Participating in outdoor sports in blue spaces is recognized to produce a range of significant social benefits. This case study empirically analyzes the social benefits associated with the School Nautical Activities project carried out in Viana do Castelo (Portugal) in school-age children and adolescents. It consisted of a 4 year program in which scholars took part in nautical activities (surfing, rowing, sailing, and canoeing) in blue spaces once a week during a semester as a part of their physical education course. The methods used for data collection were as follows: (1) a survey answered by 595 participants in the program and (2) five focus groups (FG): two FGs with participants (seven on each FG), two FGs with their parents (eight participants each), and one FG with the physical education teachers (five participants). Interviews were transcribed and qualitative analysis with NVivo software was developed. Results revealed clear evidence on the social benefits for school-age children and adolescents associated with participation in outdoor activities in blue spaces both in the overall health and in all the following analyzed categories: mental health and well-being, education, active citizenship, social behavior, and environmental awareness. More than 40% state that their overall health is much better now (13.4%) or somewhat better now (29.9%) due to their participation in the program. Thus, this article provides support for the anecdotal recognition of the benefits for school-age children and adolescents from participating in sports in the outdoors and especially in blue spaces.

Research suggests that children identified with impaired motor skills can respond well to intensive therapeutic interventions delivered via occupational and physical therapy services. There is, however, a need to explore alternative approaches to delivering interventions outside traditional referral-based clinic settings because limited resources mean such health services often struggle to meet demand. This review sets out to systematically assess the evidence for and against school-based interventions targeted at improving the motor skills of children aged between 3 and 12 years old.
Five electronic databases were searched systematically (AMED, CINAHL, Cochrane, Medline, and PsycINFO) for peer-reviewed articles published between January 2012 and July 2018. Studies were eligible if they implemented a school-based motor skill intervention with a randomized or case-controlled trial design that objectively measured motor skills as an outcome, which were not specific to an athletic or sporting skill. Participants had to be aged between 3 and 12 years old and free from neurological disorders known to affect muscle function. Risk of bias was assessed using the Cochrane risk of bias tool.
Twenty-three studies met the inclusion criteria. These studies encompassed interventions targeted at training: fundamental movement skills, handwriting, fine, and global motor skills. The majority of these studies reported beneficial impact on motor function specifically, but some interventions also assessed subsequent impacts on activity and participation (but not well-being). A number of the studies had methodological shortcomings that means these results need to be interpreted with caution.
Schools appear to be an effective setting for motor skill interventions, but the extent of benefit likely depends on the type of intervention. Moreover, confirmation is needed as to whether benefits extend beyond motor function into everyday activities, participation, and well-being. Future research should include follow-up measures to assess the longer term efficacy of school-based interventions.

In this article, we report a qualitative case study, in which we examined enablers and barriers related to the development, implementation, and sustainability of a comprehensive school physical activity program (CSPAP) aligned with the Health Optimizing Physical Education (HOPE) curriculum model at a middle school. Literature on program-diffusion and school-university partnerships guided data collection and analysis. Data sources included semi-structured interviews with the program implementation team (n = 9) and the school\'s health and physical education teachers (n = 7); a focus group interview with students; documents (e.g., lesson plans), and observations. Constant comparison techniques were used to code and draw out themes from the data. Findings revealed the extensive effort needed for program implementation and highlighted the importance of strong external support mechanisms, conducting needs assessments, and training teachers to market physical activity programming. Partnerships may provide critical support for schools in their efforts to generate and sustain CSPAPs.

This article discusses the relationship between physical education and health in Rio de Janeiro in the nineteenth century, drawing on the case of one of the most prestigious schools at the time, Colégio Abílio. Rather than merely revealing the discourses that surrounded the provision of physical education at the school, we seek to comprehend the different ways in which it was incorporated into its educational routine. Two sources of different kinds were used: newspapers published in the city and the novel O Ateneu, by Raul Pompéia. We conclude that the challenge in understanding the social presence of physical education in the period in question is how to pick up the multiple apprehensions that surrounded it.

OBJECTIVE: Investigate the influence of 4 weeks of walk training with blood flow restriction (BFR) on muscle strength, metabolic responses, 100-m and 400-m performances in an athlete with cerebral palsy.
METHODS: An elite Paralympic sprinter (20 years, 176 cm, 64.8 kg) who presented with moderate hemiplegic cerebral palsy (right side impaired) completed four visits before and after 4 weeks of the BFR training: 1) anthropometric measurements, familiarization of maximal voluntary contraction (MVC), and an incremental test; 2) MVC measurements; 3) 400-m performance, and 4) 100-m performance. The walk training with BFR consisted of four bouts of 5 min at 40% of maximal aerobic speed with 1 min of passive rest with complete reperfusion.
RESULTS: All performance times were lower with training (100-m: 1%; 400-m: 10%), accompanied by adaptations in aerobic variables (V˙O2max: 6%; OBLA: 24%) and running economy (9-10%). Lactic acid energy metabolism was reduced (25-27%), even in the presence of a higher lactate efflux from the previously active muscles after training. MVC (right leg: 19%; left leg: 9%) increased in both legs unevenly, decreasing the muscle strength asymmetry between limbs.
CONCLUSIONS: These results indicate that cardiovascular and neuromuscular adaptations can be simultaneously induced following BFR training in a paralympic sprinter.

In this article, we draw on current research to explore notions of socially just health and physical education (HPE) programs, in light of claims that a neoliberal globalization promotes markets over the states and a new individualism that privileges self-interest over the collective good. We also invite readers to consider the UN Educational, Scientific, and Cultural Organization\'s ambition for physical education in light of preliminary findings from an Australian-led research project exploring national and international patterns of outsourcing HPE curricula. Data were sourced from this international research project through a mixed-methods approach. Each external provider engaged in 4 phases of research activity: (a) Web audits, (b) interviews with external providers, (c) network diagrams, and (d) school partner interviews and observations. We then used these data to pose what we believe to be three emerging lines of inquiry and challenge for a socially just school HPE in neoliberal times. In particular, our data indicate that the marketization of school HPE is strengthening an emphasis on individual responsibility for personal health, thereby elevating expectations that schools and teachers will \"fill the welfare gap\" and, finally, influencing the nature and purchase of educative HPE programs in schools. The apparent proliferation of external providers of health work and HPE resources and services reflects the rise and pervasiveness of neoliberalism in education. We conclude that this global HPE landscape warrants attention to investigate the extent to which external providers\' resources are compatible with schooling\'s educative and inclusive mandates.

BACKGROUND: Preschool settings vary greatly, and research has shown that interventions are more successful when they can be adapted to individual settings. This is a descriptive case study of how 2 teachers successfully adapted and implemented a preschool physical activity intervention.
METHODS: The Study of Health and Activity in Preschool Environments (SHAPES) was a 3-year physical activity intervention. A detailed case study of 2 high-implementing teachers was conducted. Multiple data sources included accelerometry, direct observation, teacher surveys, and intervention staff field notes.
RESULTS: Teacher A focused on integrating physical activity into a wide range of activities, including parent and community events. Teacher B focused on high-intensity, structured activities. Both teachers supported the intervention, worked closely with intervention staff, and operated their classroom as an autonomous unit with support from their directors. Teacher A provided an average of 31.5, 78.0, and 67.5 min of physical activity opportunity per day of observation during years 1, 2, and 3. Teacher B provided an average of 2.7, 33.5, and 73.3 minutes of physical activity opportunity per day of observation.
CONCLUSIONS: Successful implementation of physical activity interventions may look different in different contexts; thus, interventions should allow for flexible implementation.

BACKGROUND: Both intense endurance training and valvular regurgitation place a volume load on the right and left ventricles, potentially leading to dilation, but their effects in combination are not well-known.
OBJECTIVE: The purpose of this case series is to describe the combined volume load of intense endurance athletic training and regurgitant valvular disease as well as the challenging assessment of each component\'s cardiovascular effect.
METHODS: In this article, the clinical course of three elite endurance athletes with congenital valvular disease were reviewed.
RESULTS: A swimmer with aortic regurgitation, a cyclist with aortic regurgitation, and a cyclist with pulmonary regurgitation were found to have severe dilation of the associated ventricles despite continuing to train at an elite level without symptoms.
CONCLUSIONS: Because of the cumulative effects of endurance training and valvular regurgitation, each athlete manifested ventricular dilation out of proportion to their valvular disease and symptoms. Although the effects of congenital valvular disease and athletic remodeling on ventricular dilation have been thoroughly studied individually, their cumulative effect is not well understood. This complicates the assessment of athletes with valvular regurgitation and underscores the need for athlete-specific recommendations for valve replacement.

OBJECTIVE: Sport-related dental injuries are a growing concern worldwide. Regardless of how minor they may appear, some of them can lead to traumas which have a negative impact on quality of life, producing psychological and social discomfort. In view of the widespread lack of knowledge with regard to first aid procedures in cases of dental trauma, we would like to report the current state of knowledge of an academy of physical education and sport students compared with medical and general university students.
METHODS: In order to assess the knowledge of appropriate first aid procedures following dental trauma a survey using questionnaires was undertaken. The sample size consisted of 356 students attending the last year of university: sport academy (123 students); medical university (115 students); general university (118 students).
RESULTS: The results revealed that just 3% of all students knew that in the case of dental avulsion immediate replantation should be performed. Only 6% of students were aware that the time factor after tooth avulsion is the single most influential factor affecting the prognosis. Only 16% of sport academy students and 23% of general university students knew the recommended transport medium for an avulsed tooth.
CONCLUSIONS: In the face of such poor knowledge regarding dental injuries there is an urgent need for adequate education programs on the subject of sport-related orofacial injuries directed at all sports students, including athletes, players and coaches, so they could offer immediate help at the site of an accident.

BACKGROUND: Few children meet physical activity (PA) recommendations, and are therefore at increased risk for overweight/obesity and adverse health outcomes. To increase children\'s opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. The purpose of this study was to understand the processes underlying adoption and diffusion of Canadian DPA policies, and to review evidence regarding their implementation and impact.
METHODS: We adopted a multiple case history methodology in which we traced the chronological trajectory of DPA policies among Canadian provinces by compiling timelines detailing key historical events that preceded policy adoption. Publicly available documents posted on the internet were reviewed to characterize adopter innovativeness, describe the content of their DPA policies, and explore the context surrounding policy adoption. Diffusion of Innovations theory provided a conceptual framework for the analyses. A systematic literature search identified studies that had investigated adoption, diffusion, implementation or impact of Canadian DPA policies.
RESULTS: Five of Canada\'s 13 provinces and territories (38.5%) have DPA policies. Although the underlying objectives of the policies are similar, there are clear differences among them and in their various policy trajectories. Adoption and diffusion of DPA policies were structured by the characteristics and capacities of adopters, the nature of their policies, and contextual factors. Limited data suggests implementation of DPA policies was moderate but inconsistent and that Canadian DPA policies have had little to no impact on school-aged children\'s PA levels or BMI.
CONCLUSIONS: This study detailed the history and current status of Canadian DPA policies, highlighting the conditional nature of policy adoption and diffusion, and describing policy and adopter characteristics and political contexts that shaped policy trajectories. An understanding of the conditions associated with successful policy adoption and diffusion can help identify receptive contexts in which to pioneer novel legislative initiatives to increase PA among children. By reviewing evidence regarding policy implementation and impact, this study can also inform amendments to existing, and development of future PA policies.