Search

Schools are important settings for not only providing and promoting children's physical activity (PA) but also for reducing PA disparities. We investigated associations between school-level demographic characteristics (racial/ethnic and socioeconomic composition, urban-rural status, and student-to-teacher ratio) and 16 PA-promoting practices in 347 Nevada public elementary, middle, and high schools in 2014. We found that low-cost and easy-to-implement practices are most prevalent. There is relative demographic equity in ten of 16 PA practices and significant differences in six PA practices in Nevada schools. Schools with comparatively larger percentages of Black students are the most disadvantaged, as they have the fewest PA-supportive practices in place. Higher percent black was associated with lower odds of providing classroom activity breaks (AOR=0.632, 95% CI=0.453-0.881) and bike racks (AOR=0.60, 95% CI=0.362-0.996), greater odds of withholding recess/PE for disciplinary reasons (AOR=1.377, 95% CI=1.006-1.885), and lower odds of having recess supervisors who are trained to promote PA (AOR=0.583, 95% CI=0.374-0.909). Schools with greater percentages of Hispanic students have lower odds of providing before-school PA programs (AOR=0.867, 95% CI=0.761-0.987), whereas schools with greater percentages of low-SES students have greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Higher student-to-teacher ratio was also associated with greater odds of providing after-school PA programs (AOR=1.135, 95% CI=1.016-1.268). Urban-rural status was unrelated to all PA practices., Competing Interests: None for all authors, (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: The National Institutes of Health's Clinical and Translational Sciences Award program emphasizes the need to speed up the process of putting evidence-based practices into place. One strategy they promote is community engagement; however, few studies describe a process for meaningfully engaging communities in the translation process., Objective: This article describes steps taken by a university- community partnership to create a plan for implementing evidence-based physical education (PE) practices in rural schools. This partnership's efforts resulted in the acquisition of a $1.86 million grant to implement the plan., Methods: Qualitative data collected during the planning process were analyzed using content analysis., Results: Key steps included undertaking a baseline assessment of community needs, reviewing and selecting evidence-based practices, developing a multilevel, community-driven action plan and establishing its feasibility with community stakeholders., Lessons Learned: These steps could be applied to other health topics across a variety of settings. Several strategies that made the process successful are described. Recommendations are made for expanding the roles of Clinical and Translational Science Awards (CTSAs) and local health foundations in supporting community-engaged translational research., Conclusions: University-community partnerships have the potential to create plans and obtain large-scale funding for translating evidence-based research into practice.

Objective: Foundations and governments fund a number of programs that provide grants to improve school physical education or other forms of school-based physical activity. The effects of these grant programs are unknown. We evaluate the effects of Texas Fitness Now, a program in which the state of Texas granted $37 million to improve physical education in high-poverty middle schools over the 4 school years from 2007-08 to 2010-11. The stated goals of Texas Fitness Now were to reduce obesity, increase fitness, and raise academic achievement., Method: We summarize how Texas Fitness Now funds were spent and estimate the impact of Texas Fitness Now using a fixed-effects longitudinal model that exploits changes in schools' eligibility over time. Changes in eligibility occurred when eligibility expanded to new schools after year 2 and when the program was terminated after year 4., Results: Most Texas Fitness Now funds were spent on sports and fitness equipment. Smaller amounts were spent on anti-obesity curricula. Texas Fitness Now improved strength and flexibility, especially among girls, but it did not improve BMI or academic achievement, and it had mixed effects on aerobic capacity. The fitness benefits were not lost in the year after the program ended, perhaps because schools kept the equipment that they had bought during their years of eligibility., Conclusion: The results of Texas Fitness Now were typical for an intervention that relied almost exclusively on physical activity. Programs that improve BMI as well as fitness tend to have a more fully developed nutrition component., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Introduction: Many American children do not meet recommendations for moderate to vigorous physical activity (MVPA). Although school-based physical education (PE) provides children with opportunities for MVPA, less than half of PE minutes are typically active. The purpose of this study is to estimate the cost effectiveness of a state "active PE" policy implemented nationally requiring that at least 50% of elementary school PE time is spent in MVPA., Methods: A cohort model was used to simulate the impact of an active PE policy on physical activity, BMI, and healthcare costs over 10 years for a simulated cohort of the 2015 U.S. population aged 6-11 years. Data were analyzed in 2014., Results: An elementary school active PE policy would increase MVPA per 30-minute PE class by 1.87 minutes (95% uncertainty interval [UI]=1.23, 2.51) and cost $70.7 million (95% UI=$51.1, $95.9 million) in the first year to implement nationally. Physical activity gains would cost $0.34 per MET-hour/day (95% UI=$0.15, $2.15), and BMI could be reduced after 2 years at a cost of $401 per BMI unit (95% UI=$148, $3,100). From 2015 to 2025, the policy would cost $235 million (95% UI=$170 million, $319 million) and reduce healthcare costs by $60.5 million (95% UI=$7.93 million, $153 million)., Conclusions: Implementing an active PE policy at the elementary school level could have a small impact on physical activity levels in the population and potentially lead to reductions in BMI and obesity-related healthcare expenditures over 10 years., (Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

This commentary is a response to PM-14-1065R1 and addresses issues raised regarding research presented in PM-14-443., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: The present study of doctoral physical education teacher education (D-PETE) programs was part of a longitudinal study that provided an extensive description of demographics including: (a) doctoral program characteristics, (b) faculty, and (c) doctoral students/graduates., Method: This trend study incorporated 3 data sets (2005-2006, 2008-2009, and 2011-2012) that described the characteristics of D-PETE programs. Academic heads of D-PETE programs provided demographic information on their doctoral students, faculty, and institutional characteristics for the 2005-2006, 2008-2009, and 2011-2012 academic years and selected summary data from 1996-1997 through 2011-2012., Results/conclusion: As a result of this longitudinal data collection, the following trends were revealed. First, there was a decrease in the number of D-PETE programs and an increase of nontenured and part-time pedagogy faculty. Second, initial teacher licensure programs remained in existence at the vast majority of D-PETE programs. Third, funding for doctoral students at D-PETE programs was decreasing. Fourth, racial composition of doctoral graduates and current doctoral students remained largely skewed toward Caucasians. Fifth, there was a slight decline in the percentage of doctoral graduates entering higher education, but employment rates were exceptionally high. Sixth, non-U.S. doctoral students and ABDs were marketable in the United States.

Objective: For optimal health, physical activity should be an integral and routine part of daily life. Youth spend a significant amount of time at school yet rarely achieve the recommended 60 min of moderate and vigorous physical activity in physical education (PE) classes or recess. This study assessed the following types of school-based opportunities to improve physical activity for youth: after-school programs, before-school programs, PE classes, extended-day PE, and short physical activity breaks during the school day., Method: An economic analysis conducted in 2013 compared school-based approaches to increasing physical activity. Analysis factors included costs, reach, effects on physical activity gains, cost-effectiveness, and other potentially augmenting benefits., Results: Two programs were significantly superior in terms of reach and cost per student: (1) extending the school day with mandatory PE participation and (2) offering short (10-minute) physical activity breaks during regular classroom hours. After-school program costs per student are high and the programs have a smaller reach, but they offer benefits (such as childcare) that may justify their higher costs. Before-school programs did not appear feasible., Conclusion: Incorporating short physical activity breaks into the existing school day would be a cost-effective way to increase school-based activity. This type of program is inexpensive and has broad reach. Inserting activity breaks throughout the day is appropriate, especially when youth are otherwise largely sedentary., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: To describe variation in U.S. state elementary school physical education (PE) policies and to assess associations between state PE policy enactment and education funding, academic achievement, sociodemographic disadvantage, and political characteristics., Methods: U.S. state laws regarding school PE time, staffing, curriculum, fitness assessment, and moderate-to-vigorous physical activity (MVPA) in 2012 were classified as strong/specific, weak/nonspecific, or none based on codified law ratings within the Classification of Laws Associated with School Students (C.L.A.S.S.). Laws were merged with state-level data from multiple sources. Logistic regression was used to determine associations between state characteristics and PE laws (N=51)., Results: Laws with specific PE and MVPA time requirements and evidence-based curriculum standards were more likely in states with low academic performance and in states with sociodemographically disadvantaged populations. School day length was positively associated with enacting a PE curriculum that referenced evidence-based standards. School funding and political characteristics were not associated with PE laws., Conclusions: Limited time and high-stake testing requirements force schools to prioritize academic programs, posing barriers to state passage of specific PE laws. To facilitate PE policy enactment, it may be necessary to provide evidence on how PE policies can be implemented within existing time and staffing structures., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: To examine school socioeconomic status (SES) in relation to school physical activity-related practices and children's physical activity., Design: A cross-sectional design was used for this study., Setting: The study was set in 97 elementary schools (63% response rate) in two U.S. regions., Subjects: Of the children taking part in this study, 172 were aged 10.2 (standard deviation (SD) = 1.5) years; 51.7% were girls, and 69.2% were White non-Hispanic., Measures: School physical education (PE) teachers or principals responded to 15 yes/no questions on school physical activity-supportive practices. School SES (low, moderate, high) was derived from the percent of students eligible for free and reduced-price lunch. Children's moderate to vigorous physical activity (MVPA) during school was measured with accelerometers., Analysis: School level analyses involved linear and logistic regression; children's MVPA analyses used mixed effects regression., Results: Low-SES schools were less likely to have a PE teacher and had fewer physical activity-supportive PE practices than did high-SES schools (p < .05). Practices related to active travel to school were more favorable at low-SES schools (p < .05). Children attending high-SES schools had 4.4 minutes per day more of MVPA during school than did those at low-SES schools, but this finding was not statistically significant (p = .124)., Conclusion: These findings suggest that more low- and moderate-SES elementary schools need PE teachers in order to reduce disparities in school physical activity opportunities and that PE time needs to be supplemented by classroom teachers or other staff to meet guidelines.

Objective: Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH., Methods: We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers., Results: The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs., Discussion: The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely cost-effective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.

Background: Injuries in children occur most often in physical activity-related activities. A lot of these injuries result in direct and indirect costs. A detailed overview of the economic burden of those injuries in children is lacking., Method: A prospective study was conducted with 996 children in Dutch primary schools to describe the economic burden of injuries that occur during organised sports, leisure time and physical education (PE) class activities. Injuries were continuously monitored by PE teachers during the school year 2006-2007. An injury was recorded if it occurred during PE class, leisure time or organised sports activity and caused the child to at least stop the current activity. If an injury was recorded, parents received a cost diary to report the direct and indirect costs of the child's injury. Costs were collected from a societal perspective., Results: During one school year, a total of 119 injuries were reported by 104 children. The mean total costs as a result of an injury were €188 ± 317. The mean direct costs as a result of an injury were much higher than the mean indirect costs (€131 ± 213 and €57 ± 159, respectively). The highest costs were found for upper extremity and leisure time injuries., Conclusion: Physical activity-related injuries are common in children and result in medical costs. Injuries that lead to the highest costs are those that occur during leisure time activities and upper extremity injuries. Intervention programmes for children to prevent upper extremity injuries and leisure time activity injuries may reduce direct (ie, healthcare) and indirect costs., Trial Registration: ISRCTN78846684.

Background: The Government of Canada implemented a Children's Fitness Tax Credit (CFTC) in 2007 which allows a non-refundable tax credit of up to $500 to register a child in an eligible physical activity (PA) program. The purposes of this study were to assess whether the awareness, uptake, and perceived effectiveness of this tax credit varied by household income among Canadian parents., Methods: An internet-based panel survey was conducted in March 2009 with a representative sample of 2135 Canadians. Of those, parents with children aged 2 to 18 years of age (n = 1004) were asked if their child was involved in organized PA programs (including dance and sports), the associated costs to register their child in these programs, awareness of the CFTC, if they had claimed the CFTC for the tax year 2007, and whether they planned to claim it in the upcoming year. Parents were also asked if they believed the CFTC has lead to their child being more involved in PA programs., Results: Among parents, 54.4% stated their child was in organized PA and 55.5% were aware of the CFTC. Parents in the lowest income quartile were significantly less aware and less likely to claim the CFTC than other income groups. Among parents who had claimed the CFTC, few (15.6%) believed it had increased their child's participation in PA programs., Conclusions: More than half of Canadian parents with children have claimed the CFTC. However, the tax credit appears to benefit the wealthier families in Canada.

Background: Schools must play a central role in combating the prevalence of overweight and obesity among children and youths. This cannot be achieved without more robust policy and funding programs at both federal and state levels., Methods: Reviews of meta-analyses were used to assess the efficacy of improving PA/MVPA through interventions in school physical education programs. Individual research studies were reviewed to assess the efficacy of improving PA/MVPA in preschool settings, recess, and classroom activity breaks. Legislation at the federal and state levels was reviewed along with surveillance and accountability mechanisms at the state level., Results: Physical education interventions produce improvements in PA/MVPA if protocols relating to use of time are followed. PA/MVPA in recess can be increased through careful planning for attractive activity opportunities on carefully designed playgrounds. Classroom activity breaks provide important PA/MVPA daily and improve student on-task behavior., Conclusions: Federal legislation is needed to provide guidelines and financial support for states to improve the quantity and quality of PA in school programs. States need to develop clear expectations for quantity and quality of PA programs in schools, surveillance systems to monitor district compliance in meeting those expectations, and an accountability system aimed at ensuring that state expectations are being met with assistance for districts that do not meet expectations.

Objective: To examine whether preschool children with Attention deficit/hyperactivity disorder (ADHD) utilize more speech and language therapy (ST), occupational therapy (OT), and physical therapy (PT) services and are more likely to be placed in special education (SPED) classrooms as compared to their peers. Corresponding financial consequences were also examined., Methods: The amount of ST, OT, and PT, as well as SPED placements, was examined in 3- and 4-year-old children with and without ADHD (n = 109 and n = 97, respectively) during the baseline portion of an ongoing, 5-year longitudinal study. Costs for individual services and aggregate cost were determined per child and compared across groups., Results: Preschool children with ADHD were more likely to receive individual and multiple services. Higher rates of service utilization translated into increased costs for each individual service with the exception of PT., Conclusions: A comprehensive understanding of service utilization in the early years of development is important in addressing the increased service use in the preschool years and assist in guiding allocation of resources.

Introduction: Physical therapy in warm water has been effective and highly recommended for persons with fibromyalgia, but its efficiency remains largely unknown. Should patients or health care managers invest in this therapy? The aim of the current study was to assess the cost-utility of adding an aquatic exercise programme to the usual care of women with fibromyalgia., Methods: Costs to the health care system and to society were considered in this study that included 33 participants, randomly assigned to the experimental group (n = 17) or a control group (n = 16). The intervention in the experimental group consisted of a 1-h, supervised, water-based exercise sessions, three times per week for 8 months. The main outcome measures were the health care costs and the number of quality-adjusted life-years (QALYs) using the time trade-off elicitation technique from the EuroQol EQ-5D instrument. Sensitivity analyses were performed for variations in staff salary, number of women attending sessions and time spent going to the pool. The cost effectiveness acceptability curves were created using a non-parametric bootstrap technique., Results: The mean incremental treatment costs exceeded those for usual care per patient by euro 517 for health care costs and euro 1,032 for societal costs. The mean incremental QALY associated with the intervention was 0.131 (95% CI: 0.011 to 0.290). Each QALY gained in association with the exercise programme cost an additional euro 3,947/QALY (95% CI: 1,782 to 47,000) for a health care perspective and euro 7,878/QALY (3,559 to 93,818) from a societal perspective. The curves showed a 95% probability that the addition of the water-based programme is a cost-effective strategy if the ceiling of inversion is euro 14,200/QALY from a health care perspective and euro 28,300/QALY from a societal perspective., Conclusion: The addition of an aquatic exercise programme to the usual care regime for fibromyalgia in women is cost effective in terms of both health care costs and societal costs. However, the characteristics of facilities (distance from the patients' homes and number of patients that can be accommodated per session) are major determinants to consider before investing in such a programme., Trial Registration: Current controlled trials ISRCTN53367487.

The authors sought to determine whether a greater academic incentive would improve the effectiveness and student adherence to a 12-week voluntary exercise program designed to decrease students' percentage of body fat. They randomly assigned 210 students to 1 of 2 groups with different academic reward structures. The group with the greater reward structure showed better exercise adherence and lost more body fat than those without the additional incentive. These findings suggest that an academic incentive can increase overall student adherence to a voluntary exercise program and can boost the effectiveness of the program in a university environment. The findings also have potential implications for on-campus promotion of physical activity.

Objective: To compare oxandrolone (OX) or strength training with nutrition alone (NA) for AIDS wasting., Subjects: Fifty patients with AIDS; 47 completing the study., Interventions: Randomization to (1) NA with placebo pills, (2) nutrition with 10 mg of OX administered orally twice a day, or (3) nutrition with progressive resistance training (PRT) for 12 weeks., Main Outcome Measures: Midthigh cross-sectional muscle area (CSMA), physical functioning (PF), costs, and cost-effectiveness in dollars/quality-adjusted life-years (dollars/QALYs)., Results: The OX and PRT subjects had increases in CSMA (7.0% +/- 2.5%, P = 0.01; 5.0% +/- 2.0%, P = 0.04, respectively), although these increases did not differ significantly from the NA arm (NA: 1.0% +/- 1.0%; OX vs. NA: P = 0.09; PRT vs. NA: P = 0.26). Only PRT caused significant improvements in PF (mean +/- SE: 10.4 +/- 3.8 points on a 100-point scale) and 7 measures of strength (P values: 0.04 to <0.001). There were no overall differences between groups in PF change. Among patients with impaired baseline PF, however, OX was significantly less effective than NA and PRT was significantly better than NA. All treatments led to increases in protein intake and performance; NA and PRT also increased caloric intake. The institutional costs per subject in this trial were 983 dollars for NA, 3772 dollars for OX, and 3189 dollars for PRT. At a community-based level of intensity, the institutional costs per QALY were 45,000 dollars (range: 42,000 dollars-64,000 dollars) for NA, 147,000 dollars (range: 147,000 dollars-163,000 dollars) for OX, and 31,000 dollars (range: 21,000 dollars-44,000 dollars) for PRT., Conclusions: OX and PRT induce similar improvements in body composition, but PRT improves quality of life more than nutrition or OX, particularly among patients with impaired PF. PRT was the most cost-effective intervention, and OX was the least cost-effective intervention.

Objectives: To evaluate the cost effectiveness of a proprioceptive balance board training programme for the prevention of ankle sprains in volleyball., Methods: A total of 116 volleyball teams participated in this study which was carried out during the 2001-2002 volleyball season. Teams were randomly allotted to an intervention group (66 teams, 628 players) or a control group (52 teams, 494 players). Intervention teams followed a prescribed balance board training programme as part of their warm up. Control teams followed their normal training routine. An ankle sprain was recorded if it occurred as a result of volleyball and caused the subject to stop volleyball activity. The injured player completed a cost diary for the duration of the ankle sprain. Analyses were performed according to the intention to treat principle. Mean direct, indirect, and total costs were calculated and were compared between the two groups., Results: The total costs per player (including the intervention material) were significantly higher in the intervention group (36.99 (93.87)) than in the control group (18.94 (147.09)). The cost of preventing one ankle sprain was approximately 444.03. Sensitivity analysis showed that a proprioceptive balance board training programme aimed only at players with previous ankle sprains could be cost effective over a longer period of time., Conclusions: Positive effects of the balance board programme could only be achieved at certain costs. However, if broadly implemented, costs associated with the balance board programme would probably be lower.

By the end of the nineteenth century, modern sport had enchanted the people of Argentina. At that time the nation enjoyed a remarkable degree of economic prosperity and embarked on increasing political democratization. These circumstances, along with the fact that the nation was represented from the beginning, in 1894, on the International Olympic Committee seemed to favour Argentina as the spearhead of the diffusion of Olympism throughout South America. However, the country only enjoyed its first official Olympic participation in the Paris Games of 1924 - a few months after the establishment of the Argentine Olympic Committee. This essay explores the reception and diffusion of Olympism in Argentina. It reveals a process of gradual adoption including conflicting views on the relationship between the state and sport, several attempts at institutionalization, international misunderstandings and the role of politics and class.

H.G. Wells called her 'that unforgettable heroine'. But she was forgotten, most particularly in New Zealand, where she was banned from mention in the newspapers under the War Regulations for her 'safe sex' work during the First World War - a very hypocritical move as it happened just as her work was officially taken on by the army. For this work she was dubbed the 'guardian angel of the ANZACs' by a French venereal disease specialist and awarded the Reconnaissance Franaise by the French. After the war she settled in London, marrying her long-time friend and wartime colleague, physical culturist Fred Hornibrook. Rout went on with her venereal disease prophylaxis campaign after the war. She also entered the birth control movement in the 1920s, playing a major role in the last big birth control court case, a role often attributed to Dora Russell, while Rout again is 'forgotten'. In her books, like the best selling Safe Marriage, a safe sex guide (which was banned in New Zealand), she encouraged women to own their own bodies and take responsibility for their own sexual health. She linked exercise and sex, arguing in books like Sex and Exercise, that exercise would enhance women's sex lives. She and Hornibrook, who wrote a best-selling book entitled The Culture of the Abdomen, presaging the current obsession with rocklike 'abs', made a pair, teaching fitness techniques, holding 'native dance' evenings, and being hailed as modern dance proponents. Rout also wrote books on vegetarianism, wholemeal cookery and Maori culture. The word most commonly used by people describing her throughout her life was 'energy'. She herself was very fit. But she did not fit in. Once her marriage to Hornibrook was over, in 1936, she returned to New Zealand, was rebuffed by former friends. She sailed for Rarotonga and died there, of a self-administered overdose of quinine that September. As she had remarked to H.G. Wells, 'It is a mixed blessing to be born too soon'. She anticipated many of the enthusiasms of our own time - in diet, in dance, in ideas about exercise and sexuality. But because she was so far ahead of her own time in her 'safe sex' campaign, she became persona non grata in her own country. With the advent of AIDS her contribution snaps into focus - and the AIDS clinic in the city of Christchurch where she used to live has been named after her.

It is argued here that Margaret Stansfeld, as Principal of Bedford Physical Training College from 1903 to 1945, succeeded in developing a strong and distinctive 'female tradition' which was widely disseminated by her students. She was realistic in recognizing the strength of opposition from a male-dominated society to women's participation in sport and physical exercise, and steadily overcame it. She achieved this partly by insisting on acceptably 'ladylike' behaviour from her students in conventional social situations, and also by bringing the work of the college into the public arena, through displays of gymnastics, through the use of elementary schools for part of the student teaching experience, through the running of a physiotherapy clinic where treatment was given free of charge, and through the use of students in the outpatients ward of the local hospital. Stansfeld herself was PE organizer for Bedford from 1923. But she was not afraid to fight against prejudice which was demonstrably based on false premises, e.g. medical opposition to women taking part in strenuous physical exercise, or to insist on appropriate clothing for women, however indecorous some might have considered it. The college's long-term success resulted from a series of factors: its curriculum and ethos, the networking process it fostered, the quality of the teachers it produced, the strength of the Old Students' Association, Stansfeld's willingness to embrace new ideas, and the growing academic respectability of the subject. The pivot of the whole process was Stansfeld herself - autocratic, austere, but an inspirational teacher - feared and loved. Students who succeeded were empowered - 'She prepared us for LIFE!' The success of her Old Students was the most important feature, e.g. Phyllis Colson, originator and director of the Central Council of Physical Recreation. Hundreds of others, less well known, in schools all over Britain and abroad, gave their pupils pride in themselves, not only through the experience of games, gymnastics and dance, but through moral example - 'fair play' - and many brought the newest innovations into schools (e.g. Elizabeth Swallow was the first to introduce Laban into a maintained school in 1939). Stansfeld's indomitable spirit was always in evidence, even at the end of her life - she returned to the office of Principal in 1948 at age 88, three years before her own death, after the unexpected death of her successor. It was this strength of will and character above all else which empowered her students as women and as teachers, and which enabled them in their turn to empower their own pupils, and so to replace the myth that physical activities were damaging to women with the growing realization that sport and physical recreation are as beneficial to women as they are to men. Stansfeld was justifiably recognized in her time as a pioneer in the advancement of women's PE, e.g. by the McNair Report (1942), which argued that nothing comparable had been achieved for men. She was the last survivor of the originators of women's PE, and the most influential. It is ironic that the rise of feminism in the second half of the century coincided with the dissipation of the female tradition, epitomised by Stansfeld, as physical education for women, developed by women, in the first half of the century increasingly came to be controlled by men in the second half. It is perhaps the ultimate demonstration of the success of Stansfeld's work that, despite this, at the beginning of the twenty-first century women are free to participate in and enjoy sport and physical leisure in a way that would have seemed impossible at the beginning of the twentieth.

This epilogue offers a critical overview of some current interpretations of modern sport's origins and evolution in Latin America by certain European and North American commentators. These analyses still adhere to the tradition of the New World's creation. They seldom refer to primary sources. Conclusions are often born out of patronizing compassion and exotic impression. Latin American sources, if any, are mostly quoted when they serve a pessimistic historical bias cultivated by outsiders. In fact, Latin American sport represents a mirror image of more developed areas and indeed a reinvention of sport in specific cases of community isolation and self-development.

The article deals with the founding circumstances of German sport associations. It argues from a sociological point of view bringing together the structural changes of modern society and the development of youth as a societal group of its own. The author holds that the beginning of the German sport movement was closely connected to the phenomenon of group building processes furthered by the Central Board for Furthering Folk and Youth Games, a social initiative whose activities have been underestimated by sporthistorians as well as sportsociologists. In the organisation's publication organ The Yearbook for Folk and Youth Games many of the elements were first outlined which characterize German sport associations until today.

This chapter examines sport in Latin America in its social, cultural, and political contexts. An analysis of the development of sport in Latin America suggests that there have been a number of distinct phases influenced by the cultures of the Spanish, British and French. More recently, the games and pastimes of the United States have made a significant impact. It is suggested that the further development of sport in Latin America is hindered by a number of significant problems. It concludes that the problems faced by some countries are immense and that governments and international organizations in the developed world should offer help where appropriate.

American impact on modern sports in Latin America overlaps geographically and chronologically with the European, especially British, impact. Principally baseball in the Caribbean basin, more recently basketball and volleyball across the hemisphere and occasionally American football in more limited areas illustrate a north-to-south movement executed by businessmen, educators, missionaries, military personnel, returning travelers (often students), sports entrepreneurs and television. Often initially supported by promoters of development within Latin America, this transfer has altered local recreational patterns and attracted Latin athletes to pursue careers in North America, provoking accusations of cultural imperialism and exploitation.

The most common methods for the economic evaluation of a fitness program at a worksite are cost-effectiveness, cost-benefit, and cost-utility analyses. In this study, we applied a basic microeconomic theory, "neoclassical firm's problems," as the new approach for it. The optimal number of physical-exercise classes that constitute the core of the fitness program are determined using the cubic health production function. The optimal number is defined as the number that maximizes the profit of the program. The optimal number corresponding to any willingness-to-pay amount of the participants for the effectiveness of the program is presented using a graph. For example, if the willingness-to-pay is $800, the optimal number of classes is 23. Our method can be applied to the evaluation of any health care program if the health production function can be estimated.