https://www.hse.ru/data/816/479/1225/Oct%2019%20Cited%20%231%20Manage%20THE%20THEORY%20OF%20PLANNED%20BEHAVIOR.pdf

The theory of planned behavior

Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols.

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Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation.

Objective. —To encourage increased participation in physical activity among Americans of all ages by issuing a public health recommendation on the types and amounts of physical activity needed for health promotion and disease prevention. Participants. —A planning committee of five scientists was established by the Centers for Disease Control and Prevention and the American College of Sports Medicine to organize a workshop. This committee selected 15 other workshop discussants on the basis of their research expertise in issues related to the health implications of physical activity. Several relevant professional or scientific organizations and federal agencies also were represented. Evidence. —The panel of experts reviewed the pertinent physiological, epidemiologic, and clinical evidence, including primary research articles and recent review articles. Consensus Process. —Major issues related to physical activity and health were outlined, and selected members of the expert panel drafted sections of the paper from this outline. A draft manuscript was prepared by the planning committee and circulated to the full panel in advance of the 2-day workshop. During the workshop, each section of the manuscript was reviewed by the expert panel. Primary attention was given to achieving group consensus concerning the recommended types and amounts of physical activity. A concise "public health message" was developed to express the recommendations of the panel. During the ensuing months, the consensus statement was further reviewed and revised and was formally endorsed by both the Centers for Disease Control and Prevention and the American College of Sports Medicine. Conclusion. —Every US adult should accumulate 30 minutes or more of moderate-intensity physical activity on most, preferably all, days of the week. ( JAMA . 1995;273:402-407)

https://jamanetwork.com/journals/JAMA/articlepdf/386766/jama_273_5_029.pdf

Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine

ABI
: ankle–brachial index
ACCORD
: Action to Control Cardiovascular Risk in Diabetes
ADVANCE
: Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation
AGREE
: Appraisal of Guidelines Research and Evaluation
AHA
: American Heart Association
apoA1
: apolipoprotein A1
apoB
: apolipoprotein B
CABG
: coronary artery bypass graft surgery
CARDS
: Collaborative AtoRvastatin Diabetes Study
CCNAP
: Council on Cardiovascular Nursing and Allied Professions
CHARISMA
: Clopidogrel for High Athero-thrombotic Risk and Ischemic Stabilisation, Management, and Avoidance
CHD
: coronary heart disease
CKD
: chronic kidney disease
COMMIT
: Clopidogrel and Metoprolol in Myocardial Infarction Trial
CRP
: C-reactive protein
CURE
: Clopidogrel in Unstable Angina to Prevent Recurrent Events
CVD
: cardiovascular disease
DALYs
: disability-adjusted life years
DBP
: diastolic blood pressure
DCCT
: Diabetes Control and Complications Trial
ED
: erectile dysfunction
eGFR
: estimated glomerular filtration rate
EHN
: European Heart Network
EPIC
: European Prospective Investigation into Cancer and Nutrition
EUROASPIRE
: European Action on Secondary and Primary Prevention through Intervention to Reduce Events
GFR
: glomerular filtration rate
GOSPEL
: Global Secondary Prevention Strategies to Limit Event Recurrence After MI
GRADE
: Grading of Recommendations Assessment, Development and Evaluation
HbA1c
: glycated haemoglobin
HDL
: high-density lipoprotein
HF-ACTION
: Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing
HOT
: Hypertension Optimal Treatment Study
HPS
: Heart Protection Study
HR
: hazard ratio
hsCRP
: high-sensitivity C-reactive protein
HYVET
: Hypertension in the Very Elderly Trial
ICD
: International Classification of Diseases
IMT
: intima-media thickness
INVEST
: International Verapamil SR/Trandolapril
JTF
: Joint Task Force
LDL
: low-density lipoprotein
Lp(a)
: lipoprotein(a)
LpPLA2
: lipoprotein-associated phospholipase 2
LVH
: left ventricular hypertrophy
MATCH
: Management of Atherothrombosis with Clopidogrel in High-risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke
MDRD
: Modification of Diet in Renal Disease
MET
: metabolic equivalent
MONICA
: Multinational MONItoring of trends and determinants in CArdiovascular disease
NICE
: National Institute of Health and Clinical Excellence
NRT
: nicotine replacement therapy
NSTEMI
: non-ST elevation myocardial infarction
ONTARGET
: Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial
OSA
: obstructive sleep apnoea
PAD
: peripheral artery disease
PCI
: percutaneous coronary intervention
PROactive
: Prospective Pioglitazone Clinical Trial in Macrovascular Events
PWV
: pulse wave velocity
QOF
: Quality and Outcomes Framework
RCT
: randomized clinical trial
RR
: relative risk
SBP
: systolic blood pressure
SCORE
: Systematic Coronary Risk Evaluation Project
SEARCH
: Study of the Effectiveness of Additional Reductions in Cholesterol and
SHEP
: Systolic Hypertension in the Elderly Program
STEMI
: ST-elevation myocardial infarction
SU.FOL.OM3
: SUpplementation with FOlate, vitamin B6 and B12 and/or OMega-3 fatty acids
Syst-Eur
: Systolic Hypertension in Europe
TNT
: Treating to New Targets
UKPDS
: United Kingdom Prospective Diabetes Study
VADT
: Veterans Affairs Diabetes Trial
VALUE
: Valsartan Antihypertensive Long-term Use
VITATOPS
: VITAmins TO Prevent Stroke
VLDL
: very low-density lipoprotein
WHO
: World Health Organization

### 1.1 Introduction

Atherosclerotic cardiovascular disease (CVD) is a chronic disorder developing insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur. It remains the major cause of premature death in Europe, even though CVD mortality has …

/pdf/european-guidelines-on-cardiovascular-disease-prevention-in-4z4nw4311i.pdf

European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012)

The purpose of this Position Stand is to provide guidance to professionals who counsel and prescribe individualized exercise to apparently healthy adults of all ages. These recommendations also may apply to adults with certain chronic diseases or disabilities, when appropriately evaluated and advised by a health professional. This document supersedes the 1998 American College of Sports Medicine (ACSM) Position Stand, "The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults." The scientific evidence demonstrating the beneficial effects of exercise is indisputable, and the benefits of exercise far outweigh the risks in most adults. A program of regular exercise that includes cardiorespiratory, resistance, flexibility, and neuromotor exercise training beyond activities of daily living to improve and maintain physical fitness and health is essential for most adults. The ACSM recommends that most adults engage in moderate-intensity cardiorespiratory exercise training for ≥30 min·d on ≥5 d·wk for a total of ≥150 min·wk, vigorous-intensity cardiorespiratory exercise training for ≥20 min·d on ≥3 d·wk (≥75 min·wk), or a combination of moderate- and vigorous-intensity exercise to achieve a total energy expenditure of ≥500-1000 MET·min·wk. On 2-3 d·wk, adults should also perform resistance exercises for each of the major muscle groups, and neuromotor exercise involving balance, agility, and coordination. Crucial to maintaining joint range of movement, completing a series of flexibility exercises for each the major muscle-tendon groups (a total of 60 s per exercise) on ≥2 d·wk is recommended. The exercise program should be modified according to an individual's habitual physical activity, physical function, health status, exercise responses, and stated goals. Adults who are unable or unwilling to meet the exercise targets outlined here still can benefit from engaging in amounts of exercise less than recommended. In addition to exercising regularly, there are health benefits in concurrently reducing total time engaged in sedentary pursuits and also by interspersing frequent, short bouts of standing and physical activity between periods of sedentary activity, even in physically active adults. Behaviorally based exercise interventions, the use of behavior change strategies, supervision by an experienced fitness instructor, and exercise that is pleasant and enjoyable can improve adoption and adherence to prescribed exercise programs. Educating adults about and screening for signs and symptoms of CHD and gradual progression of exercise intensity and volume may reduce the risks of exercise. Consultations with a medical professional and diagnostic exercise testing for CHD are useful when clinically indicated but are not recommended for universal screening to enhance the safety of exercise.

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Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise

Synopsis: Biological functions show characteristic circadian (≈ 24h), circaseptan (≈7-day), circalunar (≈ 28-day) and circa-annual rhythms. Accurate biological clocks are important to the precise timing of both internal and external events, and also contribute to control processes. Various physiological and psychological factors affecting competitive performance influence the 4 classes of biological rhythm. Normally, there is a synchronisation with external signals (Zeitgebers), but such synchronisation can be upset by rapid time shifts (as in international travel), sleep deprivation, unusual work schedules, use of oral contraceptives, and total environmental control. Sports scientists need to examine both normal times of optimum performance and the rate of adjustment after disturbance ofbiorhythm. Regular, moderate physical activity has surprisingly little influence upon the course of such adaptation. Biological Rhythms: Biological rhythms are important in timing competitions and in arranging travel schedules for athletes. Many biological functions show characteristic circadian (≈ 24h), circaseptan (≈ 7d), circalunar (≈ 28d, in the female) [Minors and Water-house, 1981; Moore-Ede et al., 1982; Webb, 1982], and circa-annual rhythms. Some are truly endogenous, while others are secondary to changes of wakefulness and core temperature, or a response to environmental indicators of time (Zeitgebers). If normal time clues are removed, different individuals develop circadian cycles varying in length from 24 to 26 hours. Normally, cycles become synchronised with the solar rhythm of illumination and social Zeitgebers. The primary oscillators lie in the hypothalamus (supraoptic chiasmata and ventromedian or lateral nuclei). Functional Importance: Biorhythms provide an internal clock that enables the coordination of rapid physiological processes and the precise timing of external events. Both attributes are vital to the skilled competitor. Longer intervals, e.g. the duration of sleep and (in animals) seasonal cycles, are also estimated with remarkable accuracy. High frequency oscillations provide the basis of fine control in many functions, ranging from focus of the eye and maintenance of balance to the adjustment of ventilation to increased CO2 production; however, it is less certain that circadian cycles contribute to normal control processes. Changes of Physiology and of Performance: Arousal is maximal in the afternoon, with associated improvements in pattern recognition, reaction speed and muscle force. Perceived effort falls, fatigue is lessened and all-out effort is better tolerated. Because international competition is itself arousing, laboratory findings may not indicate any real advantage of competitive performance. Body temperature peaks in the late afternoon. Although this is in some respects the equivalent of a ‘warm-up’ it does not influence thermoregulation when exercising in the heat. Heart rate follows arousal and core temperature, so that PWC170 and predicted maximum oxygen intake reach a minimum in the afternoon. Respiratory responses to effort are also less in the afternoon. Metabolic efficiency changes little if allowance is made for diurnal variations of body mass. Any diurnal changes of maximum oxygen intake are small, and even their direction is disputed. Most authors find competitive performance is best in the late afternoon. Physical working capacity as predicted from heart rate (PWC170) shows some circaseptan variation, with the lowest values on Saturdays. In women, the rise of core temperature in the second half of the oestrous cycle has little impact on maximum oxygen intake or anaerobic threshold; indeed, body temperature rises more if exercise is undertaken in the luteal phase. The premenstrual increase of body hydration has a small adverse effect on physical working capacity. Associated sensations may impair both skilled and all-out performance, although muscle force is often increased. Competitive results are uninfluenced by menstruation in the majority of athletes. Primary concerns are hygiene during the early stages of menstrual flow, and the risks of accidents or poor teamwork during premenstrual tension. Humans show few well-established circa-annual rhythms; if the climate is severe, curtailment of activity in the winter can lead to some loss of fitness, while in some cultures seasonal changes of performance can be traced to participation in specific sports programmes. Disturbances of Biorhythm: Diurnal rhythms are disturbed by shifts of time zone (latitudinal air travel) and sleep deprivation. Because circadian cycle length usually exceeds 24 hours, east to west travel is tolerated better than the reverse. There is difficulty in adjusting to a shift >5 hours, and at least 7 days should be allowed for resynchron-isation. Arousal is generally poor until adjustment is complete, and visiting athletes are at a particular disadvantage in the afternoons. Prior desynchronisation and Zeitgeber reinforcement speed adjustment, while short-acting sedatives that do not interfere with REM sleep may help re-establish appropriate cycles of wakefulness. Sleep deprivation is stressful per se, but additional effects may arise from physical fatigue and emotional stress. Resting heart rate and respiratory rate fall, while the resultant acidosis causes some expansion of plasma volume. The heart rate response to submaximum exercise is reduced, but so also are Harvard step test scores, all-out performance, and maximum oxygen intake. Muscle tension tends to decline unless the subject makes strenuous efforts to sustain performance, and there is some decrease of isokinetic strength. Psychomotor performance shows occasional lapses of attention. Accuracy is lost in team events, and self-paced tasks are performed more slowly; psychophysiological tests may also reveal a greater expenditure of effort in order to sustain normal performance. Athletic times usually deteriorate, although it may be difficult to distinguish the effects of sleep deprivation and fatigue. There also seems to be a progressive dampening of normal circadian rhythms. The compression of the working week, use of oral contraceptives and the elimination of seasonal changes in man-made environments undoubtedly disturb circaseptan, circalunar and circa-annual rhythms, but there has been little investigation of functional consequences. The fluid retention resulting from regular oral contraceptive use may help cardiovascular performance, but muscular strength is apparently worsened. Interactions with Exercise: Moderate physical activity should theoretically help synchronisation with new Zeitgebers, particularly if arousal is stimulated at appropriate times during the day In practice, added exercise has little impact upon physiological responses to sleep deprivation, while some authors have actually seen a worsening of psychomotor performance when the effects of sleep deprivation were compounded by vigorous physical activity. Cycles of heavy physical activity play a large part in creating circaseptan rhythms. On the other hand, endurance training may suppress normal menstrual cycles. Conclusion: Physiological and psychological biorhythms have sufficient influence upon performance that they merit close study; indeed, the rapid time shifts associated with translatitudinal travel have already influenced the outcome of some major international competitions.

Sleep, Biorhythms and Human Performance

The present review examines the cytokine response to acute exercise stress, with particular emphasis on the balance between proinflammatory and anti-inflammatory mechanisms, and the release of IL-6. Prolonged endurance exercise induces a sequenced release of pro- and anti-inflammatory cytokines, and IL-6 plays a dominant role. The magnitude of this response bears a general relationship to the intensity of effort, but the duration of activity and many environmental factors also modulate cytokine release. Although many types of cells are capable of producing cytokines, the main source of the exercise-induced IL-6 production appears to be the exercising muscle. The primary function of the additional IL-6 may be to regulate the supply of carbohydrate as muscle reserves of glycogen become depleted. There is also a delayed release of cytokines following eccentric exercise that is related to the repair of muscle injury. Since the production of cytokines is greater with endurance than with resistance exercise, it seems unlikely that they play an important role in the hypertrophy of muscle and bone. More research is needed on a number of important clinical issues where the exercise-induced release of cytokines may have relevance. Exercise-induced cytokine secretion has the potential to provide a simple model of sepsis. Preliminary observations suggest it may also modulate the risk of type 2 diabetes mellitus. Cytokine concentrations are increased in chronic fatigue syndrome, although it is less dear that the cytokine secretion is responsible for fatigue in humans. Exercise-induced modulations in cytokine secretion may contribute to allergies, bronchospasm, and upper respiratory infections in the endurance athlete. Further, the cytokine cascade is involved in the process of atherogenesis, and exercise-induced changes in cytokine production may expose latent HIV to chemotherapeutic agents.

Cytokine responses to physical activity, with particular reference to IL-6: sources, actions, and clinical implications.

The aims of this study were to test the potential of in-season heavy upper and lower limb strength training to enhance peak power output (Wpeak), vertical jump, and handball related field performance in elite male handball players who were apparently already well trained, and to assess any adverse effects on sprint velocity. Twenty-four competitors were divided randomly between a heavy resistance (HR) group (age 20 ± 0.7 years) and a control group (C; age 20 ± 0.1 years). Resistance training sessions were performed twice a week for 8 weeks. Performance was assessed before and after conditioning. Peak power (W(peak)) was determined by cycle ergometer; vertical squat jump (SJ) and countermovement jump (CMJ); video analyses assessed velocities during the first step (V(1S)), the first 5 m (V(5m)), and between 25 and 30 m (V(peak)) of a 30-m sprint. Upper limb bench press and pull-over exercises and lower limb back half squats were performed to 1-repetition maximum (1RM). Upper limb, leg, and thigh muscle volumes and mean thigh cross-sectional area (CSA) were assessed by anthropometry. W(peak) (W) for both limbs (p < 0.001), vertical jump height (p < 0.01 for both SJ and CMJ), 1RM (p < 0.001 for both upper and lower limbs) and sprint velocities (p < 0.01 for V(1S) and V(5m); p < 0.001 for V(peak)) improved in the HR group. Upper body, leg, and thigh muscle volumes and thigh CSA also increased significantly after strength training. We conclude that in-season biweekly heavy back half-squat, pull-over, and bench-press exercises can be commended to elite male handball players as improving many measures of handball-related performance without adverse effects upon speed of movement.

Effects of 8-week in-season upper and lower limb heavy resistance training on the peak power, throwing velocity, and sprint performance of elite male handball players.

Applied anatomy and biomechanics in sport

The purpose of this study was to identify the cognitive profile of people who intend to exercise but fail to carry out this intention. A theoretical framework was adopted to study the attitudinal beliefs of these persons about exercise, their evaluation of the associated consequences, and their normative beliefs and motivation to comply with these norms. Subjects were classified according to the congruence between stated intention and self-reported exercise behavior 2 months later in this way: positive intention and congruent behavior (CONG+, N = 74). positive intention and incongruent behavior (INCONG-, N = 45). negative intention and congruent behavior (CONG-, N = 42). negative intention and incongruent behavior (N = 2, not analyzed). MANOVA analysis indicated little difference between the cognitive profiles of inactive and active positive intenders. Relative to the CONG+ group, the INCONG- group perceived that regular exercise would be "tiring" (P less than 0.001) and "time consuming" (P less than 0.001); they also placed less value on the consequence of "being healthy" (P less than 0.05). Both groups differed from the CONG- group. As would be expected, those with positive intentions to exercise identified more advantages to being physically active. It appears that sedentary positive intenders perceived the exercise behavior as physically demanding and had difficulty in reconciling the time demands of an exercise program with their weekly schedules. This observation suggests that these two beliefs should be considered for the promotion of physical activity as well as the investigation of influential social and environmental variables.

Roy J. Shephard

Papers

Sleep, Biorhythms and Human Performance

Cytokine responses to physical activity, with particular reference to IL-6: sources, actions, and clinical implications.

Effects of 8-week in-season upper and lower limb heavy resistance training on the peak power, throwing velocity, and sprint performance of elite male handball players.

Applied anatomy and biomechanics in sport

The cognitive profile of those who intend to exercise but do not.