Gymnastik- och idrottshögskolan, GIH

Retirement is a major life transition that involves changes to everyday routines, roles, and habits. Previous studies suggest that retirement may influence drinking habits. Many natural inhibitors of alcohol consumption disappear with the removal of work constraints. The potential impact depends on both individual and contextual factors. Women in the cohorts undergoing retirement now have been more active on the labor market, including the occupation of higher status jobs, which indicates more financial resources as well as a larger role loss after retirement. Also, the current cohorts who retire have had more liberal drinking habits throughout their lives compared to previous cohorts. We therefore examined changes in alcohol consumption surrounding retirement in different education groups among women and men undergoing retirement using annual data from the Health, Aging and Retirement Transitions in Sweden (HEARTS) study, a longitudinal national study of 60- to 66-year-olds (n = 5,913), from 2015 to 2018. Latent growth curve models were used to estimate trajectories of alcohol consumption. Results showed that those who retired during the follow-up increased their usual weekly alcohol consumption while those who worked or were retired throughout the period had stable drinking habits. Those who were retired reported the highest alcohol consumption. The increase surrounding retirement was driven by people with higher education. Women with tertiary education and men with intermediate or tertiary education increased their weekly alcohol intake after retirement, while those with low education had unchanged drinking habits. Mechanisms and motivations that may fuel increased alcohol intake among people with higher education should be further investigated.

Syftet och frågeställning. Syftet var att undersöka sambandet mellan användning av sociala medier, psykiskt välbefinnande, kroppsideal, kroppsuppfattning och fysisk aktivitet hos unga vuxna. Följande frågor ställdes: 1) Finns det ett samband mellan användning av sociala medier och det subjektiva psykiska måendet hos kvinnor och män mellan 18-30 år? Finns det skillnader mellan kvinnor och män? 2) Finns det ett samband mellan fysisk aktivitetsnivå och det subjektiva psykiska måendet hos kvinnor och män mellan 18-30 år? Finns det skillnader mellan kvinnor och män? 3) Finns det ett samband mellan användning av sociala medier och kroppsuppfattningen hos kvinnor och män mellan 18-30 år? Finns det skillnader mellan kvinnor och män?

Metod. Kvantitativ ansats och tvärsnittsstudie med enkäter som metod. Enkäten inkluderade totalt 99 deltagare, 42 män och 57 kvinnor i åldrarna 18-30 år i Stockholm. Enkäten bestod av bakgrundsfrågor (ålder, kön och sysselsättning), GHQ-12 som mäter subjektivt psykiskt mående, PAUM som mäter passiv och aktiv användning av sociala medier, SMEQ som mäter tid på sociala medier samt två frågor om kroppsuppfattning och kroppsideal kopplat till sociala medier. Dataanalys gjordes i statistikprogrammet SPSS med hjälp av t-tester och korrelationsanalyser.

Resultat. Frågeställning 1: inget signifikant samband finns mellan subjektivt psykiskt mående och användning av sociala medier mätt med SMEQ (totalt; r=0,06, p= 0,55, kvinnor; r=0,13, p=0,35, män; r=-0,13, p=0,94) och PAUM (totalt; r=0,09, p=0,40, kvinnor; r=0,04, p=0,74, män; r=0,09, p=0,55). Frågeställning 2: Signifikant negativt samband finns mellan grad av fysisk aktivitet och subjektivt psykiskt mående för alla deltagare totalt (r=-034, p=0,001) samt för kvinnor (r=0,41, p=0,002). Inget signifikant samband finns för män (r= -0,15, p= 0,34). Frågeställning 3:  Signifikant positivt samband finns mellan kroppsuppfattning och användning av sociala medier för kvinnor mätt med SMEQ (r=0,316, p=0,017). Inget signifikant samband finns för hela gruppen totalt (r=0,06, p=0,557, män; r=-0,163, p=0,302) mätt med SMEQ. Inget signifikant samband finns för någon av grupperna mätt med PAUM (totalt; r=0,163, p=0,106, kvinnor; r= 0,093, p=0,494, män; r=0,04, p=0,801.

Slutsats. Det finns samband mellan användning av sociala medier och dess påverkan på kroppsuppfattning samt mellan fysisk aktivitet och subjektivt psykiskt mående.

Chronic negative stress may be the start of a progress of illness, that may end in serious troubles for the affected. In this Perspective we highlight the steps in such a progress, what we call a staircase of stress. This underlines the importance of recognition, understanding and therapeutic measures at an early stage of the stress disorders. 

Background: Headache of stress etiology is a common, worldwide medical problem with high sick leave and large economic consequences. There is a need to improve the understanding of underlying neurobiological processes. Research show that headache of stress etiology often is one symptom in a complex of multiple pains and augmented widespread muscular tension with a specific pattern of tender points (1). 

Objective and Method: We will present in children with recurrent stress related pain, some hormonal changes and electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain including headache. 

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 21 matched controls. Also, higher resting muscle activity was found in these children as well as increased cortisol and decreased oxytocin. 

Conclusion. Stressors evoke stress response for example in the amygdala, which can trigger and potentiate the startle reaction with amplified muscle excitability and tonus. These reactions and the increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of headache and other pain and must be heeded in the treatment of patients with pain related to stress.  

1.Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019;Jun4.doi:10.1111/apa.14884.

2.Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3.Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

For better understanding and better care of psychosomatic pain valid and reliable diagnostic criteria is a prerequisite. The startle reflex is of importance for the understanding of the stress induced pain and the increased excitability in several muscles. The pattern of increased muscle tension and tenderness that can be found in these patterns can be of valuable diagnostic support. Decreased oxytocin and increased cortisol is a sign of right brain dominance in stress and indicate psuchosomatic pain. The omega-3 and omega-6 changes are in indication metabolic pain mechanism of interest for future study. Treatment is reccomended to be guided by the knowledge here described.

We discuss the aetiology of recurrent abdominal pain of non-organic origin, according to the Rome Criteria for Functional Gastrointestinal Disorders and a psychogenic hypothesis. Stress activates the brain-gut axis, which is important for local gut symptoms, such as abdominal pain, but it also causes pain in other areas, including the head, back and chest. Our research has indicated that the startle reflex plays a dominant role in this stress-induced pain pattern, which is manifested in the whole body. Localised abdominal pain can be part of a general negative stress reaction that causes multiple pains in other areas of the body.

G. Alfvén1, E. Andersson2, 3

1. Clintec, Karolinska Institute, Stockholm, Sweden. 2. The Department of Neuroscience, Karolinska institute, Stockholm, Sweden. 3. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.

Corresponding author:  G Alfvén (gosta.alfven@slmk.org) Karolinska Institute, Sweden

ABSTRACT 

Background: Recurrent pain of stress etiology is a common, worldwide problem with impaired quality of life and decreased school attendance. Research show that pain of stress etiology, often called psychosomatic pain, often is a complex of multiple pains, other symptoms and augmented widespread muscular tension with a specific pattern of tender points (1). 

Objective and Method: We will in a clinical context present electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain. 

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 23 matched controls. Also, higher resting muscle activity was shown. We will also present data showing increased cortisol and decreased oxytocin and increased risk for developing fibromyalgia in children with psychosomatic pain. 

Conclusion. Stressors potentiated the startle reaction with increased muscle activity in rest and increased excitability. These reactions and increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of recurrent pain and must be heeded in the treatment of patients with pain related to stress.  

1. Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019; Jun4.doi:10.1111/apa.14884.

2. Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3. Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

G. Alfvén1, E. Andersson2, 3

1. Clintec, Karolinska Institute 2. Department of Neuroscience, Karolinska institute, 3. Swedish School of Sport and Health Sciences, -all Stockholm, Sweden.

Corresponding author:  G Alfvén (gosta.alfven@slmk.org) 

ABSTRACT 

Background: Negative stress is very common, always affecting brain and body resulting in different symptoms often called psychosomatic. To better understand stress, it is important to overcome the mind-body dichotomy and explore how they are connected. 

Objective and Method: We will present in children with recurrent stress related pain, some hormonal changes and electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple psychosomatic pain (1).  

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 21 matched controls. Also, higher resting muscle activity was found in these children as well as increased cortisol and decreased oxytocin. 

Conclusion. Stressors evoke stress response for example in the amygdala, which can trigger and potentiate the startle reaction with amplified muscle excitability and tonus. These reactions and the increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of psychosomatic pain and must be heeded in the treatment of patients with pain related to stress.  

1.Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019;Jun4.doi:10.1111/apa.14884.

2.Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3.Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

Background: In Paralympic sports, classification of athletes based on the impact of impairments on the ability to perform is needed, to prevent a one-sided and predictable outcome of the competition in which the least impaired athlete has the best chance to win. Classification is developing from expert opinion based to evidence based. In wheelchair court sports, there is evidence to support the impact of impairment on wheeled mobility, but not on ball handling. To assess the impact of impairment on the ability to perform ball-handling activities, standardised tests for ball handling are needed.

Purpose: To assess if reliable and valid standardised tests for the measurement of ball-handling proficiency in a wheelchair or able-bodied court sports exist; to assist in the development of Evidence-Based Classification (EBC) in wheelchair court sports according to the guidelines of the International Paralympic Committee (IPC).

Methods: The review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) statement. Search terms used were "wheelchair," "ball," "ball sports," "test," and "performance." Databases searched were Medline, Embase, PubMed, and Sport Discus. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

Results: Twenty-two articles were included. Foundational Movement Skills in ball-handling proficiency were assessed. Tests for throwing maximal distance showed sufficient reliability and validity. Precision in throwing showed low-to-moderate reliability and conflicting results in validity. Throwing techniques differed between studies. Dribbling the ball showed high reliability, but conflicting results in validity.

Conclusions: Tests for throwing maximal distance, throwing precision, and dribbling the ball can be used in standardised tests for activity limitation in wheelchair court sports. However, tests need to be adapted and standardised and then reassessed for reliability and validity in athletes with and without arm impairment.

BACKGROUND: Healthy lifestyle habits, including physical activity (PA), are associated with a broad range of positive psychosocial and physical health benefits. However, there are challenges involved in reaching vulnerable groups in socioeconomically disadvantaged areas. There is a lack of research on family-based PA interventions, specifically considering psychosocial health. The purpose of this study was to explore how families experienced psychosocial aspects of health after participation in a family-based programme, A Healthy Generation.

METHODS: A Healthy Generation is a health-promoting, family-based programme delivered in collaboration with local municipalities and sport associations in socioeconomically disadvantaged areas in Sweden. Families with children in grade 2 (8-9 years), including siblings, participate in health-promoting activities, including activity sessions, healthy meals, health information and parental support groups. Data was collected through interviews with parents and children (n = 23) from a controlled pilot trial of the programme. Interviews were audio recorded, transcribed and analysed using a phenomenological hermeneutical method.

RESULTS: Three themes and seven sub-themes emerged. The themes were: "A sense of belonging", "Awareness of one's role as a parent" and "Inspiration towards new and healthier behaviours". In terms of A sense of belonging, participation in the programme was the families own free zone, where they also had the opportunity of being together with other families in the programme. For participants that were isolated and lacked a social network, their participation helped them towards social participation. During the programme, parents created an Awareness of one's role as a parent, with new insights on how to act as a parent and they also negotiated differences between each other. Participation in the programme contributed to Inspiration towards new and healthier behaviours such as experience-based insights and healthy lifestyle changes.

CONCLUSIONS: This study highlights the importance of co-participation in family-based health-promoting programmes to enhance psychosocial health among families in socioeconomically disadvantaged areas. The results give new insights into participants' experiences of psychosocial aspects of health after participation in a family-based PA programme. This knowledge can contribute to the understanding of how to design health-promoting, family-based interventions to promote psychosocial health in socioeconomically disadvantaged areas.

TRIAL REGISTRATION: ISRCTN ISRCTN11660938 . Retrospectively registered 23 September 2019.

Syfte och frågeställningar

Syftet med denna studie var att undersöka hur kontorsanställda med övervägande stillasittande arbete på företag i Stockholmsområdet nyttjar friskvård kopplad till fysisk aktivitet (FA). Vidare var syftet att undersöka önskat friskvårdsutbud samt hinder och motivation till FA, samt om ovan varierar mellan olika nivåer av självskattad total FA. Frågeställningar: 1. Hur ser utbudet och användandet av friskvård ut för kontorsanställda idag? 2. Skulle förändring av friskvårdsbidrag kunna påverka nivån av FA? 3. Vilken typ av övrig friskvård skulle respondenterna vilja bli erbjudna på sin arbetsplats eller av sin arbetsgivare? 4. Vilka faktorer kan utgöra hinder eller motivation för att utföra FA? 5. Skiljer ovan frågeställningar mellan olika nivåer av självskattad total fysisk aktivitetsnivå?

Metod

Metoden bestod av en kvantitativ tvärsnittsstudie där en digital enkät användes för datainsamling. Enkäten skickades ut till 307 kontorsanställda på två olika arbetsplatser i Stockholmsområdet och innehöll frågor om FA, friskvårdsförmåner samt hinder och motivation. Populationen kategoriserades in i tre grupper efter skattad fysisk aktivitetsnivå. Analys gjordes på skillnader mellan hur de olika grupperna svarat på enkätfrågorna.

Resultat

Totalt 108 (35%) respondenter inkluderades i studien. Användandet av friskvårdsbidraget var högre ju mer fysiskt aktiva respondenterna ansåg sig vara (p=0,004). Den mest nyttjade friskvårdsförmånen utöver friskvårdsbidrag var organiserade hälsotävlingar (n=19, 23%), medan den mest önskade var friskvårdstimme (n=69, 65%). Det största hindret till att vara fysiskt aktiv var tidsbrist (n=71, 66%). Den största motivationsfaktorn till att vara fysiskt aktiv var att förbättra hälsan (n=97, 90%).

Slutsats

Hos kontorsanställda med övervägande stillasittande arbete var friskvårdsbidraget det som flest erbjöds och även nyttjade. Den förmån som främst skulle kunna underlätta utförandet av FA var friskvårdstimme. Tidsbrist sågs som det största hindret och förbättrad hälsa var den främsta motivationsfaktorn till FA. För de som ansåg sig vara minst fysiskt aktiva skulle även ökat friskvårdsbidrag kunna bidra till ökad nivå av FA. 

Background: Every walk takes place in a route environment, which can play an important role in deterring or facilitating walking. The focus of this thesis is on the perceptions of environmental variables, and how they relate to appraisals of route environments as hindering – stimulating for walking and unsafe – safe for reasons of traffic, in two metropolitan environments. Another focus is to expand the state of knowledge concerning the criterion-related validity of the Active Commuting Route Environment Scale (ACRES).

Methods: Commuting pedestrians in Greater Stockholm, Sweden, were recruited via advertisements. From the inner urban area there were 294 participants (77% women), aged 49.5 years, and from the suburban areas there were 233 participants (82% women), aged 50.0 years. 77 individuals walked in both areas. The participants evaluated their commuting route environments using the ACRES. Correlation, multiple regression, and mediation analyses were used to explore the relationships between the variables. Comparisons of environmental ratings between groups and settings were performed with t-tests. Studies 1 and 2 focused on the inner urban area and studies 3 and 4 on the suburban areas. Studies 1 and 3 focused exclusively on the relations between the four motorized traffic variables (vehicle speed, vehicle flow, noise, and exhaust fumes), and their relations to the outcome variables (hinders – stimulates walking and unsafe – safe traffic). Studies 2 and 4 utilised proxies from studies 1 and 3 and combined them with other environmental variables to further the understanding of route environmental variables in relation to walking.

Results: In both areas, aesthetics and greenery were positively related to stimulating walking, whereas noise, a proxy for motorized traffic, was negatively related. Aesthetics was also positively related to unsafe – safe traffic in the inner urban area, whereas greenery had the corresponding role in suburbia. Another important finding was that greenery also influenced aesthetics positively in both areas. Thus, greenery had both a direct and an indirect positive effect. On the other hand, noise influenced aesthetics negatively in the inner urban area, whereas vehicle flow had the corresponding role in suburbia. A number of variables conjointly influenced the outcome unsafe – safe traffic negatively in both areas (speeds of motor vehicles, noise, conflicts, congestion: pedestrians, red lights, and course of the route). The route environment profiles differed distinctly between the two areas.

Conclusions: Several route environmental variables appear to be particularly influential in relation to pedestrian commuting, e.g., aesthetics, greenery, and noise. An important finding is that both positive and negative interactions, between certain predictor variables, were disclosed. The contrasting route environment profiles in the different settings strengthen the criterion-related validity of the ACRES. The findings expands the state of knowledge concerning the relations between the environment and walking. If implemented, these findings can influence public health positively.

Boken handlar huvudsakligen om forskarparet Irma och Per-Olof Åstrand och deras insatser inom det arbetsfysiologiska fältet. Dessutom uppmärksammas olika aktörer som varit verksamma i anslutning till de båda. Författarna beskriver Åstrandtestet, dess bakgrund, grundläggande principer och genomförande. Därutöver presenteras en del av den utveckling som har skett inom svensk idrottsfysiologisk forskning och testning genom tiderna. Bilder, diagram och tabeller kompletterar texten och speglar det förflutna med fokus på bland annat laborationer och publikationer. Åstrandtestet vänder sig till studerande inom hälso- och sjukvård, folkhälsa, idrottsvetenskap, idrotts- och vetenskapshistoria samt yrkesverksamma inom dessa områden.

Innehåll:

• Minnen från vår uppväxt med Irma och Per-Olof, av Elin Rundqvist & Peje Åstrand
• Det biologiska arvet
• Fysisk aktivitet och hälsa
• Ett idrottsligt paradigmskifte
• Idrottsfysiologisk forskning, träning och tävling i praktiken
• Aeroba tester
• Irma Åstrand - en kvinnlig pionjär inom arbetsfysiologin, av Daniel Svensson & Peter Schantz
• Åstrandtestets bakgrund och grundläggande principer
• Åstrandtestet - förberedelser, genomförande och beräkning av konditionsnivå
• Den notoriske ergometercyklisten

Background 

It is important to examine how motorized traffic variables affect pedestrians along a gradient from rural to inner urban settings.

Methods

Relations between pedestrians´ perceptions of four traffic variables and appraisals of route environments as hindering – stimulating for walking as well as unsafe – safe for reasons of traffic, were therefore studied in the inner urban area of Stockholm, Sweden (n = 294). The pedestrians rated their perceptions and appraisals with the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the traffic variables and the outcome variables. 

Results 

Noise related negatively to both hindering – stimulating for walking, and to unsafety – safety for traffic reasons. Vehicle speed related negatively to unsafety – safety for traffic reasons. Furthermore, vehicle speed protruded as an important origin of the deterring effects of traffic among those who commute by foot. 

Conclusion

The study shows the value of both partial and simultaneous analyses of the effect of all four traffic variables in relation to outcome variables relevant for walking. 

Background and Methods

Relations between pedestrians´ perceptions of traffic variables and appraisals of route environments as hindering – stimulating for walking as well as unsafe – safe for reasons of traffic, were studied in the inner urban area of Stockholm, Sweden (n = 294). The pedestrians used the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the traffic variables and the outcome variables.

Results

Traffic noise relates negatively to both hindering – stimulating for walking, and to unsafety – safety for traffic reasons. Vehicle speed related negatively to unsafety – safety for traffic reasons. Furthermore, vehicle speed protrudes as an important origin of the deterring effects of traffic among those who commute by foot.

Conclusion

The study shows the value of both partial and simultaneous analyses of the effect of all four traffic variables in relation to outcome variables relevant for walking. 

Background

Every walk takes place in a route environment, and it can play an important role in deterring or facilitating walking, and will always affect the environmental unwell – wellbeing of pedestrians. The aim of this study is to illuminate which the important route environmental variables are in this respect. The focus is therefore on pedestrians´ perceptions of route environmental variables and how they relate to overall appraisals of route environments as hindering – stimulating for walking and unsafe – safe for reasons of traffic. 

Methods

Commuting pedestrians in the inner urban area of Stockholm, Sweden (n = 294, 49.5 ± 10.4 years, 77% women), were recruited via advertisements. They evaluated their own commuting route environments using a self-report tool, the Active Commuting Route Environment Scale (ACRES). Correlation, multiple regression, and mediation analyses were used to study the relationships between the variables and the outcome variables.

Results

Aesthetics and greenery appear to strongly stimulate walking, whereas noise, a proxy for motorized traffic, hinders it. Furthermore, aesthetics is positively related to traffic safety, whereas conflicts have the opposite role. Conflicts is an intermediate outcome, representing several basic environmental variables, whereof some were directly and negatively related to unsafe – safe traffic.

Conclusion 

Route environmental variables appear to be potent factors in deterring or facilitating walking. This knowledge is of importance for policymakers and urban planners when designing route environments with the aim of attracting new pedestrians, and simultaneously stimulating those who already walk to keep on.

Bakgrund

Regelbunden fysisk aktivitet har positiva hälsoeffekter, och många vill vara fysiskt aktiva, men upplever inte sällan olika hinder för det, till exempel tidsbrist. Att gå eller cykla till arbetet är därför en intressant möjlighet i detta sammanhang, då fysiskt aktiv arbetspendling ofta är tidseffektivt. Dessutom krävs sällan någon specialutrustning, startsträckan är kort och avstånden kan anpassas så att man går, cyklar hela eller delar av sträckan mellan hem och arbetsplats. Om färdvägsmiljön dessutom upplevs som stimulerande och trygg kan den sannolikt bidra till att upprätthålla ett beteende, och på så vis medverka till att många individer får en angelägen ”dos” fysisk aktivitet.  

Studier av hur olika trafikvariabler samspelar, och hur dessa i sin tur påverkar vår uppfattning om en färdvägsmiljö ger inga entydiga svar. Syftet med denna studie var därför att studera de interna sambanden mellan fyra olika variabler relaterade till motortrafik: hastighet, flöde, buller och avgaser samt hur dessa, i olika kombinationer, inverkar på uppfattningen om en miljö är hindrande eller stimulerande respektive trygg eller otrygg för arbetspendling till fots.

Metod

294 arbetspendlande fotgängare (49.5 ± 10.4 år, 77 % kvinnor) rekryterades via annonser, och deras upplevelser av sina färdvägsmiljöer i Stockholms innerstad har nyttjats i våra analyser. Upplevelserna skattades med färdvägsmiljöskalan ”The Active Commuting Route Environment Scale” (ACRES). Den innehåller utfallsvariablerna hindrande-stimulerande färdvägsmiljö och otrygghet-trygghet i trafiken, samt ett antal miljöprediktorer, varav vi har nyttjat de fyra som är relaterade till motortrafik: flöde av motorfordon, hastighet, buller och avgaser.  Såväl trafikvariabler som utfallsvariabler skattades med 15-gradiga skalor. För att analysera sambanden mellan trafikvariablerna och utfallsvariablerna användes multipla regressionsanalyser. 

Resultat

Alla trafikvariabler var i sig själva negativt relaterade de båda utfallsvariablerna hindrande-stimulerande färdvägsmiljö och otrygghet-trygghet i trafiken. När istället de fyra trafikvariablerna analyserades samtidigt i förhållande till om miljön upplevdes som hindrande eller stimulerande samt otrygg eller trygg var det enbart buller som var negativt relaterad till de båda utfallsvariablerna. Hastighet hade en negativ roll i förhållande till trygghetsvariabeln. Analyserna visade dessutom att både flöde av motorfordon och hastighet förutspådde buller.

Slutsatser

Samtidigt som varje trafikvariabel är negativt relaterad till hur färdvägsmiljöer upplevs av fotgängare, framträder motorfordons buller och hastigheter som de variabler som är mest bekymmersamma för fotgängare. Studier som denna kan utgöra ett underlag för arbetet med att skapa attraktiva miljöer för fotgängare, och därmed bidra till bättre folkhälsa, förändrade pendlingsmönster i urbana miljöer samt ökad ekologisk hållbarhet.

Ambitionen med detta kapitel är att på ett enkelt, sakligt och inspirerande sätt beskriva akuta sjukdoms- och skadetillstånd (inkl. missbruk) som kan förekomma i samband med fysisk aktivitet, och vilken eller vilka åtgärder som ska sättas in när olikan är framme.

Walking Football (WF) is one type of recreational football increasing in popularity, targeting older adults. Further knowledge on the intensity and physical workload of WF, characteristics of the players, the social context, and reasons for playing WF is needed. Thus, the aim of the study was to characterize the individuals that regularly play WF and their experience of WF, and the physiological characteristics of the sport. Sixty-three players from three clubs taking part in organised WF in Sweden were included. The players participated in up to four WF-games and underwent performance tests and answered a questionnaire. The participants mean age was 70.9 years, ranging from 63 to 85 years with 71% (n = 27) of the men and 68% (n = 13) of the women having a BMI > 25. Fifty-one percent (n = 27) of the players had hypertension, and 73% (n = 39) regularly used prescription drugs due to illness. During WF, the players covered on average 2,409 m (2,509 m for men and 2,205 m for women, p = .001). Expressed in percentage of their age-estimated maximal heart rate, mean heart rate represented 80 ± 9 and 80 ± 8% of max for men, and 78 ± 9 and 79 ± 9% of max for women in the first and second halves, respectively, hence WF can be considered a moderate intensity activity for older adults. The main reason for WF participation was to socialize. WF includes a considerable number of accelerations and decelerations, making it more energetically and mechanically demanding than walking.

Syfte och frågeställningar: Syftet med studien var att undersöka och beskriva vilka könsnormer som framkommer i gymnastiken enligt finländska högstadieelever. Syftet var också att undersöka och tolka elevers upplevelser av jämställdhet i skolämnet gymnastik. Frågeställningarna var: - Hur beskriver högstadieelever en gymnastiklektion?- Vilka könsnormer kommer till uttryck i dessa beskrivningar?- Hur upplever högstadieelever jämställdhet mellan könen i ämnet gymnastik? 

Metod: Studien genomfördes med kvalitativ metod där data samlades in genom högstadieelevers beskrivningar av gymnastiklektioner. 36 högstadieelever i årskurs åtta i ett högstadium i Helsingfors fick som uppgift av sin lärare i svenska och litteratur att beskriva en gymnastiklektion. 20 elever och deras vårdnadshavare gav sitt samtycke att delta i studien. Uppgiften som eleverna fick, gick ut på̊ att anonymt skriva en text om sina upplevelser och känslor av skolämnet gymnastik. Denna datainsamlingsmetod användes för att ta reda på hur elever upplever skolgymnastiken samt vilka könsnormer som framkommer. Materialet analyserades med kvalitativ innehållsanalys. 

Resultat: Studiens resultat visade att det framkommer könsnormer som kan begränsa elevers deltagande i olika aktiviteter under gymnastiklektionerna. Både flickor och pojkar gillade skolgymnastiken men ett flertal flickor hade negativa upplevelser av ämnet. Flera flickor upplevde sig själva som sämre på olika aktiviteter i gymnastiken än vad pojkar upplevde. Vidare visade resultatet att det fanns hierarkier mellan könen i skolgymnastiken vilket påverkar på jämställdheten. Speciellt av flickor upplevs inte gymnastiken jämställd. Det framkom i flickors beskrivningar att pojkar har en större inverkan på undervisningsinnehållet och dominerar i olika aktiviteter under lektionerna. 

Slutsats: Av resultatet kan man tolka att gymnastiksinnehållet gynnar speciellt idrottsintresserade elever med maskulina drag eftersom gymnastiken innehåller traditionella maskulina värderingar, så som tävlingsmoment och bollsporter. Undervisningsinnehållet bör vara så mångsidigt som möjligt och bör bestå av aktiviteter som kan anses både maskulina och feminina samt könsneutrala. Studiens resultat tyder på att skolan och lärare bör stärka elevers självbild, speciellt flickors. Elever ska ha en möjlighet att delta på lika villkor och elever ska ha en möjlighet att se sig själva som lika bra oavsett kön. Skolan och lärare behöver kunskap om könsnormer och könsmaktstrukturer för att skapa en mer jämställdundervisning där både flickor och pojkar känner att undervisningsinnehållet är rättvist. 

Syfte och frågeställningar: Syftet med studien var att undersöka hur en 2-årig intervention med ett inriktningsval i idrott och hälsa på gymnasiet samverkar med elevernas måluppfyllelse och betyg. Frågeställningarna var: Vilka eventuella skillnader i måluppfyllelse och betyg kan ses hos eleverna i interventionen jämfört med skolans övriga elever som läser samma kurs? Ytterligare frågeställningar var om detta såg olika ut för elever på yrkesförberedande program respektive högskoleförberedande program samt för flickor respektive pojkar.

Metod: Fem klasser i år 1 på gymnasiet fick göra ett inriktningsval i kursen idrott och hälsa 1. Fem olika inriktningsval gavs; ”styrketräning”, ”dans och träning till musik”, ”hälsa, motion och mental träning” samt ”boll-, slag- och nätspel”. Betygsdata samlades in efter avslutad kurs och Pearson's χ2 och Mann Whitney U användes för analys av data. 

Resultat: Analyserna visade inga signifikanta skillnader mellan intervention och kontrollgrupp i vare sig måluppfyllelse eller betyg i interventionen som helhet. Däremot sågs en signifikant skillnad (p = 0,002 respektive 0,028) på programnivå där elever på yrkesförberedande program i interventionen hade lägre måluppfyllelse såväl som lägre betyg i en jämförelse med övriga elever på yrkesförberedande program. Bland elever på högskoleförberedande program sågs en signifikant skillnad (p = 0,010) i betyg (fler A och högre medelbetyg i interventionsgruppen) men ingen skillnad i måluppfyllelse. Inga signifikanta skillnader framkom i jämförelse mellan flickor respektive pojkar i och utanför interventionen.

Slutsats: Inga skillnader i måluppfyllelse och betyg sågs mellan interventions- och kontrollgrupp i interventionen som helhet. Elever på högskoleförberedande program var den grupp som gynnades positivt av interventionen medan elever på yrkesförberedande program i stället missgynnades. Att enbart erbjuda eleverna ett inriktningsval i idrott och hälsa är inte tillräckligt för att öka måluppfyllelse och betyg i kursen för elever generellt. Andra delar av autonomistödet är också av stor vikt. Det kan utifrån studiens resultat finnas anledning att utforma valmöjligheter i idrott och hälsa på ett annat sätt än genom en intervention med ett inriktningsval.

BACKGROUND: There is a lack of a methodological standard to process accelerometer data to measures of physical activity, which impairs data quality and comparability. This study investigated the effect of different combinations of settings of multiple processing components, on the measure of physical activity and the association with measures of cardiometabolic health in an unselected population of middle-aged individuals.

METHODS: Free-living hip accelerometer data, aerobic fitness, body mass index, HDL:total cholesterol ratio, blood glucose, and systolic blood pressure were achieved from 4391 participants 50-64 years old included in The Swedish CArdioPulmonary bioImage Study (SCAPIS) baseline measurement (cross-sectional). Lab data were also included for calibration of accelerometers to provide comparable measure of physical activity intensity and time spent in different intensity categories, as well as to enhance understanding. The accelerometer data processing components were hardware recalibration, frequency filtering, number of accelerometer axes, epoch length, wear time criterium, time composition (min/24 h vs. % of wear time). Partial least regression and ordinary least regression were used for the association analyses.

RESULTS: The setting of frequency filter had the strongest effect on the physical activity intensity measure and time distribution in different intensity categories followed by epoch length and number of accelerometer axes. Wear time criterium and recalibration of accelerometer data were less important. The setting of frequency filter and epoch length also showed consistent important effect on the associations with the different measures of cardiometabolic health, while the effect of recalibration, number of accelerometer axes, wear time criterium and expression of time composition was less consistent and less important. There was a large range in explained variance of the measures of cardiometabolic health depending on the combination of processing settings, for example, 12.1%-20.8% for aerobic fitness and 5.8%-14.0% for body mass index.

CONCLUSIONS: There was a large variation in the physical activity intensity measure and the association with different measures of cardiometabolic health depending on the combination of settings of accelerometer data processing components. The results provide a fundament for a standard to process hip accelerometer data to assess the physical activity in middle-aged populations.

Galectin-1 plays a functional role in human metabolism and the levels are altered in obesity and type 2 diabetes (T2D). This study investigates the association of cardiorespiratory fitness (CRF) with galectin-1 and the interconnection with body fatness. Cross-sectional data from the Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot was analyzed, including a sample of 774 middle-aged individuals. A submaximal cycle ergometer test was used to estimate CRF as an indirect measure of the physical activity (PA) level. Serum-galectin-1 concentration was determined from venous blood collected after an overnight fast. Body mass index (BMI) was used as an indirect measure of body fatness. CRF was significantly associated with galectin-1, when controlled for age and sex (regression coefficient (regr coeff) = -0.29, p<0.001). The strength of the association was attenuated when BMI was added to the regression model (regr coeff = -0.09, p = 0.07), while the association between BMI and galectin-1 remained strong (regr coeff = 0.40, p<0.001). CRF was associated with BMI (regr coeff = -0.50, p<0.001). The indirect association between CRF and galectin-1 through BMI (-0.50 x 0.40) contributed to 69% of total association (mediation analysis). In group comparisons, individuals with low CRF-high BMI had the highest mean galectin-1 level (25 ng/ml), while individuals with high CRF-low BMI had the lowest level (21 ng/ml). Intermediate levels of galectin-1 were found in the low CRF-low BMI and high CRF-high BMI groups (both 22 ng/ml). The galectin-1 level in the low CRF-high BMI group was significantly different from the other three groups (P<0.001). In conclusion, galectin-1 is associated with CRF as an indirect measure of the PA level through interconnection with body fatness. The size of the association is of clinical relevance.

Forskning visar att det vi aktivt ägnar oss åt - våra medvetna livsstilsval - kan påverka så mycket som 40 % av vårt välbefinnande. Vi har med andra ord stora möjligheter att själva göra en skillnad i hur vi mår. Hälsosegrarna är inom räckhåll!

Här presenteras den allra senaste forskningen om hur rörelse, mat och återhämtning påverkar vår hälsa. Vi får veta vad som händer i kroppen och i hjärnan när vi till exempel stressar för mycket, sover dåligt, sitter för länge eller inte får i oss tillräckligt med näring. Men också hur vi faktiskt kan omsätta den kunskapen i praktiken och ändra våra beteenden. Hur vilar man hjärnan? Vad är egentligen "nyttig" mat? Och vilken funktion fyller vardagsmotionen? Fokus ligger på de vardagliga utmaningarna och de små men hållbara förändringar som kan göra stor skillnad.

Med gedigen kunskap och ett motiverande tilltal varvar de tre författarna vetenskapliga fakta och studier med konkreta tips. Sammantaget blir det ett inspirerande smörgåsbord av fullt genomförbara livsstilsförändringar som kan göra stor skillnad för hur vi mår.

[Text från förlaget]

BACKGROUND: Previous population-based studies investigating the relationship between physical activity and the gut microbiota have relied on self-reported activity, prone to reporting bias. Here, we investigated the associations of accelerometer-based sedentary (SED), moderate-intensity (MPA), and vigorous-intensity (VPA) physical activity with the gut microbiota using cross-sectional data from the Swedish CArdioPulmonary bioImage Study.

METHODS: In 8416 participants aged 50-65, time in SED, MPA, and VPA were estimated with hip-worn accelerometer. Gut microbiota was profiled using shotgun metagenomics of faecal samples. We applied multivariable regression models, adjusting for sociodemographic, lifestyle, and technical covariates, and accounted for multiple testing.

FINDINGS: Overall, associations between time in SED and microbiota species abundance were in opposite direction to those for MPA or VPA. For example, MPA was associated with lower, while SED with higher abundance of Escherichia coli. MPA and VPA were associated with higher abundance of the butyrate-producers Faecalibacterium prausnitzii and Roseburia spp. We observed discrepancies between specific VPA and MPA associations, such as a positive association between MPA and Prevotella copri, while no association was detected for VPA. Additionally, SED, MPA and VPA were associated with the functional potential of the microbiome. For instance, MPA was associated with higher capacity for acetate synthesis and SED with lower carbohydrate degradation capacity.

INTERPRETATION: Our findings suggest that sedentary and physical activity are associated with a similar set of gut microbiota species but in opposite directions. Furthermore, the intensity of physical activity may have specific effects on certain gut microbiota species.

FUNDING: European Research Council, Swedish Heart-Lung Foundation, Swedish Research Council, Knut and Alice Wallenberg Foundation.

OBJECTIVE: To evaluate whether physical activity on prescription, comprising five sessions, was more effective in increasing physical activity than a one-hour advice session after six months.

DESIGN: Randomized, assessor-blinded, controlled trial.

SETTING: Primary care.

SUBJECTS: Patients with clinically verified osteoarthritis of the hip or knee who undertook less than 150 minute/week of moderate physical activity, and were aged 40-74 years.

INTERVENTIONS: The advice group (n = 69) received a one-hour session with individually tailored advice about physical activity. The physical activity on prescription group (n = 72) received individually tailored physical activity recommendations with written prescription, and four follow-ups during six months.

MAIN MEASURES: Patients were assessed at baseline and six months: physical activity (accelerometer, questionnaires); fitness (six-minute walk test, 30-second chair-stand test, maximal step-up test, one-leg rise test); pain after walking (VAS); symptoms (HOOS/KOOS); and health-related quality of life (EQ-5D).

RESULTS: One hundred four patients had knee osteoarthritis, 102 were women, and mean age was 60.3 ± 8.3 years. Pain after walking decreased significantly more in the prescription group, from VAS 31 ± 22 to 18 ± 23. There was no other between groups difference. Both groups increased self-reported activity minutes significantly, from 105 (95% CI 75-120) to 165 (95% CI 135-218) minute/week in the prescription group versus 75 (95% CI 75-105) to 150 (95% CI 120-225) in the advice group. Also symptoms and quality of life improved significantly in both groups.

CONCLUSION: Individually tailored physical activity with written prescription and four follow-ups does not materially improve physical activity level more than advice about osteoarthritis and physical activity.

TRIAL REGISTRATION: ClinicalTrials.gov (NCT02387034).

OBJECTIVE: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients.

DESIGN: Randomised, assessor-blinded, controlled trial.

SETTING: Primary care.

SUBJECTS: Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40-74.

INTERVENTION: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups.

MAIN MEASURES: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months.

RESULTS: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74-130) minutes/week at baseline to 214 (95% CI 183-245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103-157) to 176 (95% CI 145-207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567-462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900-804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5-8.2) and in the prescription group by 14.7 points (95% CI 14.3-15.1) from baseline to 24 months (p = 0.024 between groups).

CONCLUSIONS: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.

OBJECTIVE: To compare the responsiveness of two unilateral lower-limb performance-based tests, the one-leg rise test and the maximal step-up test, with the bilateral 30-second chair-stand test and the self-reported measure of physical function (HOOS/KOOS). Specific aims were to evaluate responsiveness, floor/ceiling effect and association between the instruments.

METHOD: Data was included from 111 participants, mean age 61.3 years (8.3), with clinically verified hip or knee osteoarthritis, who reported less than 150 minutes/week of moderate or vigorous intensity physical activity. Responsiveness, how well the instruments captured improvements, was measured as Cohen's standardised mean difference for effect size, and was assessed from baseline to 12 months following a physical activity intervention. Other assessments were floor and ceiling effects, and correlations between tests.

RESULTS: The maximal step-up test had an effect size of 0.57 (95% CI 0.37, 0.77), the 30-second chair-stand 0.48 (95% CI 0.29, 0.68) and the one-leg rise test 0.12 (95% CI 0.60, 0.31). The one-leg rise test had a floor effect as 72% of the participants scored zero at baseline and 63% at 12 months. The correlation between performance-based tests and questionnaires was considered to be minor (r = 0.188 to 0.226) (p = 0.018 to 0.048).

CONCLUSION: The unilateral maximal step-up test seems more responsive to change in physical function compared to the bilateral 30-second chair-stand test, although the tests did not differ statistically in effect size. The maximal step-up test provides specific information about each leg for the individual and allows for comparison between the legs.

BACKGROUND: The evaluative nature of high performance (HP) sport fosters performance expectations that can be associated with harsh scrutiny, criticism, and job insecurity. In this context, (HP) sport is described as a highly competitive, complex, and turbulent work environment. The aim of this longitudinal, quantitative study was to explore whether HP coaches' perceptions of job insecurity and job value incongruence in relation to work would predict their psychological well- and ill-being over time.

METHODS: HP coaches (n = 299) responded to an electronic questionnaire at the start, middle, and end of a competitive season, designed to measure the following: job insecurity, values, psychological well-being (vitality and satisfaction with work), and psychological ill-being (exhaustion and cynicism). Structural equation model analyses were conducted using Mplus.

RESULTS: Experiencing higher levels of job insecurity during the middle of the season significantly predicted an increase in coaches' psychological ill-being, and a decrease in their psychological well-being at the end of the season. However, value incongruence did not have a significant longitudinal impact.

CONCLUSIONS: These findings cumulatively indicate that coaches' perceptions of job insecurity matter to their psychological health at work. Consequently, it is recommended that coaches and organizations acknowledge and discuss how to handle job security within the HP sport context.

Syfte och frågeställning: Syftet med uppsatsen är att öka förståelsen för hur en icke-professionell ultralöpare kan få ihop sin träning i kombination med livspusslet.

Frågeställningen i uppsatsen är hur icke-professionella ultralöpares förmåga att få ihop sin träning med sitt livspussel påverkas av motivationsfaktorer, sociala faktorer samt praktiska faktorer.

Metod: För att besvara uppsatsens syfte och frågeställning har en kvalitativ intervjumetod använts. Intervjuerna var semistrukturerade med öppna frågor och genomfördes med hjälp av 8 ultralöpare som sprang minst 50 km i veckan samt hade sambo, barn och heltidsjobb. Intervjuerna spelades in, avlyssnades, transkriberades och analyserades. Citat och huvudteman togs fram med en blandning av induktiv och deduktiv tematisk analys.

Resultat: Resultatet visade att motivation, sociala och praktiska faktorer påverkade ultralöpare avsevärt. Dessutom var undertemat inre motivation, att deltagarna upplevde hög självbestämmande motivation en viktig faktor. Även communityt, dvs gemenskapen inom ultralöpning, bedömdes som ett viktigt undertema där löparna kände en familjär känsla. Vidare var det viktigt med flexibilitet inom träningen samt ett jobb med visst anpassningsbart schema.

Slutsats: Jämfört med tidigare forskning har det konstaterats både samband och skillnader med resultatet i denna studie. Gemenskapen, självbestämmande motivation och det lustfyllda med ultralöpning är starka förutsättningar för vidmakthållande av sporten och träningen.

Syfte och frågeställningar

Syftet med uppsatsen är att undersöka hur hälsopedagoger arbetar inom offentlig och privat sektor och se hur deras utbildnings- och arbetslivserfarenheter har förberett dem för deras yrkesliv inom hälsa.

· Hur ser hälsopedagogers arbetslivs- och utbildningserfarenheter ut?

· Hur arbetar hälsopedagoger inom olika sektorer på arbetsmarknaden?

· Hur förbereder Hälsopedagogutbildningen hälsopedagogerna för deras kommande yrkesliv?

Metod

Studien har en kvalitativ ansats med semistrukturerade intervjuer. Urvalet består av fem verksamma hälsopedagoger som arbetar inom offentlig och/eller privat sektor. Hälsopedagogerna har studerat vid Gymnastik- och idrottshögskolan och avlagt examen som hälsopedagoger. Studiens teoretiska utgångspunkt är Bourdieus teori om kapital och humankapitalteorin.

Resultat 

Hälsopedagogerna har en bred utbildnings- och arbetslivserfarenhet. Majoriteten av de intervjuade hälsopedagogerna arbetade parallellt med sina studier i butik och började under sin studietid att arbeta som instruktörer. Efter Hälsopedagogutbildningen så har flera av hälsopedagogerna valt att studera vidare. Oberoende av vilken sektor de arbetar inom har de gemensamt att alla arbetar med fysisk aktivitet genom att vara instruktörer och arbetar med att administrera och planera. Inom ramen för alla hälsopedagogernas anställningar ingår internutbildning. Alla hälsopedagogerna ser ett stort värde i de praktiska delarna av utbildningen. Alla som haft arbete med Lotsmottagningen anser att momentet hade behövts ges större utrymme. Fler av hälsopedagogerna startade under sin praktik upp egna företag som de driver än idag.

Slutsats

Sammanfattningsvis har utbildningen på GIH bidragit till att hälsopedagogerna känner att de har bred kunskap inom hälsa och fysisk aktivitet. Det som har visat sig fördelaktigt för hälsopedagogerna i studien är att de har samlat på sig humankapital i form av utbildning och arbetslivserfarenhet och använt sitt sociala kapital för att förankra det och lyckats knyta an till kontakter som gett dem arbetsmöjligheter. En slutsats är dock att mycket ansvar vilar på individen själv gällande att samla på sig erfarenheter och knyta ett kontaktnät för att göra sig anställningsbar som hälsopedagog.

Debattartikeln tar upp Naturvårdsverkets förhållningssätt till att klassa elcykeln och att nyttja den för att besöka naturområden.

Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.

Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.

Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.

Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.

Introduktion

Levnadsvanor är en viktig bestämningsfaktor för hälsan. I vår tid där sociala medier är ett integrerat faktum finns det anledning att undersöka hur dessa potentiellt inverkar på levnadsvanorna fysisk aktivitet och matvanor, som båda tillhör de påverkbara levnadsvanorna. Detta för att skapa en förståelse för hur den möjliga påverkan upplevs av fysiskt aktiva individer.

Syfte

Syftet med denna studie är att få förståelse för hur fysiskt aktiva individer i åldern 18–30 år upplever att sociala medier påverkar deras kostvanor samt träningsvanor.MetodStudien har genomförts med kvalitativ metod i form av semistrukturerade intervjuer inkluderande sex fysiskt aktiva, unga vuxna i åldern 18–30 år, varav tre kvinnor och tre män. Intervjuerna analyserades genom en tematisk analys.

Resultat

Studien har gett upphov till 4 teman: 1. Påverkan 2. Upplevelser av social media 3. Källkritik och kunskap 4. Främjande av hälsosamma matvanor. Påverkan delades in i subkategorierna positiv och negativ påverkan, där positiv påverkan såsom tips på kost och träning, var ett genomgående resultat. Under temat Upplevelser av social media uppgav deltagarna att de upplevde att algoritmer styrde mycket av flödet, och så uppgav de lite olika typer av innehåll de tittade på, varför detta blev subkategorier. De betonade även vikten av källkritik och kunskap hos den som använder sociala medier, och såg en fara i hur personer utan kunskap om kost och träning skulle kunna tolka det som finns där. Deltagarna ansåg att hälsosamma levnadsvanor skulle kunna främjas med sociala medier.

Diskussion och slutsats

Deltagarna beskriver en mestadels positiv påverkan men belyser även negativa aspekter av sociala mediers influens på kostvanor och träningsvanor. De tror att sociala medier skulle kunna fungera som ett verktyg för att främja hälsosamma levnadsvanor. En viktig slutsats av deltagarnas utsagor skulle kunna vara att kunskap om kost och träning, samt en god självbild och relation till mat är viktiga faktorer som avgör om inlägg om kost och träning i sociala medier blir något som påverkar positivt eller negativt.

INTRODUCTION: Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults.

MATERIALS AND METHODS: Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI.

RESULTS: Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (>20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: -0.15 to 0.51), and no sign of publication bias was found.

CONCLUSIONS: Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.

BACKGROUND: The purpose of the present study was to examine the ability of a submaximal cycling test to detect longitudinal changes in maximal oxygen uptake (VO₂max) and examine the conformity between changes in measured and estimated VO₂max over a time span of 5-8 years.

METHODS: A total of 35 participants (21 men and 14 women), aged 29 to 63 years, performed the Ekblom-Bak (EB) submaximal cycle test for estimation of VO₂max and a maximal treadmill running test for direct measurement of VO₂max. The baseline tests were conducted between 2009 and 2012, and the follow-up tests were completed 5 to 8 years later. Pearson's coefficient of correlation (r) and paired sample t-test were used to analyse the association between change in measured and estimated VO₂max. Random and systematic errors between the measured and estimated VO₂max were evaluated using Bland-Altman plots. Repeated measures ANOVA were used to test differences between changes over time.

RESULTS: There was no significant change in mean measured VO₂max between baseline and follow-up (p = 0.91), however large individual variations were noted (- 0.78 to 0.61 L/min). The correlation between individual change in measured and estimated VO₂max was r = 0.75 (p < 0.05), and the unstandardised B-coefficient from linear regression modelling was 0.88 (95% CI 0.61 to 1.15), i.e., for each litre of change in estimated VO₂max, the measured value had changed 0.88 L. The correlation between baseline and follow-up errors (the difference between estimated-measured VO₂max at each occasion) was r = 0.84 (p < 0.05). With regard to the testing procedure, repeated measures ANOVA revealed that there was no significant difference between the group who exercised at the same work rates at baseline and follow-up (n = 25), and those who required a change in work rate (n = 10).

CONCLUSIONS: The EB test detected a change in VO₂max with reasonably good precision over a time span of 5-8 years. Further studies are needed to evaluate if the test can be used in clinical populations and in subjects with different medications.

CONTEXT: Muscle fiber composition is associated with peripheral insulin action.

OBJECTIVE: We investigated whether extreme differences in muscle fiber composition are associated with alterations in peripheral insulin action and secretion in young, healthy subjects who exhibit normal fasting glycemia and insulinemia.

METHODS: Relaxation time following a tetanic contraction was used to identify subjects with a high or low expression of type I muscle fibers: group I (n=11), area occupied by type I muscle fibers = 61.0 ± 11.8%; group II (n=8), type I area = 36.0 ± 4.9% (P<0.001). Biopsies were obtained from the vastus lateralis muscle and analyzed for mitochondrial respiration on permeabilized fibers, muscle fiber composition and capillary density. An intravenous glucose tolerance test was performed and indices of glucose tolerance, insulin sensitivity and secretion were determined.

RESULTS: Glucose tolerance was similar between groups, whereas whole-body insulin sensitivity was decreased by ~50% in group II vs group I (P=0.019). First phase insulin release (area under the insulin curve during 10 min after glucose infusion) was increased by almost 4-fold in group II vs I (P=0.01). Whole-body insulin sensitivity was correlated with % area occupied by type I fibers (r=0.54; P=0.018) and capillary density in muscle (r=0.61; P=0.005), but not with mitochondrial respiration. Insulin release was strongly related to % area occupied by type II fibers (r=0.93; P<0.001).

CONCLUSIONS: Assessment of muscle contractile function in young healthy subjects may prove useful in identifying individuals with insulin resistance and enhanced glucose stimulated insulin secretion prior to onset of clinical manifestations.