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This study aimed to analyze the efficacy of exercise interventions on muscle strength, muscle mass, and physical performance in older adults with sarcopenia. Randomized controlled studies assessing exercise effects on sarcopenia were searched in Web of Science, PubMed, Cochrane Library, ProQuest, EBSCOhost, Scopus, EMBASE, and VIP and CNKI up to 31 March 2022. Data were expressed as weighted/standardized mean difference (MD/SMD) with 95% confidence intervals (CI). I2 index was employed for heterogeneity. The initial search identified 5379 studies, and 23 studies involving 1252 participants met the inclusion criteria for further analysis. Results revealed that exercise interventions can significantly improve grip strength (MD = 2.38, 95%CI = 1.33–3.43), knee extension strength (SMD = 0.50, 95%CI = 0.36–0.64), muscle mass of lower extremities (MD = 0.28, 95%CI = 0.01–0.56), walking speed (SMD = 0.88, 95%CI = 0.49–1.27), and functional mobility (MD = −1.77, 95%CI = −2.11–−1.42) among older adults with sarcopenia. No significant exercise effects were found on fat-free muscle mass, appendicular muscle mass, skeletal muscle mass, and muscle mass of the upper extremities. The results of subgroup analysis indicated that both resistance training and multicomponent exercise could significantly increase the muscle strength, while aerobic exercise did not. The findings suggest that exercise intervention can effectively improve muscle function and physical performance in older adults with sarcopenia, but has limited effects on the muscle mass of the upper extremities. In addition, it is highly recommended to apply group-based and supervised resistance training and multicomponent exercise in the prevention and treatment of sarcopenia among the older population.

[...]the mastectomy group consisted of 100 % female which created selection bias. In our systematic review and meta-analysis, we found a pooled estimated prevalence of 24 % with preoperative cognitive impairment (CI) in the mixed surgical cohort. [...]we agree with the authors that further studies are necessary to clarify the association between neoadjuvant therapies and POCD, and the long-term effect of anti-cancer treatment (> 2 years) undergoing cancer or non-cancer related surgeries on POCD.

The growing number of older persons undergoing surgery are at a higher risk of neurocognitive disorder due to multimorbidity and age-related changes. Previous reviews estimated postoperative neurocognitive disorder or cognitive dysfunction (POCD) prevalence without accounting for the sample size or study quality. The prevalence of POCD in this population requires further investigation. This systematic review and meta-analysis applies systematic weighting to estimate the pooled prevalence of POCD in older non-cardiac surgical patients. Systematic review and meta-analysis. MEDLINE, MEDLINE ePub, Embase, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews for relevant articles. Non-cardiac surgical patients aged ≥60 years old. Perioperative cognitive assessments. The primary outcome was the prevalence of POCD. Thirty-nine studies (n = 12,921) were included with mean age of 70.0 ± 8.9 years and 44.3 % women. The overall prevalence of POCD was 23 % (95 % CI: 20 %, 27 %) at day 7, 16 % (95 % CI: 7 %, 25 %) at 1 month, 10 % (95 % CI: 8 %, 13 %) at 3 months and 3 % (95 % CI: 2 %, 4 %) at 1 year. Our meta-regression showed a higher prevalence of POCD in abdominal surgeries at day 7 (β = 0.13, 95 % CI: 0.03–0.22, P = 0.01) and 3 months (β = 0.49, 95 % CI: 0.40–0.58, P < 0.001), versus orthopedic surgeries. The overall prevalence of POCD in older non-cardiac surgical populations was 23 %, 16 %, 10 %, and 3 % at day 7, 1 month, 3 months, and 1 year, respectively. Abdominal surgery had a higher prevalence of POCD than orthopedic surgery. The substantial risk of POCD calls for cognitive screening, risk mitigation and interventions to improve surgical outcomes. Through routine preoperative cognitive screening and addressing modifiable risk factors, the incidence and impact of POCD can be markedly reduced, enhancing patient outcomes and recovery. [Display omitted] •The prevalence of POCD was 23 %, 16 % and 10 % at day 7, 1 and 3 months.•The pooled prevalence of POCD was 3 % with most recovered within 1 year.•Abdominal surgery showed a higher POCD prevalence than orthopedic surgery.•Preoperative screening and addressing modifiable risks of POCD may improve patient outcomes.

Background Due to the myriad of benefits of children’s outdoor play and time, there is increasing concern over its decline. This systematic review synthesized evidence on the correlates of outdoor play and outdoor time among children aged 3-12 years. Methods A total of 12 electronic databases in five different languages (Chinese, English, Korean, Spanish, Portuguese) were searched between October 28, 2019 and July 27, 2020. Covidence software was used for screening and Microsoft Excel with a predesigned coding form was used for data extraction. Evidence was synthesized and correlates were categorized using the socioecological model framework. Results Based on 107 studies representing 188,498 participants and 422 childcare centers from 29 countries, 85 studies examined potential correlates of outdoor play while 23 studies examined that of outdoor time (one examined both). The duration of outdoor play and outdoor time ranged between 60 and 165 min/d and 42-240 min/d, respectively. Out of 287 (outdoor play) and 61 (outdoor time) potential correlates examined, 111 correlates for outdoor play and 33 correlates for outdoor time were identified as significant correlates. Thirty-three variables were identified as key/common correlates of outdoor play/time, including eight correlates at the individual level (e.g., sex/gender, race/ethnicity, physical activity), 10 correlates at the parental level (e.g., parental attitude/support/behavior, parenting practice), nine at the microsystem level (e.g., proximal home/social environment such as residence type, peer influence), three at the macrosystem/community level (e.g., availability of space children can play), and three at the physical ecology/pressure for macrosystem change level (e.g., seasonality, rurality). No key correlates were found at the institutional level. Conclusions Individual, parental, and proximal physical (home) and social environments appear to play a role in children’s outdoor play and time. Ecological factors (i.e., seasonality, rurality) also appear to be related to outdoor play/time. Evidence was either inconsistent or lacking at institutional and macrosystem/community levels. Standardizing terminology and measures of outdoor play/time is warranted. Future work should investigate the interactions and processes of multiple variables across different levels of socioecological modelling to better understand the mechanisms through which outdoor play/time opportunities can be optimized for children while paying special attention to varying conditions in which children are born, live, and play.

Background Engaging in no moderate-to-vigorous physical activity (MVPA) has been recognized as an important indicator in physical activity (PA) surveillance, as any engagement in MVPA confers health benefits compared to none. Studying the prevalence of no MVPA can provide valuable insights into physical inactivity patterns and inform public health intervention efforts. While some cross-sectional studies have examined this issue, no research has analysed year-to-year trends. Therefore, the aim of this study was to assess trends of no MVPA among adolescents and key subgroups using a nationally representative US sample. Methods Data from 2005 to 2021 cycles of the Youth Risk Behavior Surveillance System were used, with 115,926 US adolescents aged 14–17 years included (female: unweighted sample size = 58,582, 50.5%; weighted%=49.4%). Participants self-reported their demographic (sex, age, race/ethnicity, body mass index) and behavioural information (days of ≥ 60 min of MVPA over the past week, and recreational screen time). No MVPA was operationalized as reporting 0 days of ≥ 60 min of MVPA. Trend analysis was performed to assess temporal variations from 2005 to 2021 using a series of binary logistic regression models after controlling for demographic and screen time related variables. Results Declining trends in no MVPA were observed among adolescents from 2005 (weighted: 24.3%) to 2021 (weighted: 15.5%). After stratifying by sex, age, race/ethnicity, body mass index and recreational screen time, similar downward trends were shown across all adolescent subgroups consistently ( p for trend < 0.001). Girls, older adolescents, those who identified as non-White, adolescents with excess weight, and those engaging in more than 2 h of recreational screen time per day tended to report no MVPA at higher rates (all p  < 0.001) compared to their counterparts. Conclusions No MVPA has declined among the US adolescents, especially after 2009. Notably, sociodemographic disparities were observed in no MVPA among different population subgroups. PA promotion strategies targeting girls and older adolescents should be prioritized to further reduce the prevalence of no MVPA.

Objective Childhood is a critical period for brain development. However, it remains unknown whether the behaviors in a typical 24-h day are related to children’s executive function (EF). This study aimed to investigate the relationship between the 24-h movement guidelines and children’s EF. Method Children aged 7–12 years ( n  = 376) were studied in 2017 in China. Physical activity (PA) was accelerometer-derived, while screen time (ST) and sleep duration were self-reported. Meeting the 24-h movement guidelines was defined as: 1) ≥ 60 min/day of moderate-to-vigorous PA; 2) ≤ 2 h/day of recreational ST; 3) 9–11 h/night of sleep. EF was assessed by the Wisconsin Card Sorting Test (WCST). Number of completed categories (CC), shifting efficiency (SE), non-perseverative errors (NPE), and failure to maintain set (FMS) were used to measure four processes of EF, respectively represented global performance, cognitive flexibility, efficiency in rule discovery, and sustained attention. Generalized linear mixed models (GLMM) were completed to explore the associations of meeting the PA, ST, and sleep duration recommendations with four processes of EF. Results Statistically significant positive associations were observed between the number of guidelines met, regarded as a continuous variable, with CC [ β  = 0.343 (95% confidence interval [CI]: 0.125, 0.561)] and SE [ β  = 4.028 (95% CI: 0.328, 7.727)], while number of guidelines met negatively related to NPE [ β  =  − 4.377 (95% CI:-7.952,-0.802)]. Participants not meeting the two recommendations for PA and sleep duration had lower scores in CC [ β  = -0.636(95% CI:-1.125,-0.147)] and SE [ β  = -10.610 (95% CI:-18.794,-2.425)] compared with those meeting the two, suggesting inferior global performance and worse efficiency in rule discovery. However, ST recommendation had no significant association with any processes of EF. Conclusion Meeting more recommendations of the 24-h movement guidelines was associated with superior EF in children. Specifically, more PA and healthy sleep duration should be encouraged to promote children’s EF.

eHealth literacy (EHL) refers to a variety of capabilities that enable individuals to obtain health information from electronic resources and apply it to solve health problems. With the digitization of health care and the wide availability of health apps, a more diverse range of eHealth skills is required to properly use such health facilities. Existing EHL measurements focus mainly on the skill of obtaining health information (Web 1.0), whereas skills for web-based interactions (Web 2.0) and self-managing health data and applying information (Web 3.0) have not been well measured. This study aims to develop an EHL scale (eHLS) termed eHLS-Web3.0 comprising a comprehensive spectrum of Web 1.0, 2.0, and 3.0 skills to measure EHL, and evaluate its validity and reliability along with the measurement invariance among college students. In study 1, 421 Chinese college students (mean age 20.5, SD 1.4 years; 51.8% female) and 8 health experts (mean age 38.3, SD 5.9 years; 87.5% female) were involved to develop the eHLS-Web3.0. The scale development included three steps: item pool generation, content validation, and exploratory factor analysis. In study 2, 741 college students (mean age 21.3, SD 1.4 years; 52.2% female) were recruited from 4 Chinese cities to validate the newly developed eHLS-Web3.0. The construct validity, convergent validity, concurrent validity, internal consistency reliability, test-retest reliability, and measurement invariance across genders, majors, and regions were examined by a series of statistical analyses, including confirmatory factor analysis (CFA) and multigroup CFAs using SPSS and Mplus software packages. Based on the item pool of 374 statements collected during the conceptual development, 24 items (4-10 items per subscale) were generated and adjusted after cognitive testing and content validity examination. Through exploratory factor analysis, a 3-factor eHLS-Web3.0 was finally developed, and it included acquisition (8 items), verification (6 items), and application (10 items). In study 2, CFAs supported the construct validity of the 24-item 3D eHLS-Web3.0 (χ =903.076, χ =3.701, comparative fit index=0.924, Tucker-Lewis index=0.914, root mean square error of approximation [RMSEA]=0.06, and standardized root mean residual [SRMR]=0.051). The average variance extracted (AVE) value of 0.58 and high correlation between eHLS-Web3.0 subscales and the eHealth Literacy Scale (r=0.725-0.880, P<.001) indicated the convergent validity and concurrent validity of the eHLS-Web3.0. The results also indicated satisfactory internal consistency reliability (α=.976, ρ=0.934-0.956) and test-retest reliability (r=0.858, P<.001) of the scale. Multigroup CFA demonstrated the 24-item eHLS-Web3.0 to be invariant at all configural, metric, strength, and structural levels across genders (female and male), majors (sport-related, medical, and general), and regions (Yinchuan, Kunming, Xiamen, and Beijing). The 24-item 3D eHLS-Web3.0 proved to be a reliable and valid measurement tool for EHL in the Web 3.0 context among Chinese college students.

Abstract Background: The epidemic of childhood obesity has been well documented in typically developing child populations, while situations among children with intellectual disabilities (ID) remain unclear. Methods: A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children's height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children's physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children's eating, PA, and their sociodemographic characteristics. Results: Of the participants, 31.3% were overweight or obese, which was higher than their typical counterparts (18.7%–19.9%). Multivariate logistic regression analyses revealed that overweight and obesity in children with ID were linked to their comorbidity with autism, maternal overweight and obesity, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened beverages, fried food, meats, fish, and eggs. Conclusions: Children with ID are vulnerable to being overweight or obese. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children's questionable behaviors to help them achieve a healthy weight.

Objectives Regular engagement in physical activity (PA) has numerous health benefits in young children. Young children’s parents can influence their children’s PA behavior through different PA-related parenting practices. This cross-sectional study examined the independent contributions of socio-demographic, family/home and parent-perceived neighborhood environmental characteristics explaining PA-related parenting practices encouraging or discouraging PA among Hong Kong preschool-aged children (3–5 years-old). Methods Hong Kong Chinese preschoolers’ parents were recruited from pre-selected kindergartens and Maternal and Child Health Centers located in areas stratified by residential density and socio-economic status. They self-completed socio-demographic, family/home and perceived neighborhood characteristics and PA-related parenting practices questionnaires. Generalized linear models were used to examine associations of socio-demographic, family/home and neighborhood variables with PA-related parenting practices. Results Socio-demographic and family/home characteristics were significantly correlated with parenting practices encouraging and discouraging PA. Parent-perceived neighborhood characteristics were significantly correlated with parenting practices discouraging PA only. Conclusions for Practice This study identified correlates of PA-related parenting practices among parents of Hong Kong Chinese preschoolers. The findings suggest future PA-promoting interventions among Chinese preschoolers via the promotion of parenting practices encouraging children’s PA should consider multiple factors, including family relationships and childcare sharing, promotion of PA and its benefits among parents, and neighborhood social cohesion, traffic safety and safety from crime.

High prevalence of long COVID symptoms has emerged as a significant public health concern. This study investigated the associations between three doses of COVID-19 vaccines and the presence of any and ≥3 types of long COVID symptoms among people with a history of SARS-CoV-2 infection in Hong Kong, China. This is a secondary analysis of a cross-sectional online survey among Hong Kong adult residents conducted between June and August 2022. This analysis was based on a sub-sample of 1,542 participants with confirmed SARS-CoV-2 infection during the fifth wave of COVID-19 outbreak in Hong Kong (December 2021 to April 2022). Among the participants, 40.9% and 16.1% self-reported having any and ≥3 types of long COVID symptoms, respectively. After adjusting for significant variables related to sociodemographic characteristics, health conditions and lifestyles, and SARS-CoV-2 infection, receiving at least three doses of COVID-19 vaccines was associated with lower odds of reporting any long COVID symptoms comparing to receiving two doses (adjusted odds ratio [AOR]: 0.69, 95% CI: 0.54, 0.87, P = .002). Three doses of inactivated and mRNA vaccines had similar protective effects against long COVID symptoms. It is important to strengthen the coverage of COVID-19 vaccination booster doses, even in the post-pandemic era.