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The best-known atypical chronophilia is pedophilia, referring to sexual attraction to prepubescent children (no physical changes due to puberty). Pedophilia has received the most attention because it helps explain many cases of child pornography use and child sexual abuse.
Hebephilia (some physical puberty changes, but still obviously immature) is becoming better known to researchers and the public. Though ultimately rejected, the American Psychiatric Association considered including hebephilia in the latest version of its diagnostic manual (DSM-5), where it would have joined pedophilia as a recognized mental disorder.
I think chronophilias are the result of errors in age detection, where heterosexual male preferences for youth cues like big eyes and smooth skin are not offset by sexual maturity cues like full breasts and curvy hips. For pedophilia, hebephilia and ephebophilia, the youthfulness cues dominate; for mesophilia and gerontophilia, the preference for youth cues is actually reversed.
Worldwide, public health physical activity guidelines include special emphasis on populations of children (typically 6-11 years) and adolescents (typically 12-19 years). Existing guidelines are commonly expressed in terms of frequency, time, and intensity of behaviour. However, the simple step output from both accelerometers and pedometers is gaining increased credibility in research and practice as a reasonable approximation of daily ambulatory physical activity volume. Therefore, the purpose of this article is to review existing child and adolescent objectively monitored step-defined physical activity literature to provide researchers, practitioners, and lay people who use accelerometers and pedometers with evidence-based translations of these public health guidelines in terms of steps/day. In terms of normative data (i.e., expected values), the updated international literature indicates that we can expect 1) among children, boys to average 12,000 to 16,000 steps/day and girls to average 10,000 to 13,000 steps/day; and, 2) adolescents to steadily decrease steps/day until approximately 8,000-9,000 steps/day are observed in 18-year olds. Controlled studies of cadence show that continuous MVPA walking produces 3,300-3,500 steps in 30 minutes or 6,600-7,000 steps in 60 minutes in 10-15 year olds. Limited evidence suggests that a total daily physical activity volume of 10,000-14,000 steps/day is associated with 60-100 minutes of MVPA in preschool children (approximately 4-6 years of age). Across studies, 60 minutes of MVPA in primary/elementary school children appears to be achieved, on average, within a total volume of 13,000 to 15,000 steps/day in boys and 11,000 to 12,000 steps/day in girls. For adolescents (both boys and girls), 10,000 to 11,700 may be associated with 60 minutes of MVPA. Translations of time- and intensity-based guidelines may be higher than existing normative data (e.g., in adolescents) and therefore will be more difficult to achieve (but not impossible nor contraindicated). Recommendations are preliminary and further research is needed to confirm and extend values for measured cadences, associated speeds, and MET values in young people; continue to accumulate normative data (expected values) for both steps/day and MVPA across ages and populations; and, conduct longitudinal and intervention studies in children and adolescents required to inform the shape of step-defined physical activity dose-response curves associated with various health parameters.
This literature review was commissioned by the Public Health Agency of Canada (PHAC) and includes: 1) normative data (i.e., expected values); 2) incremental changes expected from interventions; 3) controlled studies translating cadence (i.e., steps/minute) to activity intensity; 4) studies of steps/day associated with time in moderate-to-vigorous physical activity (MVPA) under free-living conditions; and, 5) health outcome-related analyses (e.g., steps/day associated with valued health outcomes). In February 2010 a professional librarian executed the search strategy of CINAHL, ERIC, MEDLINE, PsycINFO, SocINDEX, and SPORTDiscus using the keywords (pedomet* or acceleromet*) and step* and ((physical activity) or walk*), limited to English language, and published since 2000 (an earlier review covered studies published before 2000 [7]). Articles were assembled, additional research was identified by reviewing article reference sections, and relevant content was abstracted and summarized by the first author. Where recent review articles were identified (e.g., normative data, interventions), the summarized results were presented to avoid redundancy and notable original articles selected to make specific points. Subsequently, researchers with practical experience collecting step data world-wide were invited to critically review the report, identify any additional relevant literature (including known articles in press), and intellectually contribute to this consensus document focused on children and adolescents. Study details were tabulated as appropriate. Any seeming inconsistencies in details catalogued within tables (e.g., instrument brand, model, numbers of decimal points, etc.) reflect underlying reporting inconsistencies as taken directly from original articles. The adult [8] and older adult/special populations [9] literature is reviewed separately.
Graser et al. [33] asked 34 girls and 43 boys aged 10-12 years to wear a pedometer and walk on a treadmill at 3, 3.5, and 4 miles/hour. Intensity was not directly measured; however, the authors considered these speeds to represent a range of MVPA walking intensities. The boys' and girls' cadence values were similar across the walking speeds and the researchers concluded that, in general, 120-140 steps/minute represented a reasonable cadence range associated with MVPA. Intensity-related translations based on taking 120 steps/minute at 3 miles/hour correspond to 3,600 steps in 30 minutes, or 7,200 steps in 60 minutes. Graser et al. [33] studied a somewhat younger age group than the Jago et al. [35] study and this might have produced relatively higher cadence ranges. Taken together, the two studies indicate that continuous MVPA walking (assuming at least 3 METs) produces 3,300-3,600 steps in 30 minutes or 6,600-7,200 steps in 60 minutes in 10 - 15 year olds. It is important to emphasize that such a translation should only be applied to continuous ambulation performed over the specified amounts of time. It is most important to emphasize that definitions of MVPA differed between these two studies and neither used a direct measure of intensity.
More recently, Graser et al. [32] conducted another study of pedometer-determined cadence and heart-rate determined intensity in 12-14 year old adolescents. Treadmill speeds were set at 4.0, 4.8, 5.64, and 6.42 km/hr after confirming that this age group could perform all speeds without breaking into a run. These researchers defined moderate intensity as 40-59% of maximum heart rate, which may be considered low compared with physical activity recommendations (i.e., 55-90% of maximum heart rate) [46]. The corresponding cadence averaged 122 (range 108-134) steps/minute in boys and 102 (range 80-123) steps/minute in girls, suggesting great individual variation in intensity-associated cadence, a phenomenon that may reflect underlying variation in development as well as fitness. Limitations include the use of heart rate to define moderate intensity and the use of a target heart rate formula originally produced for adults. Heart rate reflects relative intensity, unlike direct measures of intensity such as MET values. As in each of the controlled studies in children and adolescents described above, steps were detected by a body-worn instrument instead of by direct observation, which is arguably the more appropriate criterion for these types of lab-based studies.
Cardon et al. [49] reported that 13,874 pedometer-determined steps/day equated to a total volume of physical activity that included at least 60 minutes of accelerometer-determined time in MVPA in Belgian preschool children; only 8% of their sample actually achieved this level of steps/day. Tanaka and Tanaka [50] used a similar analytical approach, but collected accelerometer data using a triaxial accelerometer to conclude that 60, 100, and 120 minutes of MVPA corresponded to 9,934, 12,893, and 14,373 steps/day, respectively, in Japanese preschool children. Furthermore, 92.4%, 51.6%, and 27.4% of the sample achieved these levels. Although a direct comparison between the Belgian and Japanese studies must be tempered by the fact that different instruments were used to collect step and MVPA data, the latter sample appears to have been much more active than the former; approximately 52% of the Japanese children achieved almost 13,000 steps/day and 100 minutes in MVPA while only 8% of the Belgian sample achieved a similar value of steps/day and only 60 minutes in MVPA.
In a separate study, Cardon et al. [15] examined the relationship between 60 minutes of self-reported time in MVPA and pedometer-determined steps/day in Belgian elementary school children. Overall, 13,130 steps/day was equivalent to a total volume of daily physical activity that included 60 minutes of self-reported time in MVPA. Sex-specific values were 15,340 steps/day (boys) and 11,317 steps/day (girls). These results must be interpreted with caution; the correlation between pedometer-determined steps/day and self-reported time in MVPA was r=.39. In a another study comparing pedometer data with self-reported time in MVPA conducted with 9-16 year olds, the correlations ranged from .44 to .50 [53]. Linear regression was used to determine that approximately 100 steps equated to about 1 minute of MVPA. By extrapolation, the authors suggested that at least 6,000 steps would be required to accumulate 60 min of MVPA (assumedly taken over and above lifestyle activities).
Rowlands and Eston [16] conducted a sensitivity/specificity analysis of various thresholds to ascertain likelihood of attaining 60 minutes of triaxial accelerometer-determined MVPA in Welsh primary school children. They concluded that 13,000 steps/day (boys) and 12,000 steps/day (girls) provided the most reasonable estimation of attainment of 60 minutes of MVPA by way of accumulating a total volume of daily steps. Beighle and Pangrazi [51] used a pedometer that had both a step counting function and an internal stopwatch that accumulates seconds of movement while the step counting lever arm is in motion. The resulting output is labeled \"activity time\" but also logically includes movement that is likely performed at less than MVPA. Although the outputs were dependent (obtained from the same counting mechanism), the researchers used regression to predict daily activity time from steps/day. They reported that 5,000 steps/day was equivalent to 64.5 minutes of activity, 10,000 steps/day equals 114.5 minutes, 12,000 steps/day equals 134.5 minutes, and 15,000 steps/day equals 164.5 minutes. This study must be interpreted with due caution (and cannot be reasonably considered together with the other two studies of primary/elementary school children) since the activity time output from this instrument does not necessarily reflect time spent specifically in MVPA, but rather accumulated time associated with all detected movement. 153554b96e
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