Background: Children with congenital heart disease ( CHD ) are thought to have low levels of physical activity ( PA ), but few studies have used objective measures of PA in this population. Methods and Results: We recruited patients with mild, moderate, and severe CHD and cardiac transplant recipients, aged 8 to 19 years, from pediatric cardiology clinics throughout British Columbia and Yukon, Canada. Participants were fitted with an ActiGraph accelerometer to be worn over the right hip for 7 days. Daily means were estimated for a variety of accelerometry‐derived metrics, including moderate‐to‐vigorous PA and percentage of sedentary time if they had at least 3 valid days of accelerometry data. Participants also completed a PA questionnaire. We included 90 participants (aged 13.6±2.7 years; 54% male), of which 26 had mild CHD , 26 had moderate CHD , 29 had severe CHD , and 9 were cardiac transplant recipients. Median daily moderate‐to‐vigorous PA was 43 min/day (interquartile range: 28.9–56.9 min/day), and 8% met PA guidelines of 60 minutes of moderate‐to‐vigorous PA at least 6 days a week. There were no significant differences in any accelerometry‐derived metric according to CHD severity. Boys were significantly more active and less sedentary than girls. Activity declined and sedentary behaviors increased with age in both sexes. Sports participation was common, including competitive out‐of‐school clubs (57%). PA restrictions from cardiologists were rare (15%). Conclusions: We found normal age–sex patterns of PA in children with CHD . There were no differences in PA by CHD severity, suggesting that sociocultural factors are likely important determinants of PA in these children.

To assess the criterion validity, internal consistency, reliability and cut-point for the Physical Activity Questionnaire for Children (PAQ-C) and Adolescents (PAQ-A) in children and adolescents with congenital heart disease–a special population at high cardiovascular risk in whom physical activity has not been extensively evaluated. We included 84 participants (13.6±2.9 yrs, 50% female) with simple (37%), moderate (31%), or severe congenital heart disease (27%), as well as cardiac transplant recipients (6%), from BC Children’s Hospital, Canada. They completed the PAQ-C (≤11yrs, n = 28) or–A (≥12yrs, n = 56), and also wore a triaxial accelerometer (GT3X+ or GT9X) over the right hip for 7 days (n = 59 met valid wear time criteria). Median daily moderate-to-vigorous physical activity was 46.9 minutes per day (IQR 31.6–61.8) and 25% met physical activity guidelines defined as ≥60 minutes of moderate-to-vigorous physical activity per day. Median PAQ-score was 2.6 (IQR 1.9–3.0). PAQ-Scores were significantly related to accelerometry-derived metrics of physical activity (rho = 0.44–0.55, all p<0.01) and sedentary behaviour (rho = -0.53, p<0.001). Internal consistency was high (α = 0.837), as was reliability (stability) of PAQ-Scores over a 4-months period (ICC = 0.73, 95%CI 0.55–0.84; p<0.001). We identified that a PAQ-Score cut-point of 2.87 discriminates between those meeting physical guidelines and those that do not in the combined PAQ-C and–A samples (area under the curve = 0.80 (95%CI 0.67–0.92). Validity and reliability of the PAQ in children and adolescents with CHD was comparable to or stronger than previous studies in healthy children. Therefore, the PAQ may be used to estimate general levels of physical activity in children and adolescents with CHD.

Purpose: 1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions.Methods: We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5–17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups.Results: Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment–insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups.Conclusion: School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings.Trial registration number: PROSPEROCRD42018117567.

The phase-out of mercury from clinical settings calls for valid alternatives to assess blood pressure (BP) in children. Aneroid devices provide a mercury-free alternative to BP measurements by auscultation, whereas oscillometric (automated) devices are increasingly becoming the norm in clinical practice due to their ease of use. The aim of this systematic review and meta-analysis was to investigate the accuracy of oscillometric and aneroid BP devices compared with the mercury sphygmomanometer for the measurement of BP in children. We systematically searched four electronic databases (MEDLINE, Embase, CINAHL, and Web of Science) and relevant journals for eligible articles published before 30 July 2015. We screened 1415 articles, and two authors independently reviewed 92 full-text articles. We included 29 articles (38 studies) with 26 879 children. Random-effects model meta-analyses revealed that oscillometric devices yield higher measurements of SBP than auscultation with a mercury sphygmomanometer (pooled effect estimate 2.53 mmHg; 95% CI 0.57–4.50; P < 0.05); the pooled effect estimate for SBP was smaller in studies that ‘passed’ validation protocols (1.76 mmHg; 95% CI 0.61–2.81; n = 12). There was no significant difference for DBP (pooled effect estimate 1.55 mmHg; 95% CI −0.20 to 3.31). There was heterogeneity between studies, explained in part by differences in manufacturer, study setting and observer training. Only three studies compared BP using aneroid and mercury devices and found comparable results. Oscillometric devices may serve as a suitable alternative to auscultation for initial BP screening in the pediatric population.

The third edition of Notes from Underground: Zines and the Politics of Alternative Culture by Stephen Duncombe was published in 2017. The author researches zines as an underground’s mouthpiece, as an opportunity for “losers” who do not fit in to speak up for themselves. According to Duncombe, zines serve as an identity constructor and help to find one’s place through joining a community of like-minded individuals. By deviating from conventional publishing practices, zinesters, following the DIY principle, prefer authenticity to professionalism, creativity to consumption, and the personal to the accepted and popular. Zines, while remaining in the realm of the pre-political, engage in complex relationships with politics as such. The ideology of zines allows one for a continuous questioning of existing cultural norms, never offering fixed politics but always inviting a zinester to remain in a “free space” of exploration. This enables them to evade a consumer culture that threatens to absorb certain underground identities and strategies. New challenges for zines arise from self-publishing and the overall change in communication practices associated with the development of the Internet. The translations of two chapters from the book, presented for the first time in Russian, shed light on fundamental questions about what zines are and what their place is in the modern world.

The impact of maternity (Mat) on subsequent athletic performance is not well known. This study aims to investigate the impact of maternity among elite marathoners on their overall performance progression. For each runner listed in the top 150 female marathoners, who had experienced a mid‐career maternity, performance development was reconstituted throughout the career. Maternity data and career break time span (T_total) were collected from publicly available informations. Performances were modelled according to the known age‐performance relationship and the impact of maternity was added into the model. Linear mixed effect model was used to study the influence of maternity on the overall career. Among this sample, 37 runners had at least 1 child during her career. Among them, 14 had 2 children. Eleven runners (29.72%) made their personal best performance before Mat, which occurred at an average age of 28.40 ± 4.00 years. Twenty‐six runners (70.28%) establish their best performances after Mat, at an average age of 32.20 ± 4.28. The age‐performance relationship model explains 92% of the performance variability during the career's progression. When age is considered, maternity does not have significant impact on performance development. World's most competitive marathoners can still perform at their best level after pregnancy. The ability to return and surpass previous performance level is influenced by the age at which pregnancy occurs, relative to the age of peak performance during career development.Highlights Mid‐career maternity does not have a significant impact on overall progression in high level runners, who return to official races. The ability to return and surpass previous performance level is influenced by the age at which pregnancy occurs, relative to the age of peak performance. Age is the variable that explains most of performance progression, independently of mid‐career maternity occurrence(s).