Dr. Debra M Vinci

Lifelong movement and physical activity (PA) patterns develop during early childhood. Therefore, educators (teachers and practitioners) in early childhood education and care (ECEC) should provide opportunities to support children’s play, PA, and movement development. The World Health Organization (2019) offers new recommendations for PA, for children under five years. The guidelines do not specify the ways ECEC staff can support PA through play. Therefore, this paper investigates, how physical play (PP) is enacted globally. An international policy and practice analysis of twelve countries, (Australia [Victoria], Belgium [Flanders], Canada [Alberta], China, Finland, Ireland, Italy, Portugal, Spain, Sweden, UK [England] and USA) was completed by analyzing the ECEC curricula and their implementation in different cultural contexts. A content analysis was undertaken by AIESEP Early Years SIG experts revealing that PP was not clearly defined. When defined, it was described as PA, and important for children’s holistic development. The majority of curricula did not state the length/time for PP. Three main strategies for implementing PP were found: a) pedagogical framework; b) active learning methods; and c) motor development. This international analysis highlights the global need for better ECEC staff support in acknowledging and implementing PP to aid children’s overall development, PA and wellbeing.

Public acceptance of the HPV vaccine has not matched that of other common adolescent vaccines, and HPV vaccination rates remain below the Healthy People 2020 target of 80% compliance. The purpose of this study was to evaluate the capacity of nine pediatric clinics in a Federally Qualified Health Center organization to implement a systems-based intervention targeting office staff and providers using EHRs and a statewide immunization information system to increase HPV vaccination rates in girls and boys, ages 11 to 16 over a 16-month period. System changes included automated HPV prompts to staff, postcard reminders to parents when youths turned 11 or 12 years old, and monthly assessment of provider vaccination rates. During the intervention, 8960 patients (11–16 yo) were followed, with 48.8% girls (n=4370) and 51.2% boys (n=4590). For this study period, 80.5% of total patients received the first dose of the HPV vaccine and 47% received the second dose. For the first dose, 55.5% of 11 year old girls and 54.3% of 11 year old boys were vaccinated. For ages 12 to 16, first dose
vaccination rates ranged from the lowest rate of 84.5% for 14 yo girls up to the highest rate of 90.5% for 13 yo boys. Logistic regression showed age was highly significantly associated with first dose completion (OR 1.565, 95% CI 1.501, 1.631) while males did not have a significant association with first dose completion compared to females. The intervention increased overall counts of first and second HPV vaccination rates.

Introduction and objectives
Endurance exercise (EXE) has emerged as a potent inducer of autophagy essential in maintaining cellular homeostasis in various tissues; however, the functional significance and molecular mechanisms of EXE-induced autophagy in the liver remain unclear. Thus, the aim of this study is to examine the signaling nexus of hepatic autophagy pathways occurring during acute EXE and a potential crosstalk between autophagy and apoptosis.

Materials and methods
C57BL/6 male mice were randomly assigned to sedentary control group (CON, n = 9) and endurance exercise (EXE, n = 9). Mice assigned to EXE were gradually acclimated to treadmill running and ran for 60 min per day for five consecutive days.

Results
Our data showed that EXE promoted hepatic autophagy via activation of canonical autophagy signaling pathways via mediating microtubule-associated protein B-light chain 3 II (LC3-II), autophagy protein 7 (ATG7), phosphorylated adenosine mono phosphate-activated protein kinase (p-AMPK), CATHEPSIN L, lysosome-associated membrane protein 2 (LAMP2), and a reduction in p62. Interestingly, this autophagy promotion concurred with enhanced anabolic activation via AKT-mammalian target of rapamycin (mTOR)-p70ˢ⁶ᴷ signaling cascade and enhanced antioxidant capacity such as copper zinc superoxide dismutase (CuZnSOD), glutathione peroxidase (GPX), and peroxiredoxin 3 (PRX3), known to be as antagonists of autophagy. Moreover, exercise-induced autophagy was inversely related to apoptosis in the liver.

Conclusions
Our findings indicate that improved autophagy and antioxidant capacity, and potentiated anabolic signaling may be a potent non-pharmacological therapeutic strategy against diverse liver diseases.

Given the prevalence of traumatic brain injuries (fBI) in contact sports such as American Football, the need for increased research in TBI has been dramatically increased over the last 20-years. TBI has two main mechanisms that cause neuronal cell death following an incident: direct axonal death and neuronal inflammation, with the latter being the most common because it persists more than a decade and chronically affects neighboring neurons. Therefore, proper management that reduces inflammation post-TBI should be stressed in order to facilitate propitious recovery. While sideline concussion protocols have been implemented in sports fields, it is important immediately to initiate recovery protocols in order to minimize the degree of progressive neuronal death caused by TBI. While difficult to individualize symptoms for each occurrence, it is essential to incorporate a pretest of cognition, memory, and balance as a means of determining the severity of TBI. Although the sports concussion assessment tool 2 has been used by collegiate and professional teams, this tool is just based on observation and comparison. Thus, more precise and advanced diagnosis using biological methods are needed to accurately assess individual symptoms, which should save lives. One example is to use serum creatine kinase (CK) levels because CK released from damaged brain tissues enters the bloodstream and thus TBI can be quickly assessed and identified. While the immediate diagnosis of TBI is one part of management, efficacious treatments of post-TBI is also critical. Regarding this, exercise and nutritional supplementation have been reported to be effective. While specific pathways of neuroprotective mechanisms remain to be elucidated, endurance exercise along with supplementation of fish oil, caffeine, and vitamin D seems to elicit neuroprotective effects. This review provides potential mechanisms responsible for exercise and nutritional supplementation-mediated neuroprotection against TBI. Since human subjects are limited to mechanistic studies requiring invasive surgical procedures, research involving animals (e.g., mouse and rat) are also introduced in this review.

During the last two decades there have been growing interests on recommendations for children’s physical activity. The World Health Organization (WHO) launched the first global international recommendations for children in 2010, focusing on children and youth aged 5-17-year olds. The recommendations were based on the dose-response relationship between the frequency, duration, intensity, type and amount of physical activity needed for prevention of non-communicable diseases. Until 2019, there was a gap in the recommendations, as the WHO did not offer global recommendations for those children under the age of 5 (early years). The new recent guidelines (WHO, 2019) now offer a focused recommendations for physical activity, sedentary behaviour and sleep for under 5 years of age, however what the guidelines do not offer are ways in which early years’ practitioners and teachers can support physical activity through play to ensure children are inspired, motivated and competent to have a physically active daily life as well enjoy moving.

An international policy and practice analysis, (not previously undertaken), of ten sample countries, was completed of current national physical activity practices. Also, an international comparison of early years’ education settings was examined, specifically for those under the age of 5, to investigate current curricula, as well as the qualifications, knowledge and understanding of those supporting children’s learning in different cultural contexts. The sample of ten countries (Belgium, China, Denmark, Finland, Germany, Ireland, Italy, Norway, United Kingdom and United States of America) questioned whether the global daily physical activity recommendations (WHO, 2010), currently applied at time of analysis, are costumed and used for to the early years’ age group on a national level or if they need to be adjusted, especially in light of the new guidelines.
The analysis revealed that eight countries have developed their own national recommendations for children below the age of 5, while only two countries do not have any early years’ specific physical activity recommendations. National authorities seem to be the most common executive sources behind the recommendations. The content of physical activity for children under the age of 5, mostly included the total amount and intensity of physical activity. The total daily amount of physical activity in these ten countries varies between 60 minutes moderate to vigorous intensity physical activity up to 180 min total light to moderate intensity physical activity and for some countries the daily recommendations are only from age 1 year, not between birth and 1 year, this age range remains unsupported.

The conclusions from the analysis of national recommendations, underlined the need to extend further the new global recommendations so that they are developed to support all countries to go beyond just physical activity intensity levels and to consider how young children’s development can be supported in a versatile way by physically active play. Also age specific recommendations are offered for appropriate and purposeful physical activity to support early years and school aged children’s overall development. The findings also suggest educational recommendations for staff members of early childhood education and care settings to know appropriate and age specific recommendations to ensure they are able to support young children to reach the national and global recommendations. Research recommendations are also proposed.

Purpose
Metabolic disorder such as obesity and type 2 diabetes caused by excess caloric intake is associated with an increased risk of neurodegenerative diseases. Endurance exercise (EXE) has been suggested to exert neuroprotective effects against the metabolic distress. However, the exact underlying molecular mechanisms responsible for the exercise-induced neuroprotection have not been fully elucidated. In this study, we investigated whether EXE-induced neuroprotection is associated with cellular senescence, neuroinflammation, and oxidative stress using a mouse model of obesity induced by a high-fat/high-fructose diet.

Methods
C57BL/6 female mice (10 wk old) were randomly divided to three groups: normal chow diet group (CON, n = 11), high-fat diet/high-fructose (HFD/HF) group (n = 11), and high-fat diet/high-fructose + endurance exercise (HFD/HF + EXE) group (n = 11). HFD/HF + EXE mice performed treadmill running exercise for 60 min·d⁻¹, 5 d·wk⁻¹ for 12 wk.

Results
Our data showed that EXE ameliorated HFD/HF-induced weight gain, fasting blood glucose levels, and visceral fat gain. More importantly, HFD/HF diet promoted cellular senescence, whereas EXE reversed it, evidenced by a reduction in the levels of p53, p21, p16, beta-galactosidase (SA-β-gal), and lipofuscin. Furthermore, EXE prevented HFD/HF-induced neuroinflammation (e.g., tumor necrosis factor-α and interleukin-1β) by inhibiting toll-like receptor 2 downstream signaling cascades (e.g., tumor necrosis factor receptor–associated factor 6, c-Jun N-terminal kinase, and c-Jun) in parallel with reduced reactive glial cells. This anti-inflammatory effect of EXE was associated with the reversion of HFD/HF-induced cellular oxidative stress.

Conclusion
Our study provides novel evidence that EXE-induced antisenescence against metabolic distress in the hippocampus may be a key neuroprotective mechanism, preventing neuroinflammation and oxidative stress.

Parents play a pivotal role in increasing children's physical activity levels and reducing time spent in sedentary activities. Positive role modeling of physical activity behaviors influences the amount of screen time use and engagement in at-home physical activity. This study aimed to determine the effectiveness and perceived usability of a physical activity app designed for children aged 3 to 5. Parents/guardians of preschool-age children were interviewed on the desired content of a physical activity app targeted at children. Following a review of the free physical activity app, participants were asked questions about the content, imagery, resources, and overall user friendliness. Parents suggested that the app be frequently updated with new videos and that more colorful icons that better represent the physical activity videos be added. In addition, they desired access to printable resources such as curriculum cards and coloring pages. Participants identified that the app was easy to follow and they would recommend the app to a friend. The majority of recommendations included improving the presentation of the app so that it looks more appealing and needing the app to be more preschool-age friendly. For the app to remain a resource for physical activity and not a source for sedentary activity, recommendations for more interactive games on the app were not included in the final version.

Overweight and obesity are increasing in preschool children in the US. Policy, systems, and environmental change interventions in childcare settings can improve obesity-related behaviors. The aim of this study was to develop and pilot an intervention to train childcare providers to promote physical activity (PA) in childcare classrooms. An evidence scan, key informant (n = 34) and focus group (n = 20) interviews with childcare directors and staff, and environmental self-assessment of childcare facilities (n = 22) informed the design of the training curriculum. Feedback from the interviews indicated that childcare providers believed in the importance of teaching children about PA and were supportive of training teachers to incorporate PA into classroom settings. The Promoting Physical Activity in Childcare Setting Curriculum was developed and training was implemented with 16 teachers. Participants reported a positive experience with the hands-on training and reported acquiring new knowledge that they intended to implement in their childcare settings. Our findings highlight the feasibility of working with childcare staff to develop PA training and curriculum. Next steps include evaluating the curriculum in additional childcare settings and childcare staff implementation of the curriculum to understand the effectiveness of the training on PA levels of children.