human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Observational longitudinal research is particularly useful for assessing etiology and prognosis and for providing evidence for clinical decision making . However , there are no structured reporting requirements for studies of this design to assist authors , editors , and readers . The authors developed and tested a checklist of criteria related to threats to the internal and external validity of observational longitudinal studies . The checklist criteria concerned recruitment , data collection , biases , and data analysis and descriptive issues relevant to study rationale , study population , and generalizability . Two raters independently assessed 49 r and omly selected articles describing stroke research published from 1999 to 2003 in six journals : American Journal of Epidemiology , Journal of Epidemiology and Community Health , Stroke , Annals of Neurology , Archives of Physical Medicine and Rehabilitation , and American Journal of Physical Medicine and Rehabilitation . On average , 17 of the 33 checklist criteria were reported . Criteria describing the study design were better reported than those related to internal validity . No relation was found between study type ( etiologic or prognostic ) or word count and quality of reporting . A flow diagram for summarizing participant flow through a study was developed . Editors and authors should consider using a checklist and flow diagram when reporting on observational longitudinal research Background Walking and cycling to school are one source of regular physical activity . The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content ( BMC ) and bone width than when going by car or bus . Methods 133 boys and 99 girls aged 7 - 9 years were recruited to the Malmö Prospect i ve Paediatric Osteoporosis Prevention ( POP ) study .  BMC ( g ) was measured by dual X-ray absorptiometry ( DXA ) in total body , lumbar spine ( L2-L4 ) and femoral neck ( FN ) at baseline and after 24 months . Bone width was measured in L2-L4 and FN . Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car . All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and question naires . Comparisons were made by independent student 's t-tests between means and Fisher 's exact tests . Analysis of covariance ( ANCOVA ) was used to adjust for group differences in age at baseline , duration of organized physical activity , annual changes in length and BMC or bone width if there were differences in these traits at baseline . Results After the adjustments , there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus . Furthermore , there were no differences in the levels of everyday physical activity objective ly measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day . Conclusion A physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation , possibly due to the fact that the everyday physical activity in these pre-pubertal children , independent of the mode of school transportation , was high OBJECTIVE To prospect ively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth . RESEARCH METHODS AND PROCEDURES A cohort of students from seven elementary schools was measured four times -- in the fall and spring of fourth grade ( N = 1083 ) and fifth grade ( N = 924 ) . Participants were classified as active ( walking , biking , or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting ) or non-active commuters to school . Accelerometers were used to measure physical activity . Height , weight , and skinfolds were objective ly assessed . RESULTS Boys who actively commuted to school had lower BMI ( p < 0.01 ) and skinfolds ( p < 0.05 ) than non-active commuters to school in the fourth grade . Active commuting to school over 2 years was not associated with BMI change or overweight status . DISCUSSION Walking and cycling to school may contribute to preventing excessive weight gain , or leaner children may walk or cycle to school OBJECTIVE This study examined differences in ( 1 ) psychosocial correlates of physical activity and in ( 2 ) physical activity within different context s and sedentary behaviors between normal weight and overweight adolescents . It further explored whether the prediction of physical activity by the psychosocial correlates is different in normal weight and overweight adolescents . RESEARCH METHODS AND PROCEDURE A community sample of 6078 11 to 19 year olds from 38 secondary schools , which were r and omly selected throughout the country , completed a vali date d computerized question naire about physical activity , sedentary behaviors , and psychosocial correlates . Differences in mean scores on the psychosocial correlates and on the self-rated physical activity were analyzed between the normal weight ( n=5563 ) and the overweight ( n=515 , 8.5 % ) group . RESULTS This study showed that overweight adolescents do less intense physical activities ( p<0.001 ) and have less favorable psychosocial correlates related to physical activity ( p<0.001 ) than their normal weight counterparts . However , the strength of the associations between psychosocial variables and total physical activity were comparable in overweight and normal weight adolescents . More support from family and friends , more fun in physical activity , higher self-efficacy , the perception of more competition benefits , and the perception of less lack of interest were all associated with higher total levels of physical activity . The results suggest that no specific tailoring on psychosocial correlates of physical activity is necessary for overweight adolescents compared with normal weight ones . DISCUSSION Both overweight and normal weight adolescents can be approached by interventions focusing on the same psychosocial variables to increase physical activity PURPOSE This study was conducted to determine if fifth- grade students who walked or bicycled to school on a regular basis were more physically active than those that did not . METHODS The sample consists of 219 fifth- grade students ( 10.3 + /- 0.6 yr , 44 % male , 58 % minority ) from eight r and omly selected urban and suburban elementary schools . Students wore an Acti-Graph physical activity monitor during the same week that they completed a daily survey to report their mode of transportation to and from school . Students were categorized on the number of reported active commuting trips , to and from school , per week ( regular;>or=5 ( N=11 ) , irregular ; 1 - 4 ( N=25 ) , nonactive ; 0 ( N=183 ) ) . RESULTS Compared with both other groups , regular active commuters accumulated 3 % more minutes of moderate-to-vigorous physical activity ( MVPA ; P=0.04 ) during weekdays . This weekday difference was because of regular active commuters accumulating 8.5 % more minutes of MVPA both before and after school ( P < or= 0.01 ) . No difference in physical activity was seen among groups during school or in the evening . Based on the mean number of minutes the students wore their monitors on weekdays ( 800 min.d ) , the 3 % difference translates into approximately 24 additional minutes of MVPA per day for the regular active commuters . CONCLUSION Walking to school was associated with approximately 24 additional minutes of MVPA per day in fifth- grade students . Additional observational and experimental research in larger , more diverse sample s is needed to further clarify the effects of active commuting to school on total daily physical activity and other health outcomes BACKGROUND & OBJECTIVE Overweight and obesity are important determinants of health leading to adverse metabolic changes and increase the risk of non communicable diseases . Following the increase in adult obesity , the proportion of overweight and obese children and adolescents has also been increasing . Hence , the present study was undertaken to study the magnitude of overweight/obesity and its correlates among school going children of Wardha city in central India and suggest interventions . METHODS The cross-sectional study was carried out in all the 31 middle-schools ( 5th to 7th st and ard ) and high-schools ( 8th to 10th st and ard ) of Wardha city . Probability proportionate to size of population technique ( PPS ) was used to decide the number of children to be studied from each school , each class and then each section . Systematic r and om sampling technique was used to select the children from each section . Pre- design ed and pre-tested question naire was used to elicit the information on family characteristics and individual characteristics . Height and weight was measured and BMI was calculated . Overweight and obesity was assessed by BMI for age .  Student who had BMI for age > or=85th and < 95th percentile of reference population were classified as overweight and BMI for age > or=95th percentile of reference population were classified as obese . RESULTS Overweight and obesity was found to be 3.1 per cent ( 95 % CI : 2.5 - 3.8 % ) and 1.2 per cent ( 95 % CI : 0.8 - 1.8 % ) respectively ; together constitute 4.3 per cent ( 95 % CI : 3.6 - 5.2 % ) for overweight/ obesity . Final model of the multivariate logistic regression showed that the important correlates of overweight/obesity were urban residence , father and /or mother involved in service/business , English medium school and child playing outdoor games for less than 30 min . INTERPRETATION & CONCLUSION The magnitude of overweight/obesity among school going children of Wardha city was found to be 4.3 per cent . Family characteristics play important role in predisposing the children to overweight/obesity and hence the interventions need to be directed towards the families BACKGROUND Availability of parks is associated with higher levels of physical activity among children and adolescents . Few studies examine actual park use and park-based physical activity in these population s. PURPOSE This study examined associations among individual , park , and neighborhood environmental characteristics and children 's and adolescent 's park-based physical activity . METHODS Data were collected in 2007 on 2712 children in 20 r and omly selected parks in Durham NC . The System for Observing Play and Recreation in Communities ( SOPARC ) provided measures of physical activity . Hierarchic regression analysis assessed associations among individual , park , and neighborhood environmental characteristics and children 's park-based physical activity . Data were analyzed in 2010 . RESULTS Of the 2712 children observed , 34.2 % and 13.2 % were engaged in walking or vigorous physical activity . Environmental features of parks were associated with activity levels whereas neighborhood characteristics were not . Physical activity was negatively associated with gender ( girls ) ( p=0.003 ) ; presence of a parent ( p<0.0001 ) ; presence of nonparental adult ( p=0.006 ) ; and an interaction involving the 0 - 5 years age group and style of play ( p=0.017 ) . Higher level of physical activity was associated with presence of other active children ( p<0.0001 ) ; courts ( e.g. , basketball ) ; and an interaction between number of recreation facilities and formal activities ( p=0.004 ) . CONCLUSIONS These social factors and design features should be considered in order to stimulate higher levels of park-based physical activity among children and adolescents BACKGROUND Active school transport ( AST ) is a recommended strategy to promote physical activity ( PA ) and prevent overweight ( OW ) in school-aged children . In many developing countries , such as Colombia , this association has not been well characterized . OBJECTIVE To determine the association between AST and weight status in a representative sample of adolescents from Montería , Colombia . METHODS Participants were 546 adolescents ( 278 boys ) aged 11 to 18 years old from 14 r and omly selected schools in Montería , Colombia in 2008 . The PA module of the Global School Health Survey ( GSHS-2007 ) was used to determine the prevalence of AST . To identify OW , participants were classified according to CDC 2000 criteria ( BMI ≥ 85th percentile ) . Association between AST and OW was determined by binomial logistic regression . RESULTS Odds ratios adjusted for age , sex , location of school , compliance with PA , and screen time recommendations showed that adolescents who reported AST had a significantly lower likelihood to be OW compared with adolescents who reported nonactive transportation ( OR = 0.5 , 95 % CI 0.3 - 0.8 , P < .05 ) . CONCLUSIONS These results support the importance of AST as a useful PA domain with potential implication s for overweight prevention , in rapidly developing setting s. Further epidemiologic and intervention studies addressing AST are needed in the region 
    Output:
    
agent
Most studies focussed solely on active  travel  to and /or from school , and showed significant positive associations with physical activity .
The same relationship was detected for active travel to leisure-related places and independent mobility with physical activity .
An inverse relationship between active travel to school and weight status was evident but findings were inconsistent .
Studies on independent mobility suggested that children who have the freedom to play outdoors and travel actively without adult supervision accumulate more physical activity than those who do not .
Further investigation of children 's active travel to leisure-related destinations , measurement of diverse sedentary behaviour beyond simply screen-based activities , and consistent thresholds for objective ly measured sedentary behaviour in children will clarify the inconsistent evidence base on associations of active travel with sedentary behaviour and weight status
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Observational longitudinal research is particularly useful for assessing etiology and prognosis and for providing evidence for clinical decision making . However , there are no structured reporting requirements for studies of this design to assist authors , editors , and readers . The authors developed and tested a checklist of criteria related to threats to the internal and external validity of observational longitudinal studies . The checklist criteria concerned recruitment , data collection , biases , and data analysis and descriptive issues relevant to study rationale , study population , and generalizability . Two raters independently assessed 49 r and omly selected articles describing stroke research published from 1999 to 2003 in six journals : American Journal of Epidemiology , Journal of Epidemiology and Community Health , Stroke , Annals of Neurology , Archives of Physical Medicine and Rehabilitation , and American Journal of Physical Medicine and Rehabilitation . On average , 17 of the 33 checklist criteria were reported . Criteria describing the study design were better reported than those related to internal validity . No relation was found between study type ( etiologic or prognostic ) or word count and quality of reporting . A flow diagram for summarizing participant flow through a study was developed . Editors and authors should consider using a checklist and flow diagram when reporting on observational longitudinal research Background Walking and cycling to school are one source of regular physical activity . The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content ( BMC ) and bone width than when going by car or bus . Methods 133 boys and 99 girls aged 7 - 9 years were recruited to the Malmö Prospect i ve Paediatric Osteoporosis Prevention ( POP ) study .  BMC ( g ) was measured by dual X-ray absorptiometry ( DXA ) in total body , lumbar spine ( L2-L4 ) and femoral neck ( FN ) at baseline and after 24 months . Bone width was measured in L2-L4 and FN . Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car . All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and question naires . Comparisons were made by independent student 's t-tests between means and Fisher 's exact tests . Analysis of covariance ( ANCOVA ) was used to adjust for group differences in age at baseline , duration of organized physical activity , annual changes in length and BMC or bone width if there were differences in these traits at baseline . Results After the adjustments , there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus . Furthermore , there were no differences in the levels of everyday physical activity objective ly measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day . Conclusion A physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation , possibly due to the fact that the everyday physical activity in these pre-pubertal children , independent of the mode of school transportation , was high OBJECTIVE To prospect ively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth . RESEARCH METHODS AND PROCEDURES A cohort of students from seven elementary schools was measured four times -- in the fall and spring of fourth grade ( N = 1083 ) and fifth grade ( N = 924 ) . Participants were classified as active ( walking , biking , or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting ) or non-active commuters to school . Accelerometers were used to measure physical activity . Height , weight , and skinfolds were objective ly assessed . RESULTS Boys who actively commuted to school had lower BMI ( p < 0.01 ) and skinfolds ( p < 0.05 ) than non-active commuters to school in the fourth grade . Active commuting to school over 2 years was not associated with BMI change or overweight status . DISCUSSION Walking and cycling to school may contribute to preventing excessive weight gain , or leaner children may walk or cycle to school OBJECTIVE This study examined differences in ( 1 ) psychosocial correlates of physical activity and in ( 2 ) physical activity within different context s and sedentary behaviors between normal weight and overweight adolescents . It further explored whether the prediction of physical activity by the psychosocial correlates is different in normal weight and overweight adolescents . RESEARCH METHODS AND PROCEDURE A community sample of 6078 11 to 19 year olds from 38 secondary schools , which were r and omly selected throughout the country , completed a vali date d computerized question naire about physical activity , sedentary behaviors , and psychosocial correlates . Differences in mean scores on the psychosocial correlates and on the self-rated physical activity were analyzed between the normal weight ( n=5563 ) and the overweight ( n=515 , 8.5 % ) group . RESULTS This study showed that overweight adolescents do less intense physical activities ( p<0.001 ) and have less favorable psychosocial correlates related to physical activity ( p<0.001 ) than their normal weight counterparts . However , the strength of the associations between psychosocial variables and total physical activity were comparable in overweight and normal weight adolescents . More support from family and friends , more fun in physical activity , higher self-efficacy , the perception of more competition benefits , and the perception of less lack of interest were all associated with higher total levels of physical activity . The results suggest that no specific tailoring on psychosocial correlates of physical activity is necessary for overweight adolescents compared with normal weight ones . DISCUSSION Both overweight and normal weight adolescents can be approached by interventions focusing on the same psychosocial variables to increase physical activity PURPOSE This study was conducted to determine if fifth- grade students who walked or bicycled to school on a regular basis were more physically active than those that did not . METHODS The sample consists of 219 fifth- grade students ( 10.3 + /- 0.6 yr , 44 % male , 58 % minority ) from eight r and omly selected urban and suburban elementary schools . Students wore an Acti-Graph physical activity monitor during the same week that they completed a daily survey to report their mode of transportation to and from school . Students were categorized on the number of reported active commuting trips , to and from school , per week ( regular;>or=5 ( N=11 ) , irregular ; 1 - 4 ( N=25 ) , nonactive ; 0 ( N=183 ) ) . RESULTS Compared with both other groups , regular active commuters accumulated 3 % more minutes of moderate-to-vigorous physical activity ( MVPA ; P=0.04 ) during weekdays . This weekday difference was because of regular active commuters accumulating 8.5 % more minutes of MVPA both before and after school ( P < or= 0.01 ) . No difference in physical activity was seen among groups during school or in the evening . Based on the mean number of minutes the students wore their monitors on weekdays ( 800 min.d ) , the 3 % difference translates into approximately 24 additional minutes of MVPA per day for the regular active commuters . CONCLUSION Walking to school was associated with approximately 24 additional minutes of MVPA per day in fifth- grade students . Additional observational and experimental research in larger , more diverse sample s is needed to further clarify the effects of active commuting to school on total daily physical activity and other health outcomes BACKGROUND & OBJECTIVE Overweight and obesity are important determinants of health leading to adverse metabolic changes and increase the risk of non communicable diseases . Following the increase in adult obesity , the proportion of overweight and obese children and adolescents has also been increasing . Hence , the present study was undertaken to study the magnitude of overweight/obesity and its correlates among school going children of Wardha city in central India and suggest interventions . METHODS The cross-sectional study was carried out in all the 31 middle-schools ( 5th to 7th st and ard ) and high-schools ( 8th to 10th st and ard ) of Wardha city . Probability proportionate to size of population technique ( PPS ) was used to decide the number of children to be studied from each school , each class and then each section . Systematic r and om sampling technique was used to select the children from each section . Pre- design ed and pre-tested question naire was used to elicit the information on family characteristics and individual characteristics . Height and weight was measured and BMI was calculated . Overweight and obesity was assessed by BMI for age .  Student who had BMI for age > or=85th and < 95th percentile of reference population were classified as overweight and BMI for age > or=95th percentile of reference population were classified as obese . RESULTS Overweight and obesity was found to be 3.1 per cent ( 95 % CI : 2.5 - 3.8 % ) and 1.2 per cent ( 95 % CI : 0.8 - 1.8 % ) respectively ; together constitute 4.3 per cent ( 95 % CI : 3.6 - 5.2 % ) for overweight/ obesity . Final model of the multivariate logistic regression showed that the important correlates of overweight/obesity were urban residence , father and /or mother involved in service/business , English medium school and child playing outdoor games for less than 30 min . INTERPRETATION & CONCLUSION The magnitude of overweight/obesity among school going children of Wardha city was found to be 4.3 per cent . Family characteristics play important role in predisposing the children to overweight/obesity and hence the interventions need to be directed towards the families BACKGROUND Availability of parks is associated with higher levels of physical activity among children and adolescents . Few studies examine actual park use and park-based physical activity in these population s. PURPOSE This study examined associations among individual , park , and neighborhood environmental characteristics and children 's and adolescent 's park-based physical activity . METHODS Data were collected in 2007 on 2712 children in 20 r and omly selected parks in Durham NC . The System for Observing Play and Recreation in Communities ( SOPARC ) provided measures of physical activity . Hierarchic regression analysis assessed associations among individual , park , and neighborhood environmental characteristics and children 's park-based physical activity . Data were analyzed in 2010 . RESULTS Of the 2712 children observed , 34.2 % and 13.2 % were engaged in walking or vigorous physical activity . Environmental features of parks were associated with activity levels whereas neighborhood characteristics were not . Physical activity was negatively associated with gender ( girls ) ( p=0.003 ) ; presence of a parent ( p<0.0001 ) ; presence of nonparental adult ( p=0.006 ) ; and an interaction involving the 0 - 5 years age group and style of play ( p=0.017 ) . Higher level of physical activity was associated with presence of other active children ( p<0.0001 ) ; courts ( e.g. , basketball ) ; and an interaction between number of recreation facilities and formal activities ( p=0.004 ) . CONCLUSIONS These social factors and design features should be considered in order to stimulate higher levels of park-based physical activity among children and adolescents BACKGROUND Active school transport ( AST ) is a recommended strategy to promote physical activity ( PA ) and prevent overweight ( OW ) in school-aged children . In many developing countries , such as Colombia , this association has not been well characterized . OBJECTIVE To determine the association between AST and weight status in a representative sample of adolescents from Montería , Colombia . METHODS Participants were 546 adolescents ( 278 boys ) aged 11 to 18 years old from 14 r and omly selected schools in Montería , Colombia in 2008 . The PA module of the Global School Health Survey ( GSHS-2007 ) was used to determine the prevalence of AST . To identify OW , participants were classified according to CDC 2000 criteria ( BMI ≥ 85th percentile ) . Association between AST and OW was determined by binomial logistic regression . RESULTS Odds ratios adjusted for age , sex , location of school , compliance with PA , and screen time recommendations showed that adolescents who reported AST had a significantly lower likelihood to be OW compared with adolescents who reported nonactive transportation ( OR = 0.5 , 95 % CI 0.3 - 0.8 , P < .05 ) . CONCLUSIONS These results support the importance of AST as a useful PA domain with potential implication s for overweight prevention , in rapidly developing setting s. Further epidemiologic and intervention studies addressing AST are needed in the region 
    Output:
    