BackgroundThe prevalence of obesity increased while certain measures of physical fitness deteriorated in preschool children in China over the past decade. This study tested the effectiveness of a multifaceted intervention that integrated childcare center, families, and community to promote healthy growth and physical fitness in preschool Chinese children.MethodsThis 12-month study was conducted using a quasi-experimental pretest/posttest design with comparison group. The participants were 357 children (mean age = 4.5 year) enrolled in three grade levels in two childcare centers in Beijing, China. The intervention included: 1) childcare center intervention (physical activity policy changes, teacher training, physical education curriculum and food services training), 2) family intervention (parent education, internet website for support, and family events), and 3) community intervention (playground renovation and community health promotion events). The study outcome measures included body composition (percent body fat, fat mass, and muscle mass), Body Mass Index (BMI) and BMI z-score and physical fitness scores in 20-meter agility run (20M-AR), broad jump for distance (BJ), timed 10-jumps, tennis ball throwing (TBT), sit and reach (SR), balance beam walk (BBW), 20-meter crawl (20M-C)), 30-meter sprint (30M-S)) from a norm referenced test. Measures of process evaluation included monitoring of children’s physical activity (activity time and intensity) and food preparation records, and fidelity of intervention protocol implementation.ResultsChildren in the intervention center significantly lowered their body fat percent (−1.2%, p < 0.0001), fat mass (−0.55 kg, p <0.0001), and body weight (0.36 kg, p <0.02) and increased muscle mass (0.48 kg, p <0.0001), compared to children in the control center. They also improved all measures of physical fitness except timed 10-jumps (20M-AR: −0.74 seconds, p < 0.0001; BJ: 8.09 cm, p < 0.0001; TBT: 0.52 meters, p < 0.006; SR: 0.88 cm, p < 0.03; BBW: −2.02 seconds, p <0.0001; 30M-S: −0.45 seconds, p < 0.02; 20M-C: −3.36 seconds, p < 0.0001). Process evaluation data showed that the intervention protocol was implemented with high fidelity.ConclusionsThe study demonstrated that a policy-driven multi-faceted intervention can improve preschool children’s body composition and physical fitness. Program efficacy should be tested in a randomized trial.Trial registrationChiCTR-ONRC-14004143.
Rate of obesity was alarmingly high in the primary school Chinese children in this cohort, especially in younger children. Excessive time spent on academic-related activities outside school hours, inadequate sleep, physical inactivity and higher levels of screen viewing were major contributors to obesity in these Chinese children.
Background: Based on its high resolution in soft tissue, MRI, especially diffusion-weighted imaging (DWI), is increasingly important in the evaluation of cholesteatoma. The purpose of this study was to evaluate the role of the 2D turbo gradient-and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with the BLADE trajectory technique in the diagnosis of cholesteatoma at 3 T and to qualitatively and quantitatively compare image quality between the TGSE BLADE and RESOLVE methods. Method: A total of 42 patients (23 males, 19 females; age range, 7-65 years; mean, 40.1 years) with surgically confirmed cholesteatoma in the middle ear were enrolled in this study. All patients underwent DWI (both a prototype TGSE BLADE DWI sequence and the RESOLVE DWI sequence) using a 3-T scanner with a 64-channel brain coil. Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR]) were assessed for the two diffusion acquisition techniques by two independent radiologists. Result: A comparison of qualitative scores indicated that TGSE BLADE DWI produced less geometric distortion, fewer ghosting artifacts (P < 0.001) and higher image quality (P < 0.001) than were observed for RESOLVE DWI. A comparison of the evaluated quantitative image parameters between TGSE and RESOLVE showed that TGSE BLADE DWI produced a significantly lower SNR (P < 0.001) and higher parameter values (both contrast and CNR (P < 0.001)) than were found for RESOLVE DWI. The ADC (P < 0.001) was significantly lower for TGSE BLADE DWI (0.763 × 10 − 3 mm 2 /s) than RESOLVE DWI (0.928 × 10 − 3 mm 2 /s). Conclusion: Compared with RESOLVE DWI, TGSE BLADE DWI significantly improved the image quality of cholesteatoma by reducing magnetic sensitive artifacts, distortion, and blurring. TGSE BLADE DWI is more valuable than RESOLVE DWI for the diagnosis of small-sized (2 mm) cholesteatoma lesions. However, TGSE BLADE DWI also has some disadvantages: the whole image intensity is slightly low, so that the anatomical details of the air-bone interface are not shown well, and this shortcoming should be improved in the future.
Aerobic fitness is considered to be an important marker of current health and even a predictor of future health. The aim of this study was to systematically analyse the available scientific information on temporal changes in maximal long-distance running performance (a widely and long-used marker of aerobic fitness) of Asian children. A systematic review of the scientific literature was undertaken to locate studies explicitly reporting on temporal changes (spanning a minimum of 5 years) in maximal long-distance running of apparently healthy (free from known disease or injury) Asian children aged 9-17 years. Studies were located up to October 2010 via computerized searching of bibliographical databases, reference list searching and personal communication with international experts. Temporal changes were analysed at the country by sex by age by test level using best-fitting linear or polynomial regression models relating the year of testing to long-distance running performances expressed as average running speeds. Changes in means were expressed as percent changes and as standardized effect sizes. Eight studies reporting temporal changes in the long-distance running performance of 23,897,571 children aged 9-17 years from four Asian countries over the period 1964-2009 were included. Overall, there was a large decline in long-distance running performance equivalent to -16.6 ± 1.3% (mean change ± 95% confidence interval) or -1.2 ± 0.1 standard deviations. Temporal changes were generally consistent for different sex and age groups, but not for different countries, with large declines observed for children from China and the Republic of Korea, small declines for children from Japan and very small declines for children from Singapore. There is overwhelming evidence of meaningful declines in the maximal long-distance running performance of Asian children in recent decades, which are probably caused by a network of social, behavioural, physical, psychosocial and physiological factors. These declines highlight the need for regular surveillance of Asian children's health-related fitness and proactive public health strategies.
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