muscles in middle-aged and older adults.However,VT can improve shoulder flexor muscles'time to reach peak force in these populations.VT had no obvious effect on the time required to reach peak force in other shoulder muscles and elbow extensors.

Health Emergency Response Readiness of Undergraduate Student

The increased threats of terrorism, disease outbreak and natural disasters clearly support the need to incorporate health emergency education into the school curricula to enhance emergency awareness and the development of Emergency Response Management Plans. The purpose of this study was to explore the health emergency response readiness of the undergraduate students upon completion of a “Health Emergency Education” course in Hong Kong. Thirty-three undergraduate students (aged from 19 to 23) enrolled in the course were selected for investigation. A 21-item semi-structured class exercise was administered to the students before and after the course. A significant improvement in the knowledge of emergency signage was observed. There was a strong positive correlation between the participants’ knowledge of performing the cardiopulmonary resuscitation (CPR) and their confidence in giving first aid to friends (r = 0.81, p = 0.00). The participants were more confident in administering first aid to family members and friends than strangers and the findings in this study were consistent with previous studies. The elective course significantly increased the students’ health emergency knowledge and confidence to provide assistance in an emergency situation. It is important to accompany advisories with educational messages to help the public understand emergency risks and enhance response readiness.

Associations of social participation, demographic, socioeconomic and disease factors with nutritional risk in a group of older Hong Kong adults

Aims: To identify the impact of social participation, socio-demographic, socio-economic and disease factors on nutritional risk among older persons in Hong Kong. Background: Few published work has investigated the relative risks of social participation, demographic, socioeconomic and disease factors with malnutrition in community-living older people, this study is to investigate the associations of these risk factors on the nutritional status in better nutrition support for the old age group. Design: A crosssectional study. Methods: It was a secondary analysis of a database in a mobile community centre between January 2008 and December 2009. One thousand seven hundred and thirty one participants aged between 54 and 103 were collected. With 319 full Mini Nutritional Assessment (MNA) completed, the participants’ demographic, socio-economic data, diseases, and nutritional status were analyzed with relative risk and 95% confidence interval level to identify the factors that make them vulnerable to nutritional risk. Results: The prevalence of malnutrition in the community-dwelling old was 3.95% and 83.7% of the sample was at risk of malnutrition. Living on allowances, young old who was socially engaged and good relationship with family members were at less risk to malnutrition. Conclusions: Special attention should be taken to these groups as they are prone to develop malnutrition.

Usability Test of eHealth Promotion @HKIEd—A Community of Practice Platform to Promote Healthy Lifestyles

Community of Practice (CoP) has been proved as an effective means for co-creation of knowledge. It is not yet widely used in health promotion, not to mention to utilize technological environment such as Web 2.0 to add value to the CoP. Under this study, an eHealth promotion @HKIEd, a CoP platform to promote healthy lifestyles was designed and constructed. It helped facilitate the CoP to share useful health information, locate expertise, promote health related events, communicate health updates effectively, co-construct shared repertoire of knowledge and build shared best practice on effective health promotion which was not limited to time, space and distance. Usability test was conducted to evaluate user acceptance of the eHealth promotion CoP platform using the Computer System Usability Questionnaire. A random sample of eighty-three active participants was recruited. Fifty females and thirty-three males with mean (S.D.) aged 21.1 were asked to evaluate the e-platform. The average scores of each domain were calculated with the corresponding means of the average scores of System Use, Information Quality and Interface Quality being 2.69, 2.83 and 2.74 respectively. The overall usability was 2.48 and the eHealth promotion @HKIEd demonstrated a high usability. It will provide a promising way to disseminate information for the public in health awareness promotion.

Can changes in midsole bending stiffness of shoes affect the onset of joint work redistribution during a prolonged run?

Purpose This study aimed to investigate if changing the midsole bending stiffness of athletic footwear can affect the onset of lower limb joint work redistribution during a prolonged run.Methods Fifteen trained male runners(10-km time of<44 min)performed 10-km runs at 90%of their individual speed at lactate threshold(i.e.,when change in lactate exceeded 1 mmol/L during an incremental running test)in a control and stiff shoe condition on 2 occasions.Lower limb joint kinematics and kinetics were measured using a motion capture system and a force-instrumented treadmill.Data were acquired every 500 m.Results Prolonged running resulted in a redistribution of positive joint work from distal to proximal joints in both shoe conditions.Compared to the beginning of the run,less positive work was performed at the ankle(approximately 9%;p≤0.001)and more positive work was performed at the knee joint(approximately 17%;p≤0.001)at the end of the run.When running in the stiff shoe condition,the onset of joint work redistribution at the ankle and knee joints occurred at a later point during the run.Conclusion A delayed onset of joint work redistribution in the stiff condition may result in less activated muscle volume,because ankle plantar flexor muscles have shorter muscles fascicles and smaller cross-sectional areas compared to knee extensor muscles.Less active muscle volume could be related to previously reported decreases in metabolic cost when running in stiff footwear.These results contribute to the notion that footwear with increased stiffness likely results in reductions in metabolic cost by delaying joint work redistribution from distal to proximal joints.

Reviewing the trends of nursing doctoral thesis research in Hong Kong

This review aimed to analyze the trends and contributions of nursing doctoral theses produced in Hong Kong. A total of 56 nursing doctoral theses were included in this review. The most often studied topic was cardiovascular rehabilitation care (n = 9, 16%). More recently, the most often studied topics has been health technology advancements in nursing care (n = 6, 10.7%). The common trend of study methods was to be quantitative in nature. Of the total, 35 out of 56 were quantitative studies. Half were experimental/ quasi-experimental research studies (n = 28, 50%). For theoretical foundations or applications, the majority (n = 21, 36%) of doctoral theses had no specific theoretical/conceptual models as study frameworks. This trend indicates that there is space for improving the theoretical and philosophical foundation of nursing research in Hong Kong. For the contributions of doctoral thesis research, Hong Kong nursing scholars place more emphasis on direct enhancement of clinical practice or the improvement of patient outcomes. This review provides concrete evidence of the status of nursing research and knowledge development in Hong Kong nursing.

Develop a Participatory Model in Nutrition Education to Prevent Childhood Obesity

Purpose: To investigate the effect of nutrition education and the engagement of students, parents and teachers in addressing school-specific environmental influences in eating problem. Design: This study adopted the action research process of diagnosing, action planning, taking action, evaluating, and specifying learning. Each of obese and non-obese male and female students was randomly selected based on physical screening based on obesity criteria. Dietary intake records were taken over seven days as the pre-intervention period. These four students, one of each of their parents and the teacher from the primary school, were given 3 sessions of nutrition education. After the nutrition education, dietary intake records were taken over the subsequent 7 days as the post-intervention period. Lunch observation and lunch menu review were included to identify eating problem of primary school children in school level. Findings: Students were found to consume less whole grains and more food items belonged to the “limited” and “strongly discouraged” as set in government lunch guidelines. Students’ dietary intakes before and after the nutrition education were found improved in their energy intake (p = 0.012), total fat, saturated fat, calcium, sodium, and cholesterol. Conclusion: A participatory model in elementary nutrition education could be effective.

Can a cardiorespiratory field parameter assess both cardiovascular and respiratory fitness in schoolchildren?

Background: Cardiorespiratory fitness involves both cardiovascular and respiratory capacities. However, existing methods have been criticised for reflecting cardiovascular fitness, but not pulmonary fitness. The objective of this study was to investigate the relationship between these two testing parameters. Methods: A cross-sectional population-based physical fitness assessment was conducted in 23 schools. The body height and weight, lung capacity, and step test results of students aged 10-18 were recorded. Criterion-referenced standards from the China Sports Bureau were adopted, as they include separate measurements for cardiovascular and pulmonary fitness. Results: The Pearson coefficients of lung capacity and the step test index from 13,028 schoolchildren ranged from 0.007 to 0.086 and from 0.026 to 0.105 for boys and girls, respectively, showing that poor correlations exist between the two parameters. Cluster analysis resulted in three clusters of children with similar characteristics. A good degree of similarity was found between the two parameters in children obtaining an “excellent” grade, but only a moderate degree of similarity between the two parameters in those obtaining a “good”, “pass” or “fail” grade. Conclusion: When cardiovascular fitness and pulmonary fitness are considered separately, there is a poor correlation between them, thus indicating further studies of cardiopulmonary fitness measurements is necessary.

Walk Your Life to Health—Motivating Young Adolescents to Engage in a Brisk Walking Program

Increasing numbers of overweight and obese children resulting from sedentary and abundant lifestyles are a health concern in Hong Kong and other affluent communities around the globe. The importance of physical activity is well documented for health and wellbeing, with sedentary behavior emerging as an independent risk factor for chronic diseases and mortality. In this study, Pender’s Health-Promotion Model informed the development of an intervention program aimed to engage junior high school students in increased physical activity, specifically brisk-walking. The model set out to motivate participants to engage in behaviors to enhance their health across the life span, including developing self-efficacy with regard to brisk walking. The intervention featured four stages. First, participants were provided with information about the benefits and in stage two were trained in the technique of brisk walking. Next they engaged in the brisk walking program and in stage four were encouraged to serve as health ambassadors by introducing brisk walking and its associated benefits to others, thereby exercising peer influence to diffuse the practice of brisk walking more widely among members of the community. Motivational strategies were used as incentives in the program, including the involvement of a popular singing band to award certificates at the completion of the program. This 7-week intervention program including a 4-week brisk walking component was conducted in a high school context with 71 participants. Data were collected to enable paired-sample t-tests to be conducted to statistically analyze the data at pre- and post-intervention. Findings indicate significant differences among the mean Body Mass Index (BMI), Waist-to-Hip Ratio (WHR), knowledge and attitudes of the participants at pre- and post-intervention. These findings suggest that the intervention was effective as a strategy to reduce sedentary behavior with the concomitant effect of positive shifts in measurable indicators and attitudes.

Sexual knowledge, attitudes and values among Chinese migrant adolescents in Hong Kong

Internal migration in China has introduced critical challenges to the education and health of migrant adolescents. The aim of this study was to explore the differences in sexual knowledge and attitudes among migrate and local adolescents. Survey research with a total of 616 adolescents in grades equivalent to US 10th and 11th grades including 113 migrants completed a selfadministered questionnaire. Misconceptions of adolescent physical development, sexual activity, marriage, birth control, sexually transmitted diseases and the probability of pregnancy were found in most of the migrant adolescents. Significantly lower attitudinal scores were found for the sub-scales of clarity of personal sexual values, understanding of emotional needs, social behavior, sexual responses;attitudes towards gender role, birth control, premarital intercourse, use of force in sexual activity, the importance of family and satisfaction with social relationship in migrant adolescents. Migrant adolescents have a low level of knowledge of sexual activities. The content of education programs should include engagement in sexual behavior to equip adolescents with unbiased and factual knowledge. The adolescents have a high demand for family support. School based sex education programs should involve the participation of parents to address these issues.

Impacts of social desirability response bias on sexuality care of cancer patients among Chinese nurses

The purpose of this study was to detect social desirable response bias on Chinese nurses’ attitudes and beliefs toward sexuality care of cancer patients. A cross-sectional self-reported questionnaire based survey was used. Measures included a 12-item Inventory of Sexuality Attitude and Belief Survey (SABS) and a 10-item Marlowe-Crowne Social Desirability Scale. Total social desirability scores were significantly correlated with four individual items of the SABS, and significantly predicted the total SABS scores (β=﹣0.155, p= 0.028). Before controlling social desirability variable, nurses’ age, marital status, years of working experience, and working units were significantly correlated with total SABS scores. After controlling social desirability variable, only nurses’ age and working units were statistically significant predictors of SABS. Social desirable response bias had impacts on Chinese nurses’ attitudes and beliefs toward sexuality care of cancer patients. Study findings demonstrated that social desirable response bias would potentially jeopardize human sexuality assessment and counseling in nursing practice. Controlling social desirable response should consider using a social desirability scale to detect and control potential social desirability bias during data analysis.

Fighting age-related orthopedic diseases: focusing on ferroptosis

Ferroptosis, a unique type of cell death, is characterized by iron-dependent accumulation and lipid peroxidation. It is closely related to multiple biological processes, including iron metabolism, polyunsaturated fatty acid metabolism, and the biosynthesis of compounds with antioxidant activities, including glutathione. In the past 10 years, increasing evidence has indicated a potentially strong relationship between ferroptosis and the onset and progression of age-related orthopedic diseases, such as osteoporosis and osteoarthritis. Therefore, in-depth knowledge of the regulatory mechanisms of ferroptosis in age-related orthopedic diseases may help improve disease treatment and prevention. This review provides an overview of recent research on ferroptosis and its influences on bone and cartilage homeostasis. It begins with a brief overview of systemic iron metabolism and ferroptosis,particularly the potential mechanisms of ferroptosis. It presents a discussion on the role of ferroptosis in age-related orthopedic diseases, including promotion of bone loss and cartilage degradation and the inhibition of osteogenesis. Finally, it focuses on the future of targeting ferroptosis to treat age-related orthopedic diseases with the intention of inspiring further clinical research and the development of therapeutic strategies.

The Road to the Beijing Winter Olympics and Beyond: Opinions and Perspectives on Physiology and Innovation in Winter Sport

Beijing will host the 2022 Winter Olympics,and China strengthens research on various aspects to allow their athletes to compete successfully in winter sport.Simultaneously,Government-directed initiatives aim to increase public participation in recreational winter sport.These parallel developments allow research to advance knowledge and understanding of the physiological determinants of performance and health related to winter sport.Winter sport athletes often conduct a substan-tial amount of training with high volumes of low-to-moderate exercise intensity and lower volumes of high-intensity work.Moreover,much of the training occur at low ambient temperatures and winter sport athletes have high risk of developing asthma or asthma-related conditions,such as exercise-induced bronchoconstriction.The high training volumes require optimal nutrition with increased energy and dietary protein requirement to stimulate muscle protein synthesis response in the post-exercise period.Whether higher protein intake is required in the cold should be investigated.Cross-country ski-ing is performed mostly in Northern hemisphere with a strong cultural heritage and sporting tradition.It is expected that innovative initiatives on recruitment and training during the next few years will target to enhance performance of Chinese athletes in classical endurance-based winter sport.The innovation potential coupled with resourcing and population may be substantial with the potential for China to become a significant winter sport nation.This paper discusses the physiological aspects of endurance training and performance in winter sport highlighting areas where innovation may advance in athletic performance in cold environments.In addition,to ensure sustainable development of snow sport,a quality ski patrol and rescue system is recommended for the safety of increasing mass participation.