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Alessandra Buja, Andrea Rabensteiner, Milena Sperotto, Giulia Grotto, Chiara Bertoncello, Silvia Cocchio, Tatjana Baldovin, Paolo Contu, Chiara Lorini and Vincenzo Baldo

Background: The importance of health literacy (HL) in health promotion is increasingly clear and acknowledged globally, especially when addressing noncommunicable diseases. This paper aimed to collect and summarize all current data from observational studies generating evidence of the association between HL and physical activity (PA) and to analyze intervention studies on the promotion of PA to ascertain whether HL moderates the efficacy of such intervention. Methods: A comprehensive systematic literature search of observational studies investigating the association between HL and PA was performed. Intervention studies on the promotion of PA that also measured the HL levels of participants and its effect on the outcome of the intervention were also identified. Results: Of the 22 studies included in this review, 18 found a significant positive association between high HL and high levels of PA. The only intervention study among them indicated that HL was not a significant moderator of the intervention’s effectiveness. Conclusion: HL can enable individuals to make deliberate choices about their PA and thus contribute to preventing many chronic noncommunicable diseases. That said, low levels of HL do not seem to influence the efficacy of health promotion interventions.

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Sophia Nimphius and Matthew J. Jordan

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Sofie Koch, Jens Troelsen, Samuel Cassar and Charlotte Skau Pawlowski

Purpose: In 2014, the Danish Government introduced a new public school reform, which included implementation of 45 min of daily physical activity (PA) within the academic classroom curriculum. The purpose of the present study was to explore school staff’s perceived barriers to implementation of a national PA policy. Method: A mixed-methods approach using a questionnaire and semistructured interviews was conducted. A total of 198 teachers and 26 school management team members (principals, deputy principals, and leading teachers) from 31 schools completed a questionnaire, and 11 school management team members were interviewed. The socioecological model was used as a theoretical framework to examine the results. Results: A total of 15 different barriers were identified and reflected within all levels of the socioecological model. Facilities, motivation, and time were the most prominent barriers identified. Conclusion: Development and deployment of a national PA policy needs to be done in cooperation with consumers from all levels within the socioecological model to ensure successful implementation.

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Steve H. Faulkner and Philippa Jobling

Purpose: Cycling time trials (TTs) are characterized by riders’ adopting aerodynamic positions to lessen the impact of aerodynamic drag on velocity. The optimal performance requirements for TTs likely exist on a continuum of rider aerodynamics versus physiological optimization, yet there is little empirical evidence to inform riders and coaches. The aim of the present study was to investigate the relationship between aerodynamic optimization, energy expenditure, heat production, and performance. Methods: Eleven trained cyclists completed 5 submaximal exercise tests followed by a TT. Trials were completed at hip angles of 12° (more horizontal), 16°, 20°, 24° (more vertical), and their self-selected control position. Results: The largest decrease in power output at anaerobic threshold compared with control occurred at 12° (−16 [20] W, P = .03; effect size [ES] = 0.8). There was a linear relationship between upper-body position and heat production (R 2 = .414, P = .04) but no change in mean body temperature, suggesting that, as upper-body position and hip angle increase, convective and evaporative cooling also rise. The highest aerodynamic–physiological economy occurred at 12° (384 [53] W·C d A −1·L−1·min−1, ES = 0.4), and the lowest occurred at 24° (338 [28] W·C d A −1·L−1·min−1, ES = 0.7), versus control (367 [41] W·C d A −1·L−1·min−1). Conclusion: These data suggest that the physiological cost of reducing hip angle is outweighed by the aerodynamic benefit and that riders should favor aerodynamic optimization for shorter TT events. The impact on thermoregulation and performance in the field requires further investigation.

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Brady M. Smith, David O. Draper, Robert D. Hyldahl and Justin H. Rigby

Context: Low current intensity iontophoresis treatments have increased skin perfusion over 700% from baseline potentially altering drug clearance from or diffusion to the targeted area. Objective: To determine the effects of a preceding 10-minute ice massage on subcutaneous dexamethasone sodium phosphate (Dex-P) concentration and skin perfusion during and after a 4-mA iontophoresis treatment. Design: Controlled laboratory study. Setting: Research laboratory. Patients or Other Participants: Twenty-four participants (male = 12, female = 12; age = 25.6 [4.5] y, height = 173.9 [8.51] cm, mass = 76.11 [16.84] kg). Intervention(s): Participants were randomly assigned into 2 groups: (1) pretreatment 10-minute ice massage and (2) no pretreatment ice massage. Treatment consisted of an 80-mA·minute (4 mA, 20 min) Dex-P iontophoresis treatment. Microdialysis probes (3 mm deep in the forearm) were used to assess Dex-P, dexamethasone (Dex), and its metabolite (Dex-Met) concentrations. Skin perfusion was measured using laser Doppler flowmetry. Main Outcome Measure(s): Microdialysis samples were collected at baseline, at conclusion of treatment, and every 20 minutes posttreatment for 60 minutes. Samples were analyzed to determine Dex-Total (Dex-Total = Dex-P + Dex + Dex-Met). Skin perfusion was calculated as a percentage change from baseline. A mixed-design analysis of variance was used to determine Dex-Total and skin perfusion difference between groups overtime. Results: There was no difference between groups (P = .476), but [Dex-Total] significantly increased over the course of the iontophoresis and posttreatment time (P < .001). Dex-P was measured in 18 of 24 participants with a mean concentration of 0.67 (1.09) μg/mL. Skin perfusion was significantly greater in the no ice treatment group (P = .002). Peak skin perfusion reached 27.74% (47.49%) and 117.39% (103.45%) from baseline for the ice and no ice groups, respectively. Conclusions: Ice massage prior to iontophoresis does not alter the tissue [Dex-Total] even with less skin perfusion.