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(1) Background: Violence against healthcare professionals is becoming a growing concern for healthcare systems and a public health issue, and in Portugal it remains undocumented at a national level, leaving a critical knowledge gap. This scenario compromises the development of effective public policies and evidence-based institutional strategies, which are essential for guiding policymakers in the implementation of preventive measures and appropriate safety protocols to assess the nature, frequency, and key factors contributing to violence against healthcare professionals (doctors and nurses) in clinical settings. (2) Methods: This is a quantitative, descriptive, and cross-sectional study. The sample size was 440 professionals (n = 440). Between January and May 2024, healthcare professionals (physicians and nurses) working in four local health units located in the south of Portugal were invited to participate in this study via institutional e-mail. Data was collected using a structured questionnaire on the healthcare professional’s sociodemographic and work-related characteristics and aspects related to violence towards healthcare professionals in the workplace. Unconditional logistic regression models were fitted to compute crude odds ratios (ORs) and 95% confidence intervals (95%CIs) for the association between sociodemographic and work-related characteristics and violence at work. (3) Results: Nearly 40% of the healthcare professionals sampled reported having been victims of violence in the workplace, and, among these, the majority reported experiencing psychological violence (94.2%), followed by physical violence (46.2%), another type of violence (39.1%), and sexual violence (4.1%). Incidents were mostly occasional (65.5%), occurring during the daytime (51.5%) and on weekdays (84.8%). Healthcare professionals aged between 34 and 55 years old were approximately twice as likely to experience violence compared to those who were 56 years old or older (OR = 2.28; 95%CI 1.33–3.90). Also, those who had been with the organization for more than 4 years (5–7 years: OR = 2.37; 95%CI 1.05–5.37. ≥8 years: OR = 1.87; 95%CI 1.00–3.50), as well as those who worked shifts (OR = 1.84; 95%CI 1.25–2.72), reported incidents of violence more frequently. (4) Conclusions: The low response rate (12.5%) and cross-sectional design limit the generalizability of the results, which should be interpreted considering these methodological limitations. Workplace violence in Portugal is a reality, and it requires solutions. Information related to violent incidents must be comprehensively gathered to understand the full extent of the problem and develop prevention strategies based on potentially changeable risk factors to minimize the negative effects of workplace violence. Full article

Introduction: Chronic primary low back pain (CPLBP) is a prevalent condition in primary care and a leading cause of disability and absenteeism worldwide. Multidimensional approaches may be necessary to achieve physical and mental health benefits in individuals with CPLBP. Objective: The BACKFIT randomized controlled trial aims to evaluate the effectiveness of a multidimensional intervention—combining supervised exercise and mindfulness—on pain, physical fitness, mental health, and functional outcomes in individuals with CPLBP. Hypothesis: Both the supervised exercise program focused on motor control and trunk muscle strength (IG1) and the multidimensional intervention combining supervised exercise with mindfulness training (IG2) are expected to produce significant health improvements in individuals with CPLBP. It is further hypothesized that IG2 will yield greater improvements compared to IG1, both immediately post-intervention and at the two-month follow-up. Design: Randomized controlled trial. Setting: Virgen de las Nieves University Hospital, Granada (Spain). Participants: 105 individuals. Inclusion criteria: Previously diagnosed with CPLBP, aged ≥18 and ≤65 years, able to read and understand the informed consent, and able to walk, move, and communicate without external assistance. Exclusion criteria: serious lumbar structural disorders, acute or terminal illness, physical injury, mental illness, and medical prescriptions that prevent participation in the study. Intervention: Individuals will be randomly assigned to a supervised physical exercise group (2 days per week, 45 min per session), a multidimensional intervention group (same as supervised physical exercise group, and mindfulness 1 day per week, 2.5 h per session) or an active control group (usual care, 2 days per week, 45 min per session). The intervention will last 8 weeks. Main Outcome Measures: Primary outcome: pain threshold, perceived acute pain, and disability due to pain. Secondary measures: body composition, muscular fitness, gait parameters, device-measured physical activity and sedentary behavior, self-reported sedentary behavior, quality of life, pain catastrophizing, mental health, sleep duration and quality, and central sensitization. The groups will undergo pre-intervention, post-intervention, and a 2-month follow-up after a detraining period. Statistical Analysis: Both per-protocol and intention-to-treat approaches (≥70% attendance) will be used. Program effects will be assessed via one-way ANCOVA for between-group changes in primary and secondary outcomes. Conclusions: Given the complex nature of CPLBP, multidimensional approaches are recommended. If effective, this intervention may provide low-cost alternatives for health professionals. Full article

Purpose: This study aims to demonstrate the value of physical education (PE) in fostering prosociality and academic motivation through active approaches derived from the sports education model (SEM), in contrast with the traditional methodology (TM). One of the new features introduced is based on an approach focused on physical fitness and health that goes beyond sports practice. Method: A 10-week intervention was conducted with a sample of 127 students (n = 127). In total, 63 students (n = 63) received an SEM-based intervention and 64 (n = 64) received traditional teaching. The effect of these methodologies on motivation, prosocial climate, and the perceived importance of PE has been verified, based on a fitness-oriented proposal. Results: The findings indicate improvements in the SEM group’s prosociality (giving, p = 0.015; verbal comfort, p = 0.019; solidarity, p = 0.039). Additionally, the TM group showed increased importance attributable to PE, though a deterioration in prosocial values was also observed. No evidence was found regarding changes in motivation. Discussion/Conclusion: The implementation of SEM has positive effects on students’ prosociality, whereas the opposite effect can be observed when employing TM. The non-inclusion of sports activities can affect the motivation variable Full article

Background: Cardiometabolic risk in adolescents represents a growing public health concern that is closely linked to modifiable factors such as physical fitness. Traditional statistical approaches often fail to capture complex, nonlinear relationships among anthropometric and fitness-related variables. Objective: To develop and evaluate supervised machine learning algorithms, including artificial neural networks and ensemble methods, for classifying cardiometabolic risk levels among Chilean adolescents based on standardized physical fitness assessments. Methods: A cross-sectional analysis was conducted using a large representative sample of school-aged adolescents. Field-based physical fitness tests, such as cardiorespiratory fitness (in terms of estimated maximal oxygen consumption [VO_2max]), muscular strength (push-ups), and explosive power (horizontal jump) testing, were used as input variables. A cardiometabolic risk index was derived using international criteria. Various supervised machine learning models were trained and compared regarding accuracy, F1 score, recall, and area under the receiver operating characteristic curve (AUC-ROC). Results: Among all the models tested, the gradient boosting classifier achieved the best overall performance, with an accuracy of 77.0%, an F1 score of 67.3%, and the highest AUC-ROC (0.601). These results indicate a strong balance between sensitivity and specificity in classifying adolescents at cardiometabolic risk. Horizontal jumps and push-ups emerged as the most influential predictive variables. Conclusions: Gradient boosting proved to be the most effective model for predicting cardiometabolic risk based on physical fitness data. This approach offers a practical, data-driven tool for early risk detection in adolescent populations and may support scalable screening efforts in educational and clinical settings. Full article

Background: This pilot study aimed to investigate the experiences of participating in a brief walking football intervention among rural older adults and explore the functional health outcomes of participation. Methods: This multi-methods study saw 13 older adults (7 males/6 females, 63.2 ± 9.4 years) complete 1-h of walking football per week for six weeks. Pre- and post-intervention, participants underwent assessments of body composition, as well as functional assessments using the Senior Fitness Testing Battery. On completion of the walking football intervention, all participants joined in a semi-structured focus group interview to explore their experiences of participation. Results: Thematic analysis of focus group data identified three themes that captured participant’s experiences, including: (1) “Opportunity to jump back in with what we can physically do”, (2) Social connection and feeling “part of something bigger”, and (3) “It’s how our brain is engaged”. Trivial changes were observed in assessments of body composition (0.07–0.08) and flexibility (0.02–0.19). Furthermore, small-to-large magnitude changes were observed for several functional health outcomes suggestive of improved walking capacity (0.72–1.6), agility (−0.9) and upper and lower body muscular strength (0.49). Conclusions: Rural older adults reported experiencing perceived health and well-being improvements from participation in a brief walking football intervention, with functional health benefits also evident; however, further suitably powered evidence is highly warranted. Full article

Background: This study includes an investigation of lower-limb muscle strength and physical activity among children in Japan and China, with the aim of promoting children’s health. Methods: A total of 564 children (300 boys, 264 girls) aged 9–12 years from public primary schools in Tokyo, Japan, and Jiangxi Province, China, were included. Height, body weight (BW), hip adductor and abductor strength, and toe grip strength were measured. The side-step test (SST) and timed-up-and-go test (TUGT) were performed. Exercise habits were assessed via a questionnaire. Results: Japanese students produced significantly higher values than Chinese students in SST (23.3–37.1%) and TUGT (6.6–8.0%), except among 11-year-old girls. Japanese boys aged 10–11 and girls aged 10–12 had significantly greater hip adductor strength/BW and toe grip strength/BW. Japanese students also showed significantly higher hip abductor strength/BW at all ages. Additionally, the proportion of children engaging in vigorous-intensity physical activity (VPA) was significantly higher in Japanese boys aged 10–12 and girls aged 9–11 than in their Chinese counterparts. Conclusions: Chinese students showed diminished lower-limb strength and agility compared to Japanese students. These findings highlight the importance of promoting outdoor play, particularly VPA, to improve children’s physical fitness and health, especially in China. Full article

Background: Taekwondo (TKD) athletes’ nutritional and health statuses and body composition are critical to their physical performance and overall fitness. In Lebanon, TKD is widely practiced; however, there is a significant gap in the literature regarding the nutritional and health profiles of its athletes. This study aimed to assess the nutritional status, anemia prevalence, body composition, and other health-related characteristics, among Lebanese TKD athletes. Additionally, it explored the determinants of normal hemoglobin (Hb) levels, blood pressure, normal muscle mass, and normal fat mass. Methods: A cross-sectional study was conducted between January and July 2023, involving 110 TKD athletes. Hemoglobin and hematocrit levels were measured to assess anemia, while body composition was evaluated using a bioelectrical impedance analyzer. Blood pressure was also recorded. Household dietary diversity was assessed using the Food Consumption Score, and additional data on sociodemographic factors, training frequency, and supplement or medication use were gathered through a structured questionnaire. Logistic regression models were applied to identify predictors of normal Hb levels, hypertension, and optimal muscle and fat mass. Results: Results showed that male athletes had significantly higher rates of normal Hb (p-value = 0.013) and muscle mass percentages (p-value < 0.001), while females had higher rates of normal blood pressure (p-value = 0.002) and were more likely to use iron supplements (p-value = 0.002) and painkillers (p-value = 0.041). Normal fat mass was positively associated with normal Hb levels (aOR: 11.98, p-value = 0.033). Female gender was linked to a lower likelihood of normal muscle mass (aOR: 0.13, p-value < 0.001) and hypertension (aOR: 0.19, p-value = 0.009). Higher training duration (10 h or more per week) (aOR: 3.46, p-value = 0.04) and normal BMI (aOR: 4.93, p-value = 0.003) were positively associated with normal muscle mass. Normal BMI (aOR: 14.68, p-value < 0.001) was positively associated with normal fat mass. Conclusion: These findings underscore the importance of individualized dietary interventions to enhance athletes’ overall health and performance, through the optimization of athletes’ body composition, and the prevention of deficiencies, especially iron deficiency. Full article

The aim of this paper was to evaluate health, psychological distress, and functioning during the COVID-19 pandemic among Danish adults with and without a history of mental illness. Data were drawn from three online surveys conducted in May 2020 (n = 3134), January 2021 (n = 1170), and January 2022 (n = 1174) as part of the Danish contribution to the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT). The prevalence of mental and physical health issues, psychological distress (stress, sleep problems, loneliness, and boredom) and levels of functioning (self-care, interpersonal relationships, hobbies/leisure, and work/education) were evaluated at four different time points stratified by history of mental illness. Findings indicated that physical health was not differentially affected between people with and without prior mental illness. However, mental health declined significantly more among respondents with a history of mental illness. While levels of stress did not differ between the two groups, boredom was more pronounced in May 2020 among those with prior mental illness. Loneliness was significantly higher in this group in January 2021. Sleep disturbances were more pronounced for respondents with former mental illness during the whole period. A decline in functioning was observed in people both with and without a former mental illness. It seemed a little more pronounced for people with mental illness but seldom reached statistical significance. For all measures of health, distress, and functioning, 10–20% of respondents reported improvements in health, distress, and functioning during the pandemic, with stress showing the most improvement—one third of participants reported feeling less stressed. In most of the parameters measured, the influence of the COVID-19 pandemic seemed to decrease with time. However, the effects were not uniform, and more investigations are needed to understand the whole picture. Full article

Volunteer firefighters often have lower cardiorespiratory fitness (CRF) and less access to health monitoring and fitness programs than career firefighters, yet few studies explore how individual and departmental factors influence their CRF. This study assessed associations between CRF and both firefighter-level (e.g., years of service, firefighting calls, and firefighter rank) and department-level (e.g., department characteristics and fitness infrastructure) factors among volunteer firefighters. Surveys were administered to United States volunteer firefighters and departments, capturing CRF and related characteristics. CRF was analyzed as both a continuous and categorical variable (≤8, >8–<10, 10–<12, ≥12 METs) using bivariate analyses and mixed effects linear and logistic regression. Among 569 incumbent volunteer firefighters from 41 departments, 79.9% did not meet the recommended 12 METs threshold. Only 56.8% of departments provided routine physical exams; 35.1% had a wellness coordinator or committee; and 40.5% offered fitness resources. More years of service were associated with lower CRF and reduced odds of meeting the 12 METs benchmark, while more frequent training and responding to more calls were associated with better CRF. These findings highlight individual and structural challenges for CRF in volunteer fire service, underscoring the need for targeted fitness support to protect firefighter health and community safety. Full article

Background/Objectives: Physical fitness is a key determinant of health in university students, a population at risk of sedentary behaviors and lifestyle-related health issues. The European Fitness Badge (EFB) provides a comprehensive assessment of fitness parameters and individualized feedback. This study aimed to evaluate the physical fitness of Romanian university students using the EFB to examine the effects of activity profile, sex, age, and academic major and to associate physical fitness with body composition indices, including Body Mass Index (BMI) and A Body Shape Index (ABSI). Methods: A cross-sectional study was conducted with 180 university students (43.33% male; age 18–53 years). Participants were categorized into two fitness profiles: Basic (TP1) and Advanced (TP2). Physical fitness was assessed through standardized EFB protocols measuring endurance, strength, flexibility, coordination, and overall fitness. Independent t-tests, one- and two-way ANOVA, and Pearson correlations were used to analyze differences and associations. Results: TP2 participants scored significantly higher in endurance, strength, coordination, and overall fitness, Males outperformed females in strength and coordination. Strength decreased with age, particularly in the oldest group. The sports students demonstrated superior fitness compared to peers in other majors. Two-way ANOVA revealed significant interactions between profile and sex for strength and overall fitness. BMI and ABSI were negatively correlated with physical fitness, in strength, coordination, and overall fitness. Conclusions: The EFB proved effective in differentiating physical fitness profiles. Demographic factors and body composition influenced fitness outcomes, underscoring the need for targeted, profile-based physical activity strategies specifically adapted to university curricula and extracurricular sport programs. However, the findings should be interpreted in light of the study’s geographic limitation, as the sample included only Romanian university students. Full article

Adolescents’ physical activity patterns appear to be changing, with indications of a shift from nature-based activities toward more structured, indoor forms of exercise. However, it remains unclear how participation in outdoor recreation and fitness center use has developed in parallel over time, and whether these trends vary by degree of urbanization. The aim of the present study was to examine the trends in adolescents’ engagement in outdoor recreation and use of fitness centers across Norwegian municipalities between 2010 and 2019 and to assess how these patterns relate to individual and contextual factors. Repeated cross-sectional data were drawn from the Ungdata survey (N = 67,554), and multilevel linear models were applied to estimate time trends and test interactions with municipal population density. Analyses were adjusted for depressive symptoms, gender, school grade, and vegetation density (NDVI). The results indicated a significant decline in outdoor recreation during the period, particularly in more urban municipalities, alongside a marked increase in fitness center use. The two activity types were positively associated but not mutually exclusive. The findings point to a broader shift in adolescent activity preferences that may reflect changing environmental and sociocultural conditions. These patterns underline the need for public health approaches that recognize diverse forms of youth engagement in physical activity. Full article

Background: Age is considered an independent cardiovascular disease (CVD) risk factor, but limited data exist concerning the impact of age and years in the fire service on firefighter health and physical performance. Objectives: We assessed the impact of age and years in the fire service on structural firefighter health and physical performance. Methods: 142 firefighters completed an annual clinical assessment. General linear model (GLM) multivariate and univariate analyses were performed across age groups, with years of fire service experience as a covariate. Partial Eta squared (η_p²) values for the GLM statics and Cohen’s d for pairwise comparisons were used to assess effect size. Results: GLM analyses revealed statistically significant differences (p < 0.05) for several demographic, body composition, blood biomarker, and physical performance parameters. Pairwise comparisons revealed that younger firefighters displayed more favorable health and fitness profiles than their older counterparts. Interestingly, when accounting for years of fire service experience, differences for only the following variables remained: body mass index, waist circumference, lean mass, visceral adipose tissue, triglycerides, cardiopulmonary exercise test time-to-exhaustion, and VO₂max. Conclusions: These findings suggest differences in CVD risk biomarkers, physical fitness levels, and body composition metrics across age groups. However, years of fire service experience appears to have a greater impact on these variables, suggesting that firefighters’ time in the fire service may accelerate the effects of aging on these outcomes. While age-specific health interventions are recommended to manage and mitigate CVD risk effectively, there also should be consideration for the years of fire service. Full article

Background/Objectives: Physical activity (PA) is widely recognized as a beneficial approach to improving the health-related quality of life (HRQoL) of breast cancer survivors. This study explored key research topics and emerging trends in studies related to PA and HRQoL among breast cancer survivors. Methods: Titles and abstracts of 3847 English-language research articles (2000–2024) were retrieved from PubMed, EMBASE, Web of Science, and Scopus using keywords related to ‘breast cancer’, ‘PA/exercise’, and ‘HRQoL’. A text-mining algorithm based on the Dirichlet-multinomial regression approach in Python was applied to identify the top 10 research topics and their trends over time. Results: In total, 10 key topics emerged: (1) Quality of Life and Well-being, (2) Cancer Treatment and Health-Related Fitness, (3) Supportive Care and Psychosocial Factors, (4) Survivorship, Palliative Care, and Integrative Medicine, (5) Physical Activity and Sedentary Behaviors, (6) Upper Limb-Related Side Effects, (7) Cancer-Related Fatigue and Symptoms, (8) Epidemiological and Clinical Factors, (9) Side Effects of Cancer Treatment, and (10) Weight Management. Among these, Topics 1, 2, 3, 8, and 9 followed upward trajectories, while others showed relatively stable trends. Conclusions: Findings highlight that PA research on breast cancer survivors’ HRQoL spans all stages of survivorship and considers both clinical outcomes and psychosocial and emotional well-being. Understanding how PA and HRQoL have been represented in research helps clarify which survivor needs have received attention and which remain underexplored. These thematic patterns underscore growing acknowledgement of survivors’ lived experiences and offer a roadmap for addressing future research and care gaps. Full article

Compression pants, as functional sportswear providing external pressure, are widely used to enhance athletic performance and accelerate recovery. However, systematic investigations into their effectiveness during anaerobic exercise and the impact of different pressure levels on performance and post-exercise recovery remain limited. This randomized crossover controlled trial recruited 20 healthy male university students to compare the effects of four garment conditions: non-compressive pants (NCP), moderate-pressure compression pants (MCP), high-pressure compression pants (HCP), and ultra-high-pressure compression pants (UHCP). Anaerobic performance was assessed through vertical jump, agility tests, and the Wingate anaerobic test, with indicators including time at peak power (TPP), peak power (PP), average power (AP), minimum power (MP), power drop (PD), and total energy produced (TEP). Post-exercise blood lactate concentrations and heart rate responses were also monitored. The results showed that both HCP and UHCP significantly improved vertical jump height (p < 0.01), while MCP outperformed all other conditions in agility performance (p < 0.05). In the Wingate test, MCP achieved a shorter TPP compared to NCP (p < 0.05), with significantly higher AP, lower PD, and greater TEP than all other groups (p < 0.05), whereas HCP showed an advantage only in PP over NCP (p < 0.05). Post-exercise, all compression pant groups recorded significantly higher peak blood lactate (Lamax) levels than NCP (p < 0.05), with MCP showing the fastest lactate clearance rate. Heart rate analysis revealed that HCP and UHCP induced higher maximum heart rates (HR_max) (p < 0.05), while MCP exhibited superior heart rate recovery at 3, 5, and 10 min post-exercise (p< 0.05). These findings suggest that compression pants with different pressure levels yield distinct effects on anaerobic performance and physiological recovery. Moderate-pressure compression pants demonstrated the most balanced and beneficial outcomes across multiple performance and recovery metrics, providing practical implications for the individualized design and application of compression garments in athletic training and rehabilitation. Full article

The Red River Jig is a traditional Métis dance practiced among Indigenous and non-Indigenous Peoples. While exercise improves physical health and fitness, the impacts of cultural dances on wholistic health are less clear. This study aimed to investigate the psychosocial (cultural and mental), social, physical function, and physical fitness benefits of a Red River Jig intervention. In partnership with Li Toneur Nimiyitoohk Métis Dance Group, Indigenous and non-Indigenous adults (N = 40, 39 ± 15 years, 32 females) completed an 8-week Red River Jig intervention. Social support, cultural identity, memory, and mental wellbeing questionnaires, seated blood pressure and heart rate, weight, pulse-wave velocity, heart rate variability, baroreceptor sensitivity, jump height, sit-and-reach flexibility, one-leg and tandem balance, and six-minute walk test were assessed pre- and post-intervention. Community, family, and friend support scores, six-minute walk distance (553.0 ± 88.7 m vs. 602.2 ± 138.6 m, p = 0.002), jump, leg power, and systolic blood pressure low-to-high-frequency ratio increased after the intervention. Ethnic identity remained the same while affirmation and belonging declined, leading to declines in overall cultural identity, as learning about Métis culture through the Red River Jig may highlight gaps in cultural knowledge. Seated systolic blood pressure (116.5 ± 7.3 mmHg vs. 112.5 ± 10.7 mmHg, p = 0.01) and lower peripheral pulse-wave velocity (10.0 ± 2.0 m·s⁻¹ vs. 9.4 ± 1.9 m·s⁻¹, p = 0.04) decreased after the intervention. Red River Jig dance training can improve social support, physical function, and physical fitness for Indigenous and non-Indigenous adults. Full article