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Ross E. Andersen and John M. Jakicic

The aim of this review is to provide a scientific update on the current guidelines for both health and weight management. There has been confusion among health professionals as to which physical activity guidelines should be used to help various specific populations adopt more active lifestyles. We first review the history of the physical activity guidelines. Using the physical activity guidelines in clinical practice is also explored. We also describe common barriers to physical that overweight individuals report and we discuss when it is appropriate for a health care professional to seek a referral from an exercise scientist to help sedentary adults increase their levels of activity. It is important for individuals who care for overweight patients and sedentary adults to understand the current physical guidelines and how these guidelines can be worked into clinical practice.

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Barbara Resnick, Marcia G. Ory, Kerrie Hora, Michael E. Rogers, Phillip Page, Jane N. Bolin, Roseann M. Lyle, Cody Sipe, Wojtek Chodzko-Zajko and Terry L. Bazzarre

The Exercise Assessment and Screening for You (EASY) is a tool developed to help older individuals, their health care providers, and exercise professionals identify different types of exercise and physical activity regimens that can be tailored to meet the existing health conditions, illnesses, or disabilities of older adults. The EASY tool includes 6 screening questions that were developed based on an expert roundtable and follow-up panel activities. The philosophy behind the EASY is that screening should be a dynamic process in which participants learn to appreciate the importance of engaging in regular exercise, attending to health changes, recognizing a full range of signs and symptoms that might indicate potentially harmful events, and becoming familiar with simple safety tips for initiating and progressively increasing physical activity patterns. Representing a paradigm shift from traditional screening approaches that focus on potential risks of exercising, this tool emphasizes the benefits of exercise and physical activity for all individuals.

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Cecilia Winberg, Gunilla Carlsson, Christina Brogårdh and Jan Lexell

Maintaining regular physical activity (PA) can be challenging for persons with late effects of polio. This qualitative study of ambulatory persons with late effects of polio explored their perceptions of PA, as well as facilitators of and barriers to PA. Semistructured interviews were conducted with 15 persons and analyzed with content analysis using the International Classification of Functioning, Disability and Health (ICF) as a framework. The participants described positive perceptions of PA and its health benefits. PA was used to prevent further decline in functioning, and the type and frequency of activities had changed over time. Past experiences and personal characteristics impacted PA. Support from close relatives, knowledgeable health care professionals, mobility devices, and accessible environments facilitated PA, whereas impairments, inaccessible environments, and cold weather were the main barriers. To perform PA regularly, persons with late effects of polio may benefit from individualized advice based on their disability and personal and environmental factors.

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Sandra O'Brien Cousins

This study analyzed older women's (age 57–92, N = 32) descriptions of motivating triggers for physical activity. Among active women, activity was triggered by situations such as declining fitness levels, low bone density, more free time, fears about inadequate health care leading to self-care, expectations for reduced aches and pains, awareness of new community programs, and public reports of the health benefits. Semiactive women had doubts about the appropriateness of being active. Inactive people also experienced triggers but seemed firmly committed to a less active lifestyle by reminding themselves that retirement requires no commitments, exercise is not needed if you are healthy, exercise is not appropriate if you are ill, being very busy is a substitute activity, and serving others is less selfish. The findings suggest that active-living interventions might be more effectively aimed at semi active seniors who seem positively disposed to participating but need help to get started or to stay involved.

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Alan G. Ingham

What follows here is an essay—a rather one-sided viewpoint that is both tentative and, within the limits of a journal article, incomplete. I attempt to understand how our recent preoccupation with our bodies is being mobilized as one solution to the fiscal crisis of the welfare state. The deep-rooted assumptions of voluntarism that characterize liberal ideology, I claim, are surfacing again in the debate over lifestyle. And lifestyle, it appears, has become an ideological construction which diverts attention from the structural impediments to well-being by framing health issues in terms of personal, moral responsibilities—a “pull yourself up by the bootstraps” alternative to state intervention in health care. Some implications of the lifestyle ideology for physical educationists are presented.

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Michael B. Hudson

It can be challenging deciding how to resolve personal and professional dilemmas, and the dilemmas that athletic trainers and athletic therapists experience are no different, if not more complex, than the dilemmas other health care professionals experience. The moral behaviors individuals demonstrate with these dilemmas come from their experiences; however, moral beliefs may not always coincide with professional obligations and ethics. The purpose of this article is to examine factors that influence decision making for athletic trainers and athletic therapists to identify and describe policies for guiding moral behaviors in the workplace. These key policies include education in ethical decision making, developing a workplace code of conduct, communicating policies regarding professional behaviors, appraising accepted values and behaviors in the workplace, and investigating possible ethical violations and applying appropriate sanctions.

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Christian C. Evans and Sandra L. Cassady

Objective:

To describe the underlying conditions that predispose athletes to sudden cardiac death (SCD) and review signs and symptoms that indicate an athlete is at risk.

Data Sources:

MEDLINE, the Los Angeles Times and Triathlon Times archives, and other sources identified in the references of articles initially located therein. A total of 43 references were included.

Conclusions:

Most cases of SCD in younger athletes (≤35 years) are attributable to multiple hereditary conditions, with familial hyper-trophic cardiomyopathy being the primary cause, whereas the major cause of SCD in older athletes (>35 years) is coronary artery disease. Health-care professionals evaluating athletes should pay particular attention to past medical and family history. Items in an athlete’s screening that suggest increased risk include a history of chest pain, syncope, excessive shortness of breath, irregular heart rate or murmur, or a history of SCD in an immediate family member.

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Dominic Malcolm

In this article I examine the role and working practice of rugby union club doctors in England. While medicine is widely perceived to be one of the most powerful professions in Western societies, sociologists of sport have argued that sport clinicians often wield relatively limited power over their athlete-patients. In this article I therefore attempt to shed further light on the “peculiar” character of sports medicine. Using data drawn from interviews and questionnaires, I argue that this phenomenon can be understood only by looking at the structure of the sports medicine profession, the specificities of the rugby club as a workplace setting, and the relationships club doctors have with clients (coaches and athletes) and other health care providers (physiotherapists).

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Anna-Karin Welmer, Annika Mörck and Synneve Dahlin-Ivanoff

The aim of this study was to describe experiences of physical activity, perceived meaning, and the importance of and motives and barriers for participation in physical activity in people 80 years of age and older. A qualitative design with focus-group methodology was used. The sample consisted of 20 community-living people age 80–91 yr. Data analyses revealed 4 themes: physical activity as a part of everything else in life, joie de vivre, fear of disease and dependence, and perceptions of frailty. Our results suggest that physical activity was not seen as a separate activity but rather as a part of activities often rated as more important than the physical activity itself. Thus, when designing physical activity interventions for elderly people, health care providers should consider including time for social interaction and possibilities to be outdoors. Moreover, assessment of physical activity levels among elderly people should include the physical activity in everyday activities.

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Thomas Rowland

Recognizing the cardiac features of athletically trained children bears importance for health care providers and exercise physiologists alike. This literature review reveals that ventricular enlargement and/or hypertrophy are commonly observed in studies of pre- and early-adolescent endurance athletes, yet the magnitude of these features is less than that described in adult athletes. Moreover, the upper range of values in child athletes is sufficiently small that clinical confusion with findings mimicking those in individuals with heart disease should not be expected to occur. In contrast to sex differences in the “athlete’s heart” in adults, cardiac structural findings in child athletes are similar in males and females. The extent that cardiac features observed in trained child athletes reflect a response to training or are influenced by genetic preselection remains uncertain.