Background Children and adolescents do not meet the current recommendations on physical activity (PA), and as such, the health-related benefits of regular PA are not achieved. Nowadays, technology-based programs represent an appealing and promising option for children and adolescents to promote PA. Objective The aim of this review was to systematically evaluate the effects of mobile health (mHealth) and wearable activity trackers on PA-related outcomes in this target group. Methods Electronic databases such as the Cochrane Central Register of Controlled Trials, PubMed, Scopus, SPORTDiscus, and Web of Science were searched to retrieve English language articles published in peer-reviewed journals from January 2012 to June 2018. Those included were articles that contained descriptions of interventions designed to increase PA among children (aged 6 to 12 years) only, or adolescents (aged 13 to 18 years) only, or articles that include both populations, and also, articles that measured at least 1 PA-related cognitive, psychosocial, or behavioral outcome. The interventions had to be based on mHealth tools (mobile phones, smartphones, tablets, or mobile apps) or wearable activity trackers. Randomized controlled trials (RCTs) and non-RCTs, cohort studies, before-and-after studies, and cross-sectional studies were considered, but only controlled studies with a PA comparison between groups were assessed for methodological quality. Results In total, 857 articles were identified. Finally, 7 studies (5 with tools of mHealth and 2 with wearable activity trackers) met the inclusion criteria. All studies with tools of mHealth used an RCT design, and 3 were of high methodological quality. Intervention delivery ranged from 4 weeks to 12 months, whereby mainly smartphone apps were used as a tool. Intervention delivery in studies with wearable activity trackers covered a period from 22 sessions during school recess and 8 weeks. Trackers were used as an intervention and evaluation tool. No evidence was found for the effect of mHealth tools, respectively wearable activity trackers, on PA-related outcomes. Conclusions Given the small number of studies, poor compliance with accelerometers as a measuring instrument for PA, risk of bias, missing RCTs in relation to wearable activity trackers, and the heterogeneity of intervention programs, caution is warranted regarding the comparability of the studies and their effects. There is a clear need for future studies to develop PA interventions grounded on intervention mapping with a high methodological study design for specific target groups to achieve meaningful evidence.

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Intervention at the level of the HPA axis altered the immune response to surgical stress. This resulted in decreased postoperative pneumonia rates and shortened intensive care unit stay in long-term alcoholic patients.

Laparoscopy does not increase bacteremia and intraperitoneal abscess formation compared to laparotomy in an animal model of peritonitis.

Currently, children with CHD are not limited in their submaximal exercise performance. However, there is still a reduction in peak oxygen uptake.

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Low cardiorespiratory fitness is associated with higher cardiovascular risk, whereas high levels of cardiorespiratory fitness protect the cardiovascular system. Carotid intima-media thickness and arterial distensibility are well-established parameters to identify subclinical cardiovascular disease. Therefore, this study investigated the influence of cardiorespiratory fitness and muscular strength on carotid intima-media thickness and arterial distensibility in 697 children and adolescents (376 girls), aged 7-17 years. Cardiorespiratory fitness and strength were measured with the test battery FITNESSGRAM; carotid intima-media thickness, arterial compliance, elastic modulus, stiffness index β, and pulse wave velocity β were assessed by B- and M-mode ultrasound at the common carotid artery. In bivariate correlation, cardiorespiratory fitness was significantly associated with all cardiovascular parameters and was an independent predictor in multivariate regression analysis. No significant associations were obtained for muscular strength. In a one-way variance analysis, very fit boys and girls (58 boys and 74 girls>80th percentile for cardiorespiratory fitness) had significantly decreased stiffness parameters (expressed in standard deviation scores) compared with low fit subjects (71 boys and 77 girls<20th percentile for cardiorespiratory fitness): elastic modulus -0.16±1.02 versus 0.19±1.17, p=0.009; stiffness index β -0.15±1.08 versus 0.16±1.1, p=0.03; and pulse wave velocity β -0.19±1.02 versus 0.19±1.14, p=0.005. Cardiorespiratory fitness was associated with healthier arteries in children and adolescents. Comparison of very fit with unfit subjects revealed better distensibility parameters in very fit boys and girls.

To detect more alcoholic patients at risk for major complications, patients should be seen more often, and additional diagnostic tools such as the CAGE, CDT, and GGT should be used before surgery.