On the basis of these findings, we recommend that researchers use the EV ActiGraph cut points to estimate time spent in sedentary, light-, moderate-, and vigorous-intensity activity in children and adolescents.

Obesity is associated with lower skeletal muscle capillarization and lower insulin sensitivity. Vascular endothelial growth factor (VEGF) is important for the maintenance of the skeletal muscle capillaries. To investigate whether VEGF and VEGF receptor [kinase insert domain-containing receptor (KDR) and Flt-1] expression are lower with obesity, vastus lateralis muscle biopsies were obtained from eight obese and eight lean young sedentary men before and 2 h after a 1-h submaximal aerobic exercise bout for the measurement of VEGF, KDR, Flt-1, and skeletal muscle fiber and capillary characteristics. There were no differences in VEGF or VEGF receptor mRNA at rest between lean and obese muscle. Exercise increased VEGF (10-fold), KDR (3-fold), and Flt-1 (5-fold) mRNA independent of group. There were no differences in VEGF, KDR, or Flt-1 protein between groups. Compared with lean skeletal muscle, the number of capillary contacts per fiber was the same, but lower capillary density (CD), greater muscle cross sectional area, and lower capillary-to-fiber area ratio were observed in both type I and II fibers in obese muscle. Multiple linear regression revealed that 49% of the variance in insulin sensitivity (homeostasis model assessment) could be explained by percentage of body fat (35%) and maximal oxygen uptake per kilogram of fat-free mass (14%). Linear regression revealed significant relationships between maximal oxygen uptake and both CD and capillary-to-fiber perimeter exchange. Although differences may exist in CD and capillary-to-fiber area ratio between lean and obese skeletal muscle, the present results provide evidence that VEGF and VEGF receptor expression are not different between lean and obese muscle.

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The purpose of this bounded case study (Merriam and Tisdell, 2016) was to add to the existing research literature on early childhood trauma in addition to understanding teacher and administrator perceptions on students' adverse childhood experiences (ACEs) in rural, Northwest Missouri elementary schools from 2009 through 2019. Survey participants (n=31), consisting of kindergarten through third grade teachers and elementary administrators completed surveys on their perceptions of students' ACEs within their school districts. Interview participants (n=11), consisting of kindergarten through third-grade teachers and elementary principals, shared their perceptions and lived experiences of students' ACEs. Teachers and administrators noticed the most adverse childhood experiences K - 3rd grade children in rural Missouri elementary schools were exposed to include: (a) divorce, (b) substance abuse, (c) mental illness, (d) physical abuse, and (e) emotional neglect. Three themes emerged from the study: (1) the family system included household dysfunction that may include impactful events such as divorce, substance abuse, and mental illness (2) increase of teachers' and administrators' awareness of trauma, and (3) resources and supports. Teachers and administrators noticed an increase in continued trauma perceived to be because of unstable family conditions systems described by Urie Bronfenbrenner's (1970) human ecological systems theory as the microsystem. Suggested implications for teachers, administrators included: (1) an increase of teacher and administrator awareness of trauma, (2) trauma-informed training opportunities through the Missouri Trauma Informed School Initiative for teachers and administrators, (3) a curriculum focus on children's social emotional development, (4) additional youth mental health resources and support for families and school district personnel, and (5) developing and implementing a mentor program partnering teachers and administrators with families in crisis. Additionally, results from the study could aid in helping the MASA, MAESP, and MSTA consider new evidence related to student trauma in rural public elementary schools. This may lead to an opportunity for these professional organizations to review their structures in order to collaborate to create a more robust and meaningful dialogue about childhood trauma. These educational discussions may lead to compelling evidence suggesting adjustments in legislation to support children impact by adverse childhood experiences.