A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents Intervening to Reduce Sedentary Behaviors and Childhood Obesity among School-Age Youth: A Systematic Review of Randomized Trials Higher levels of objectively measured sedentary behavior is associated with worse cognitive ability: Two-year follow-up study in community-dwelling older adults Comparison of Actical and activPAL measures of sedentary behaviour in preschool children. Feasibility and preliminary efficacy of an intervention to reduce older adults’ sedentary behavior Definition, measurement, and health risks associated with sedentary behavior. Sedentary behavior & health-related quality of life among congestive heart failure patients. Randomised controlled feasibility study of a school-based multi-level intervention to increase physical activity and decrease sedentary behaviour among vocational school students Study protocol for Chronic Obstructive Pulmonary Disease-Sitting and ExacerbAtions Trial (COPD-SEAT): a randomised controlled feasibility trial of a home-based self-monitoring sedentary behaviour intervention What helps children to move more at school recess and lunchtime? Mid-intervention results from Transform-Us! cluster-randomised controlled trial Correlates of preschool children’s objectively measured physical activity and sedentary behavior: a cross-sectional analysis of the SPLASHY study The effect of a movement-to-music video program on the objectively measured sedentary time and physical activity of preschool-aged children and their mothers: A randomized controlled trial Motivational counselling and SMS-reminders for reduction of daily sitting time in patients with rheumatoid arthritis: a descriptive randomised controlled feasibility study Detection of Small Bowel Mucosal Healing and Deep Remission in Patients With Known Small Bowel Crohn’s Disease Using Biomarkers, Capsule Endoscopy, and Imaging What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol Standing Up for Student Health: An Application of the Health Action Process Approach for Reducing Student Sedentary Behavior-Randomised Control Pilot Trial. Examination of mid-intervention mediating effects on objectively assessed sedentary time among children in the Transform-Us! cluster-randomized controlled trial Prostate cancer diagnosis: multiparametric MR-targeted biopsy with cognitive and transrectal US-MR fusion guidance versus systematic biopsy--prospective multicenter study. A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds: The Transform-Us! Study Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study Square-stepping exercise versus strength and balance training for fall risk factors One-year changes in physical activity and sedentary behavior among adolescents: the Croatian Physical Activity in Adolescence Longitudinal Study (CRO-PALS). Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women.
ABSTRACT Lack of  physical activity  (  PA  ) and high levels of sedentary behaviour ( SB ) have been associated with health problems . This systematic review evaluates the effectiveness of school-based interventions to increase PA  and decrease SB  among 15–19-year-old adolescents , and examines whether intervention characteristics ( intervention length , delivery mode and intervention provider ) and intervention content ( i.e. behaviour change techniques , BCTs ) are related to intervention effectiveness . A systematic search of r and omised or cluster r and omised controlled trials with outcome measures of PA and /or SB rendered 10 results . Risk of bias was assessed using the Cochrane risk of bias tool . Intervention content was coded using Behaviour Change Technique Taxonomy v1 . Seven out of 10 studies reported significant increases in PA . Effects were generally small and short-term ( Cohen 's d ranged from 0.132 to 0.659 ) . Two out of four studies that measured SB reported significant reductions in SB . Interventions that increased PA  included a higher number of BCTs , specific BCTs ( e.g. , goal setting , action planning and self-monitoring ) , and were delivered by research staff . Intervention length and mode of delivery were unrelated to effectiveness . More studies are needed that evaluate long-term intervention effectiveness and target SBs among older adolescents Objective . To assess the effectiveness of interventions that focus on reducing  sedentary behavior ( SB ) among school-age youth and to identify elements associated with interventions ' potential for translation into practice setting s. Methods . A comprehensive literature search was conducted using 4 data bases for peer- review ed studies published between 1980 and April 2011 . R and omized trials , which lasted at least 12 weeks , aim ed at decreasing  SB among children aged 6 to 19 years were identified . Results . Twelve studies were included ; 3 focused only on SB , 1 focused on  physical activity ( PA )  , 6 were combined SB and PA interventions , and 2 studies targeted SB , PA , and diet .  The majority of the studies were conducted in a school setting , while others were conducted in such setting s as clinics , community centers , and libraries . Conclusions . Overall , interventions that focused on decreasing SB were associated with reduction in time spent on SB and /or improvements in anthropometric measurements related to childhood obesity . Several of the studies did consider elements related to the intervention 's potential for translation into practice setting Background : A number of cross‐sectional studies have suggested that higher levels of  sedentary behavior ( SB ) are associated with worse cognitive abilities  in older age . There is a paucity of longitudinal studies investigating this relationship utilizing objective ly assessed SB . This study investigated the relationship between objective ly assessed SB and future cognitive abilities in a cohort of older adults . Methods : A longitudinal study over 22.12 ± 1.46 months including 285 community‐dwelling older adults across 14 regions in Taiwan was undertaken . Cognitive ability was ascertained using a Chinese version of the Ascertain Dementia 8‐item Question naire ( AD8 ) and SB captured by 7 days accelerometer data . Multivariable negative binomial regression models adjusted for confounders were undertaken . Results : 274 community‐dwelling older adults finished the study ( age = 74.6 ± 6.2 , % female = 54.4 % ) . At baseline , 20.1 % ( n = 55 ) , 48.5 % ( n = 133 ) and 31.4 % ( n = 86 ) of the sample engaged in high ( 11 + h ) , medium ( 7–10.99 h ) and low ( < 7 h ) of SB respectively . In the fully adjusted model , higher levels of SB were associated with an increased risk of worse cognitive ability at follow up ( adjusted rate ratio (ARR)1.09 ( 95%CI:1.00–1.19 ) ) , with the strongest relationship evident in those engaging in over 11 h of SB ( ARR 2.27 ( 95%CI:1.24–4.16 ) ) . The relationship remained evident after adjusting for depressive symptoms and physical activity . Conclusion : Our data suggests that objective ly assessed SB , particularly when over 11 h a day , is independently associated with worse cognitive ability over a two year period . Our data adds to the pressing reasons to reduced SB in older age . HighlightsFirst prospect i ve study to investigate objective  ly sedentary behavior ( SB ) and cognition in older adults . Higher levels of objective SB were independently associated with worse cognitive ability over two years . This relationship was most pronounced in older people spending over 11 h a day being sedentary OBJECTIVES The purpose of this study was to examine the convergent validity of the Actical and activPAL to measure  sedentary behaviour ( SB ) and non-SB in preschoolers in a free-living environment . DESIGN A convenience sample of 49 preschoolers ( 22 boys ; 4.0 ± 0.5 years ) from six early childhood centres in Auckl and , New Zeal and were included in data analysis . METHODS Participants wore a hip-mounted Actical and a thigh-mounted activPAL accelerometer simultaneously during centre attendance for one day and data were collected in 15s epochs . Bl and -Altman tests were used to assess differences in group mean minutes and percentage of time in (non-)SB between both monitors . Agreement between binary coded ( SB vs. non-SB ) 15s-by-15s Actical and activPAL data was evaluated by calculating percentage agreement and κ statistic . RESULTS The monitors were worn on average for 294.8 ± 46.3 min result ing in a total of 57,780 15s epochs . Bl and -Altman tests suggested a small group mean difference in (non-)SB ( 1.3 min ; 0.1 % ) and a wide prediction interval ( 121.3 min ; 39.2 % ) . No obvious systematic bias was observed in the Bl and -Altman plot . Percentage agreement between the 15s-by-15s Actical and activPAL data of all participants was 73.0 % ( inter-child range : 36.8 - 93.8 % ) . The κ statistic showed moderate agreement with a value of 0.46 ( 95 % CI : 0.45 - 0.47 ) . CONCLUSIONS Although the group mean estimate of (non-)SB was similar between the Actical and activPAL , the output of both monitors can not be considered convergent as meaningful r and om disagreement was found between both monitors Older adults represent the segment of the population that sits the most . This study evaluated the feasibility , acceptability , safety , and preliminary efficacy of an intervention to reduce sedentary behavior ( SB ) in older adults that can be disseminated broadly for limited cost and delivered by paraprofessionals with limited training . Senior centers in Central Pennsylvania were r and omized to receive one of two healthy aging programs ( i.e. , intervention or comparison ) . Participants in both groups attended three 90-min meetings over 2 weeks . Behavior change content was delivered at the second session ( i.e. , day 7 ) . Forty-two participants ( nintervention = 25 , ncomparison = 17 ) were recruited from five senior centers . Content for the intervention group focused on  reducing SB while comparison group content focused on reducing social isolation  . Self-reported SB was assessed on days 7 and 14 . Repeated- measures ANOVA revealed a significant group × time interaction for total and weekday , but not weekend , SB . In the week following the delivery of group content , participants in the intervention group reported an average decrease in total SB of 837.8 min/week ; however , the comparison group reported a nonsignificant average decrease of 263.0 min/week of total SB . Participants in the intervention group also reported an average decrease in weekday SB of 132.6 min/weekday ( d = −0.83 ) in the week following the delivery of group content ; however , the comparison group reported a nonsignificant decrease of 24.0 min/weekday ( d = −0.16 ) . There were no significant changes in weekend SB in either group in the week following the delivery of group content . Participants ’ attendance , measurement completion , and program ratings were high . Safety issues were minimal . This intervention was feasible to implement and evaluate , acceptable to older adults , and showed promise for reducing older adults ’ SB PURPOSE AND METHODS Although evidence is accumulating that sedentary behavior ( SB ) , independent of moderate-to-vigorous intensity physical activity ( MVPA ) , is associated with cardiometabolic and aging outcomes in adults , several gaps present opportunities for future research . This article reports on the " Research Evidence on Sedentary Behavior " session of the Sedentary Behavior : Identifying Research Priorities workshop , sponsored by the National Heart , Lung , and Blood Institute and the National Institute on Aging , which aim ed to identify priorities in SB research . RESULTS AND CONCLUSIONS A consensus definition of SB has not yet been established , although agreement exists that SB is not simply all behaviors other than MVPA . The two most common definitions are as follows : one based solely on intensity ( < 1.5 metabolic equivalents [ METs ] ) and another which combines low intensity ( ≤1.5 METs ) with a seated or reclining posture . Thus , for the definition of SB , evaluation of whether or not to include a postural component is a research priority . SB assessment method ologies include self-report and objective measurement , each offering distinct information . Therefore , evaluation , st and ardization , and comparison across self-report and objective assessment methods are needed . Specific priorities include the development and validation of novel devices capable of assessing posture and st and ardization of research practice s for SB assessment by accelerometry . The prospect i ve evidence that SB relates to health outcomes is limited in that SB is almost exclusively measured by self-report . The lack of longitudinal studies with objective ly measured SB was recognized as a major research gap , making examination of the association between objective ly measured SB and adverse health outcomes in longitudinal studies a research priority . Specifically , studies with repeated measures of SB , evaluating dose-response relationships , with inclusion of more diverse population s are needed BACKGROUND Previous research demonstrates that participation in light-intensity physical activity ( LIPA ) and moderate-to-vigorous physical activity ( MVPA ) are favorably associated with health-related quality of life ( HRQOL ) . Emerging work demonstrates that  sedentary behavior  ( SB ) is detrimentally associated with various cardiometabolic biomarkers , with few studies exploring the association of SB on HRQOL , and no studies examining this among congestive heart failure patients . Therefore , the purpose of this study was to examine the potential independent associations of SB on HRQOL among congestive heart failure patients . METHODS Data from the 2003 - 2006 National Health and Nutrition Examination Survey were used .  Physical activity was assessed over 7days during all waking hours using the ActiGraph 7164 accelerometer .  HRQOL was assessed using the Centers for Disease Control HRQOL index survey . RESULTS 190 participants self-reported a physician-diagnosis of congestive heart failure . After adjustments , SB behavior ( 1-min/day increase ) was associated with worse HRQOL ( β=0.004 ; 95 % CI : 0.0004 - 0.007 ; P=0.03 ) . When MVPA was added as a covariate to this model , SB remained significantly associated with worse HRQOL ( β=0.003 ; 95 % CI : 0.0001 - 0.007 ; P=0.04 ) . However , when adding LIPA to this model that also included MVPA as a covariate , SB was no longer associated with HRQOL ( β=0.0001 ; 95 % CI : -0.003 - 0.004 ; P=0.92 ) . CONCLUSIONS If confirmed by prospect ive/experimental work , this suggests that SB may not have detrimental HRQOL effects among congestive heart failure patients Background No school-based physical activity ( PA ) interventions among older adolescents have demonstrated long-term effectiveness , and few of them so far have addressed sedentary behaviour ( SB ) . Based on behavioural theories and evidence , we design ed a multi-level intervention to increase  PA  and decrease SB  among vocational school students . This study investigates feasibility and acceptability of two main intervention components and research procedures . We also examine uptake of behaviour change techniques ( BCTs ) by the participants . Methods Design was an outcome assessor blinded , cluster-r and omised controlled trial . Four classes of students ( matched pairs ) were r and omised into one intervention and one control arm . The intervention consisted of ( 1 ) a 6-h group-based intervention for students , ( 2 ) two 2-h training workshops to reduce their students ’ sitting in class for teachers , and ( 3 ) provision of light PA equipment in classrooms . At baseline ( T1 ) , mid-intervention ( T2 ) at 3 weeks , post-intervention ( T3 ) and 6 months after baseline ( T4 ) we measured hypothesised psychosocial mediators and self-reported PA and sitting . Objective assessment of PA and SB ( 7-day accelerometry ) was conducted at T1 , T3 and T4 . Body composition ( bioimpedance ) was measured at T1 and T4 . Students and teachers in the intervention arm filled in acceptability question naires at T3 . Results  Recruitment rate was 64 % ( students ) and 88.9 % ( teachers ) , and at T3 , all post-intervention measurements were completed by 33 students ( retention 76.7 % ) and 15 teachers ( retention 93.8 % ) .  Acceptability ratings of sessions were high ( students M = 6.29 , scale 1–7 ) , and data collection procedures were feasible . Intervention arm students reported increased use of BCTs , but uptake of some key BCTs was suboptimal . BCT use correlated highly with objective measures of PA . Based on both self-report and student evaluation , teachers in the intervention arm increased the use of sitting reduction strategies  at post-intervention and T4 follow-up ( p < .05 ) . Conclusions We detected willingness of the target groups to participate , good response rates to question naires , adequate retention , as well as acceptability of the trial protocol . Investigation of BCT use among students helped further enhance intervention procedures to promote BCT use . After making necessary modifications identified , intervention effectiveness can next be tested in a definitive trial . Trial registration IS RCT N34534846 . Registered 23 May 2014 . Retrospectively registered Introduction An acute exacerbation of chronic obstructive pulmonary disease ( COPD ) marks a critical life event , which can lower patient quality of life and ability to perform daily activities . Patients with COPD tend to lead inactive and highly sedentary lifestyles , which may contribute to reductions in functional capacity . Targeting sedentary behaviour ( SB ) may be more attainable than exercise ( at a moderate-to-vigorous intensity ) for behaviour change in patients following an exacerbation . This study aims to evaluate the feasibility and acceptability of a 2-week at-home intervention providing education and self-monitoring to reduce prolonged periods of SB in patients with COPD discharged following an acute exacerbation . Methods and analysis Patients will be r and omised into 1 of 3 conditions : usual care ( control ) , education or education+feedback . The education group will receive information and suggestions about reducing long periods of sitting . The education+feedback group will receive real-time feedback on their  sitting time , st and -ups and step count at home through an inclinometer linked to a smart device app . The inclinometer will also provide vibration prompts to encourage movement when the wearer has been sedentary for too long . Data will be collected during hospital admission and 2 weeks after discharge . Qualitative interviews will be conducted with patients in the intervention groups to explore patient experiences . Interviews with healthcare staff will also be conducted . All data will be collected January to August 2016 . The primary outcomes are feasibility and acceptability , which will be assessed by qualitative interviews , uptake and drop-out rates , reasons for refusing the intervention , compliance , app usage and response to vibration prompts . Ethics and dissemination The research ethics committee East Midl and s Leicester- Central has provided ethical approval for the conduct of this study . The results of the study will be disseminated through appropriate conference proceedings and peer- review ed journals . Trial registration number IS RCT N13790881 ; Pre- results Background To investigate the interpersonal and physical environment mediators of the Transform-Us ! mid-intervention effects on  physical activity ( PA )  during recess and lunchtime . Methods Transform-Us ! is a clustered r and omised school-based intervention with four groups : sedentary behaviour intervention ( SB-I ) , PA intervention ( PA-I ) , combined PA+SB-I and control group .  All children in grade 3 from 20 participating primary schools in Melbourne , Australia were eligible to complete annual evaluation assessment s. The outcomes were the proportion of time spent in moderate-to-vigorous PA ( MVPA ) and light PA ( LPA )  during recess and lunchtime assessed by accelerometers . Potential mediators included : perceived social support from teachers ; perceived availability of line markings ; perceived accessibility of sports equipment ; and perceived school play environment . Generalised linear models were used and mediation effects were estimated by product-of-coefficients ( a·b ) approach . Results 268 children ( 8.2 years , 57 % girls at baseline ) provided complete data at both time points . A significant intervention effect on MVPA during recess in the SB-I and PA-I groups compared with the control group ( proportional difference in MVPA time ; 38 % ( 95 % CI 21 % to 57 % ) and 40 % ( 95 % CI 20 % to 62 % ) , respectively ) was found . The perceived school play environment was significantly positively associated with MVPA at recess among girls . An increase in perceived social support from teachers suppressed  the PA+SB-I effect on light PA  during recess ( a·b= −0.03 , 95 % CI −0.06 to −0.00 ) . No significant mediating effects  on PA during recess and lunchtime were observed . Conclusions A positive perception of the school play environment was associated with higher MVPA during recess among girls . Future studies should conduct mediation analyses to explore underlying mechanisms of PA interventions Background Identifying ways to promote physical activity and decrease sedentary time during childhood is a key public health issue . Research on the putative influences on preschool children ’s  physical activity ( PA ) and  sedentary behavior  ( SB ) is limited and has yielded inconsistent results . Our aim was to identify correlates of PA and SB in preschool children . Methods Cross-sectional data were drawn from the Swiss Preschoolers ’ Health Study ( SPLASHY ) , a Swiss population -based cohort study . Of 476 two to six year old children , 394 ( 54 % boys ) had valid PA data assessed by accelerometry .  Information on exposure data was directly measured or extracted from parental question naires . Multilevel linear regression modeling was used to separately assess associations between 35 potential correlates and  total PA ( TPA ) , moderate-to-vigorous PA ( MVPA ) and SB . Results In total , 12 correlates from different domains were identified . TPA and MVPA were greater in boys than girls , increased with age and were positively associated with gross motor skills . Children from single parent families had a higher level of TPA and spent less time sedentary than those living with two parents . Time spent outdoors was positively associated with TPA and negatively with SB . The child ’s activity temperament was related all three outcomes , whereas parental sports club membership , living area per person and neighborhood safety were associated with SB only . Fixed and r and om factors in the final models accounted for 28 % , 32 % and 22 % of the total variance in TPA , MVPA and SB , respectively . Variance decomposition revealed that age , sex and activity temperament were the most influential correlates of both , TPA and MVPA , whereas the child ’s activity temperament , time outdoors and neighborhood safety were identified as the most important correlates of SB . Conclusions A multidimensional set of correlates of young children ’s  activity behavior has been identified . Personal factors had the greatest influence on PA , whereas environmental-level factors had the greatest influence on SB . Moreover , we identified a number of previously unreported , potentially modifiable correlates of young children ’s PA and SB . These factors could serve to define target groups or become valuable targets for change in future interventions .Trial registration Current Controlled Trials IS RCT N41045021 ( date of registration : 21.03.14 ) Regular physical activity ( PA ) and the avoidance of prolonged sitting are essential for children ’s healthy growth , and for the physical and mental wellbeing of both children and adults . In the context of exercise , music may promote behavioral change through increased exercise adherence and participation . The purpose of this study was to determine whether a movement-to-music video program could reduce sedentary behavior ( SB ) and increase PA in mother-child pairs in the home environment . A r and omized controlled trial was conducted in the Pirkanmaa region , Finl and , in 2014–2016 . The participants consisted of 228 mother-child pairs ( child age 5–7 years ) . The primary outcomes of interest were tri-axial accelerometer-derived SB and PA , which were measured in weeks one ( baseline ) , two , and eight in both the intervention and control groups . Further , the mothers and children in the intervention group used a movement-to-music video program from the beginning of week two to the end of week eight . Secondary outcomes included self-reported screen time . The statistical methods employed comprised an intention-to-treat and linear mixed effects model design . No statistically significant differences between groups were found in primary or secondary outcomes . Among the children in the control group  , light PA  decreased significantly over time and screen time increased from 89 ( st and ard deviation , SD 37 ) to 99 ( SD 41 ) min/d . Among mothers and children in the intervention group , no statistical differences were found . In supplementary analysis , the children who stayed at home instead of attending daycare/preschool had on average 25 ( 95 % confidence interval , CI 19–30 ) min/d more sedentary time and 11 ( 95 % CI 8–14 ) min/d less moderate-to-vigorous PA than those who were at daycare/preschool . The higher body mass index of mothers was related with 5 ( 95 % CI 2–7 ) min/d more sedentary time and 1 ( 95 % CI 0–2 ) min/d less moderate-to-vigorous PA . The movement-to-music video program did not change the objective ly measured SB or PA of the mother-child pairs . However , mothers and children seemed to be more sedentary at home , and therefore interventions for decreasing SB and increasing PA should be targeted in the home environment Background Patients with rheumatoid arthritis ( RA ) spend a high proportion of their waking time in sedentary behaviour ( SB ) and have an increased risk of cardiovascular disease . Reduction of SB and increase in light intensity physical activity has been suggested as a means of improvement of health in patients with mobility problems . Short-term intervention studies have demonstrated that SB can be reduced by behavioural interventions in sedentary population s. To evaluate descriptively the feasibility of recruitment , r and omisation , outcome assessment s , retention and the acceptability of an individually tailored , theory-based behavioural intervention targeting reduction in daily sitting time in patients with RA . Methods A r and omised , controlled trial with two parallel groups . RA patients > 18 years of age and Health Assessment Question naire ( HAQ ) score < 2.5 were consecutively invited and screened for daily leisure time sitting > 4 h. The 16-week intervention included 1 ) three individual motivational counselling sessions and 2 ) individual text message reminders aim ed at reducing daily sitting time . The control group was encouraged to maintain their usual lifestyles . Outcomes were assessed at baseline and after the 16 week intervention . Daily sitting time was measured using  an ActivPAL3TM activity monitor .  The study was not powered to show superiority ; rather the objective was to focus on acceptability among patients and clinical health professionals . Results In total , 107 patients were invited and screened before 20 met eligibility criteria and consented ; reasons for declining study participation were mostly flares , lack of time and co-morbidities . One patient from the control group dropped out before end of intervention ( due to a RA flare ) . Intervention participants completed all counselling sessions . All procedures regarding implementation of the trial protocol were feasible . The daily sitting time was reduced on average by 0.30 h in the intervention group unlike the control group that tended to increase it by 0.15 h after 16 weeks . Conclusions This study shows that an individually tailored behavioural intervention targeting reduction of SB was feasible and acceptable to patients with RA.Trial registration The Danish Data Protection Agency ( ref.nb . 711 - 1 - 08 - 20 March 2011 ) , the Ethics Committee of the Capital Region of Denmark ( ref.nb . H-2 - 2012 - 112- 17 October 2012 ) , clinical trials.gov ( NCT01969604 - October 17 2013 , retrospectively registered ) Objectives : Mucosal healing ( MH ) and deep remission ( DR ) are associated with improved outcomes in Crohn ’s disease ( CD ) . However , most of the current data pertain to colonic MH and DR , whereas the evidence regarding the prevalence and impact of small bowel ( SB ) MH is scarce . The aim of this study was to to evaluate the prevalence of SBMH and DR in quiescent SBCD . Methods : Patients with known SBCD in clinical remission ( CDAI<150 ) or with mild symptoms ( CDAI<220 ) were prospect ively recruited and underwent video capsule endoscopy after verification of SB patency . Inflammation was quantified using the Lewis score ( LS ) . SBMH was defined as LS<135 , whereas a significant inflammation was defined as LS>790 . Clinico-biomarker remission was defined as a combination of clinical remission and normal biomarkers . DR was defined as a combination of clinico-biomarker remission and MH . Results : Fifty-six patients with proven SB patency were enrolled ; 52 ( 92.9 % ) patients were in clinical remission and 21 ( 40.4 % ) in clinico-biomarker remission . SBMH was demonstrated in 8/52 ( 15.4 % ) of patients in clinical remission . Moderate-to-severe SB inflammation was demonstrated in 11/52 ( 21.1 % ) of patients in clinical remission and in 1/21 ( 4.7 % ) of patients in clinical and biomarker remission . Only 7/52 ( 13.5 % ) patients were in DR . Conclusions : SB inflammation is detected in the majority of CD patients in clinical and biomarker remission . SBMH and DR were rare and were independent of treatment modality . Our findings represent the true inflammatory burden in quiescent patients with SBCD Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) BACKGROUND Sedentary behavior ( SB ) has been associated with chronic diseases . University students are a high-risk population for excessive SB . The purpose of this pilot study was to determine if a Health Action Process Approach ( HAPA ) based intervention , specifically action and coping planning , would increase student break frequency and decrease duration . METHODS Fifty-two university students ( 14 men , mean age 23.5 ) were r and omised into an 8-week HAPA-treatment ( sedentary behavior ) or HAPA-control ( nutrition ) group . Participants completed an SB question naire that assessed break frequency and duration of student SB ( Baseline , Weeks 1 - 6 Treatment , and Weeks 7 - 8 Follow-up ) , and received behavioral counselling on either dietary information or SB ( Baseline and Week 3 ) . RESULTS An intent-to-treat analysis revealed a significant group by time interaction effect for student break frequency ( p = .05 , ηρ2 = 0.27 ) , and a non-significant effect for student break duration ( p = .10 , ηρ2 = 0.23 ) . For occupational ( student ) break frequency and duration , the large accompanying effect sizes favored the treatment group . CONCLUSIONS The current pilot study provides preliminary evidence for the potential of a HAPA-based intervention for increasing student break frequency in full-time university students Background The optimal targets and strategies for effectively reducing sedentary behavior among young people are unknown . Intervention research that explores changes in mediated effects as well as in outcome behaviors is needed to help inform more effective interventions . Therefore , the purpose of this study was to examine the mid-intervention mediating effects on children ’s objective ly assessed classroom and total weekday sedentary time in the Transform-Us ! intervention . Methods The results are based on 293 children , aged 7- to 9-years-old at baseline , from 20 schools in Melbourne , Australia . Each school was r and omly allocated to one of four groups , which targeted reducing sedentary time in the school and family setting s ( SB ; n = 74 ) , increasing or maintaining moderate- to vigorous-intensity physical activity in the school and family setting s ( PA ; n = 75 ) , combined SB and PA ( SB + PA ; n = 80 ) , or the current practice control ( C ; n = 64 ) . Baseline and mid-intervention data ( 5–9 months ) were collected in 2010 and analyzed in 2012 . Classroom and total weekday sedentary time was objective ly assessed using ActiGraph accelerometers . The hypothesized mediators including , child enjoyment , parent and teacher outcome expectancies , and child perceived access to st and ing opportunities in the classroom environment , were assessed by question naire . Results The SB + PA group spent 13.3 min/day less in weekday sedentary time at mid-intervention compared to the control group . At mid-intervention , children in the SB group had higher enjoyment of st and ing in class ( 0.9 units ; 5-unit scale ) and all intervention groups had more positive perceptions of access to st and ing opportunities in the classroom environment ( 0.3 - 0.4 units ; 3-unit scale ) , compared to the control group . However , none of the hypothesized mediator variables had an effect on sedentary time ; thus , no mediating effects were observed . Conclusions While beneficial intervention effects were observed on some hypothesized mediating variables and total weekday sedentary time at mid-intervention , no significant mediating effects were found . Given the dearth of existing information , future intervention research is needed that explores mediated effects . More work is also needed on the development of reliable mediator measures that are sensitive to change overtime . Trial registration ACTRN12609000715279IS RCT PURPOSE To compare biopsy performance of two approaches for multiparametric magnetic resonance (MR)-targeted biopsy ( TB ) with that of extended systematic biopsy ( SB ) in prostate cancer ( PCa ) detection . MATERIAL S AND METHODS This institutional review board-approved multicenter prospect i ve study ( May 2009 to January 2011 ) included 95 patients with informed consent who were suspected of having PCa , with a suspicious abnormality ( target ) at prebiopsy MR . Patients underwent  12-core SB and four-core TB with transrectal ultrasonographic ( US ) guidance , with two cores aim ed visually ( cognitive TB [ TB-COG ] ) and two cores aim ed using transrectal US-MR fusion software ( fusion-guided TB [ TB-FUS ] ) . SB and TB positivity for cancer and sampling quality ( mean longest core cancer length , Gleason score ) were compared . Clinical ly significant PCa was any 3 mm or greater core cancer length or any greater than 3 Gleason pattern for SB or any cancer length for TB . Statistical analysis included t test , paired χ(2 ) test , and κ statistic . Primary end point ( core cancer length ) was calculated ( paired t test ) . RESULTS Among 95 patients ( median age , 65 years ;  mean prostate-specific antigen level  , 10.05 ng/mL [ 10.05 μg/L ] ) , positivity rate for PCa was 59 % ( n = 56 ) for SB and 69 % ( n = 66 ) for TB ( P = .033 ) ; rate for clinical ly significant PCa was 52 % ( n = 49 ) for SB and 67 % ( n = 64 ) for TB ( P = .0011 ) . Cancer was diagnosed through TB in 16 patients ( 17 % ) with negative SB results . Mean longest core cancer lengths were 4.6 mm for SB and 7.3 mm for TB ( P < .0001 ) . In 12 of 51 ( 24 % ) MR imaging targets with positive SB and TB results , TB led to Gleason score upgrading . In 79 MR imaging targets , positivity for cancer was 47 % ( n = 37 ) with TB-COG and 53 % ( n = 42 ) with TB-FUS ( P = .16 ) . Neither technique was superior for Gleason score assessment .  CONCLUSION Prebiopsy MR imaging combined with transrectal US-guided TB increases biopsy performance in detecting PCa , especially clinical ly significant PCa . No significant difference was observed between TB-FUS and TB-COG for TB guidance Background Physical activity ( PA ) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior ( SB ) may be detrimental to children 's health independent of PA . The primary aim of the Transform-Us ! study is to determine whether an 18-month , behavioral and environmental intervention in the school and family setting s results in higher levels of PA and lower rates of SB among 8 - 9 year old children compared with usual practice ( post-intervention and 12-months follow-up ) . The secondary aims are to determine the independent and combined effects of PA and SB on  children 's cardio-metabolic health risk factors ; identify the factors that mediate the success of the intervention ; and determine whether the intervention is cost-effective . Methods / design A four-arm cluster-r and omized controlled trial ( RCT ) with a 2 × 2 factorial design , with schools as the unit of r and omization . Twenty schools will be allocated to one of four intervention groups , sedentary behavior ( SB-I ) , physical activity ( PA-I ) , combined SB and PA ( SB+PA-I ) or current practice control ( C ) , which will be evaluated among approximately 600 children aged 8 - 9 years in school year 3 living in Melbourne , Australia . All children in year 3 at intervention schools in 2010 ( 8 - 9 years ) will receive the intervention over an 18-month period with a maintenance ' booster ' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessment s. To maximize the sample and to capture new students arriving at intervention and control schools , recruitment will be on-going up to the post-intervention time point . Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey . Discussion To our knowledge , Transform-Us ! is the first RCT to examine the effectiveness of intervention strategies for reducing children 's overall sedentary time , promoting PA and optimizing health outcomes . The integration of consistent strategies and messages to children from teachers and parents in both school and family setting s is a critical component of this study , and if shown to be effective , may have a significant impact on educational policies as well as on pedagogical and parenting practice s . Trial registration ACTRN12609000715279 ; Current Controlled Trials IS RCT Background Physical activity ( PA ) interventions design ed to prevent prenatal complications have focused on increasing moderate PA yielding conflicting results . Minimal attention has focused on the evaluation of sleep , sedentary behavior ( SB ) , light activity or total daily PA during pregnancy . The purpose of this prospect i ve , longitudinal study was to 1 ) objective ly quantify and compare habitual PA and SB during the 2nd and 3rd trimester ; and 2 ) evaluate differences in activity patterns for women meeting prenatal PA guidelines versus those that did not . Methods Forty-six participants wore 2 PA monitors ( SenseWear ® Mini and activPAL ™ ) during week 18 and week 35 of pregnancy . We compared differences in sleep duration , postural allocation , daily steps , and PA between the 2nd and 3rd trimester and for women who met and did not meet PA guidelines . Results During the 2nd trimester , 30 % of the women ’s day ( 24-hours ) was total sleep ; 52 % SB ; 13 % light ; 3 % moderate ; and 0 % vigorous PA . Light ( P = 0.05 ) , vigorous ( P = 0.02 ) , and moderate-vigorous PA ( MET-minutes ; P = 0.02 ) , decreased with a trend in increased SB ( P = 0.07 ) . Activity of other intensities and sleep duration did not significantly change . Only 39 % and 37 % of participants slept between 7–9 hours/night at week 18 and 35 , respectively . Forty-six percent ( n = 21 ) and 28 % ( n = 13 ) of participants met prenatal PA guidelines during the 2nd and 3rd trimester , respectively . At week 18 , no differences in total sleep , SB , or light PA existed for women who met PA guidelines versus those who did not ; total PA was significantly greater for women who met guidelines . At week 35 , women that met PA guidelines had significantly less SB ( P < 0.005 ) than women who did not . Conclusions This study demonstrates that pregnant women spend the majority of their day in SB . Significant reductions in total activity across pregnancy may be attributed , in part to shifts in light PA and increased SB . Based on the lifestyle of our sample , regardless of meeting PA guidelines in mid-pregnancy , no significant difference exists in time spent in SB , however meeting PA recommendations in late pregnancy may reduce SB . Future interventions should target reducing SB by increasing light and moderate PA beyond volitional exercise Background and aims : Feasible and low-cost exercise programmes targeting fall risk factors may decrease the risk of falling in older adults . The purpose of this study was to compare the effects of square-stepping exercise ( SSE ) training , which is a new and low-cost method design ed to improve lower-extremity functional fitness , with strength and balance ( SB ) training . Methods : The study included 39 community-dwelling adults aged 65 to 74 years . The participants were r and omized to either group SSE  ( n=20 ) or SB ( n=19 ) . They engaged in 70-min group exercise sessions twice a week for 12 weeks . The efficacy of the program was measured with both a 9-item test battery for assessment of physical performance and self-reported scales ( fear of falling , pleasure in exercise , perceived health status ) . Fall incidence was followed up for 14 months . Results : The results of a 2-way ANOVA revealed that the time effect in 7 of the 9 performance tests was significant , although group-by-time interactions were not . No significant changes were observed in the self-reported scales . During the 14-month follow-up period , 7 falls in 6 participants in the SSE group and 12 falls in 11 participants in the SB group were reported . The incidence rate per person in the SSE group ( 30.0 % ) was not significantly different from that in the SB group ( 57.9 % ) . The rate of falls per trip [ falls/(falls + trips ) ] in the SSE group ( 17.1 % ) was significantly lower than in the SB group ( 50.0 % ) . Conclusions : SSE is as equally effective as SB training in improving lower-extremity functional fitness . SSE may also be recommended for older adults , due to its low cost and effectiveness Background Little is known about the concurrent change in  physical activity ( PA )  ,  sedentary behavior ( SB ) and  sport participation  ( SP ) during adolescence . The main purpose of this prospect i ve and partly objective study was to simultaneously investigate PA , SBs and SP changes between the 1st and 2nd grade s of high school in urban adolescents . Methods In this 1-year follow-up study , the participants were 81 secondary -school students ( 28 boys and 53 girls ) aged 15.5 years at the baseline .  PA was assessed with the SenseWear Armb and multi-sensor activity monitor , while SBs were assessed by using School Health Action , Planning and Evaluation System ( SHAPES ) PA question naire . The SHAPES question naire was supplemented with two questions inquiring about SP in organized sports in school and outside of school . Results PA decreased markedly in both genders between the 1st and 2nd grade s of high school . Total energy expenditure ( TEE ) was reduced by 13 kcal/kg/day on average in boys and by 10 kcal/kg/day in girls ( p for both < 0.001 ) , while mean daily active energy expenditure ( AEE ) decreased by 7 kcal/kg/day ( p < 0.001 ) and 3 kcal/kg/day ( p = 0.04 ) in boys and girls , respectively . Similarly , the amount of moderate PA declined by 49 min/day in boys and 21 min/day in girls ( p for both < 0.001 ) . At the same time vigorous PA was cut by 14 min/day ( p < 0.001 ) and 3 min/day ( p = 0.003 ) in boys and girls , respectively . Conversely , time spent in SBs did not show any change . Conclusion In conclusion , a decline in PA between the 1st and 2nd grade s of high school was marked but was not accompanied with an increase in SBs . Policies aim ed at increasing PA should be targeting the period of entering secondary school to offset the observed drop in PA OBJECTIVE To investigate whether prescribing exercise in several short-bouts versus one long-bout per day would enhance exercise adherence , cardiorespiratory fitness , and weight loss in overweight adult females in a behavioral weight control program . DESIGN R and omized controlled trial with subjects r and omized to either a short-bout exercise group ( SB , n = 28 , age = 40.4 + /- 5.9 yrs ) or a long-bout exercise group ( LB , n = 28 , age = 40.9 + /- 7.3 yrs ) , with subjects followed for a period of 20 weeks . Both groups were instructed to exercise 5 days per week with exercise duration progressing from 20 to 40 min per day . The LB group performed one exercise bout per day , whereas the SB group performed multiple 10 min bouts of exercise per day . The recommended caloric intake for all subjects was 5022 - 6277 kJ/day ( 1200 - 1500 kcal/day ) , with fat reduced to 20 % of caloric intake . SUBJECTS Fifty-six obese , sedentary females ( BMI = 33.9 + /- 4.1 kg/m2 ) . MEASUREMENTS Exercise participation was assessed from self-reported diaries and Tri-Trac Accelerometers . Cardiorespiratory fitness was assessed using a submaximal cycle ergometer test . RESULTS Exercising in multiple short-bouts per day improved adherence to exercise : the SB group reported  exercising on a greater number of days ( mean + /- s.d . = 87.3 + /- 29.5 days vs 69.1 + /- 28.9 days ; P < 0.05 ) and for a greater total duration ( 223.8 + /- 69.5 min/week vs 188.2 + /- 58.4 min/week ; P = 0.08 ) than the LB group . Predicted VO2Peak increased by 5.6 % and 5.0 % for the LB and SB groups , respectively ( P < 0.05 ) . There was a trend for the weight loss to be greater in the SB group ( -8.9 + /- 5.3 kg ) compared to the LB group ( -6.4 + /- 4.5 kg ; P < 0.07 ) . CONCLUSION These results suggest that short-bouts of exercise may enhance exercise adherence .  Short-bouts of exercise may also enhance weight loss and produce similar changes in cardiorespiratory fitness when compared to long-bouts of exercise . Thus , short-bouts of exercise may be preferred when prescribing exercise to obese adults
R and omized controlled trials found a positive correlation for SB with BMI , neck circumference , fat mass , HbA1C , cholesterol and insulin levels , cohort studies additionally for WC , leptin , C-peptide , ApoA1 and Low density lipoprotein and a negative correlation for HDL .
Most studied biomarkers associated with SB were of cardiovascular or metabolic origin .
OBJECTIVE Pathomechanisms of sedentary behaviour ( SB ) are unclear .
We conducted a systematic review to investigate the associations between SB and various biomarkers in older adults .