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Background The prevalence of childhood obesity has substantially increased in the Gulf Cooperation Council countries, including Saudi Arabia. The Rashaka initiative is a Saudi national school-based multicomponent intervention that was introduced in the school year 2016–2017 to address childhood overweight and obesity. This study aims to examine the effect of the Rashaka initiative on students' body mass index (BMI) for two academic years (2016–2017 and 2018–2019) and to analyse predictors of BMI change. Methods Secondary data for this pre–post study was provided by the Ministry of Health for 38 026 students from 89 intermediate and secondary schools that implemented the initiative in Makkah City, Saudi Arabia. It was analysed using non-parametric tests and multiple regressions at a 5% level of significance. Results Over 2 y of implementation, BMI was reduced significantly across the schools (p < 0.001). Based on the regression modelling, school gender and education stage were found to be the only significant predictors of BMI change. Girls and intermediate schools had greater BMI reductions than boys and secondary schools (p < 0.001 and p = 0.031). Conclusions This study provides tentative evidence for the effectiveness of the Rashaka intervention in Makkah City. In addition, our study has identified that the Rashaka initiative may require modification to improve its effect on boys and students in secondary schools. [ABSTRACT FROM AUTHOR]

Background: The benefits of exercise and weight reduction for overweight or obese people with coronary heart disease and/or diabetes mellitus are well recognised. The Healthy Eating and Exercise Lifestyle Program demonstrated these outcomes at 4 months, but longer-term outcomes are not yet reported. Aim: To determine whether positive weight, body mass index, waist and exercise duration outcomes were sustained in the long term (12 months) and to identify the independent predictors of these outcomes at 4 and 12 months. Methods: Longitudinal design, combining data of all Healthy Eating and Exercise Lifestyle Program participants (intervention and wait-list control, n = 134). Participants had a body mass index between 27 and 39 kg/m2 and had completed cardiac rehabilitation and/or diabetes education programmes. Healthy Eating and Exercise Lifestyle Program intervention included an active phase of two 1-hour group-based supervised structured exercise sessions every week for 4 months and four 90-minute group information and support sessions. The maintenance phase included one 90-minute group-based booster information session and three 15-minute goal-focused telephone follow-up calls over 8 months. Results: Participants had statistically significant reductions from baseline in weight, body mass index and waist circumference and improvements in exercise duration and capacity at 4 and 12 months. Time, self-efficacy, depressive symptoms and male gender were independent predictors for body mass index, waist and/or exercise duration (p < 0.05). Conclusion: The Healthy Eating and Exercise Lifestyle Program was an effective programme to achieve and sustain weight loss and increase exercise participation over 1 year. [ABSTRACT FROM AUTHOR]

Background: Psychosocial factors are considered as risk factors for some chronic diseases. A paucity of research exists surrounding the role of perceived stress in arthritis onset. Purpose: Perceived stress as a risk factor for arthritis development was explored in an ageing cohort of Australian women. Methods: This study focused on 12,202 women from the 1946-1951 cohort who completed the Australian Longitudinal Study on Women's Health surveys in 2001, 2004 and 2007. Longitudinal associations were modelled, with and without a time lag. Results: Findings from the multivariate time lag modelling, excluding women with persistent joint pain, revealed that perceived stress predicted the onset of arthritis, with women experiencing minimal and moderate/high stress levels having a 1.7 and 2.4 times greater odds of developing arthritis 3 years later, respectively ( p's < 0.001). Conclusion: Chronically perceiving life as stressful is detrimental to future health. The findings provide support for perceived stress to be considered alongside other modifiable risk factors. [ABSTRACT FROM AUTHOR]

Background: urinary incontinence carries major social burden and considerable costs for health care systems. Objective: the aim of this study was to investigate changes in continence status among a large cohort of older women, and to identify factors associated with incidence of incontinence in later life. Subjects: participants of the Australian Longitudinal Study of Women's Health (ALSWH), aged 70-75 years in 1996 and who have completed four health surveys over the past 10 years. Methods: continence status across four survey periods, spanning 9 years, were defined according to women's reports of `leaking urine' at each survey. Generalised estimating equation (GEE) models were used in longitudinal analyses of the factors associated with changing continence status over time. Results: this study presents longitudinal data on the prevalence and incidence of incontinence from a large cohort of older women, over 9 years of follow-up. Over this time, 14.6% (95% CI 13.9-15.3) of the women in the study who had previously reported leaking urine 'rarely' or 'never' developed incontinence, and 27,2% (95% CI 26.2%, 28.3%) of women participating in Survey 4 (S4) in 2005 reported leaking urine 'sometimes' or 'often' at that survey, with women being twice as likely to report incontinence at S4 as they were 6 years earlier. Longitudinal models demonstrated the association between incontinence and dementia (P < 0.001; OR = 2.34; 95% CI 1.64, 3.34), dissatisfaction with physical ability (P < 0.001; OR = 1.70; 95% CI 1.52, 1.89), falls to the ground (P<0.001; OR = 1.23; 95%CI 1.13, 1.33), BMI (P <0.001; OR = 2.18; 95% CI 1.70,2.80 for obese), constipation (P< 0.001; OR 1.46; 95% CI 1.34-1.58), urinary tract infection (P< 0.001; OR 2.07; 95% CI 1.89-2.28), history of prolapse (P⩽ 0.001; OR = 1.53; 95% CI 1.35, 1.74) and prolapse repair (P= 0.002; OR = 1.23; 95% CI 1.08, 1.40). Stroke (P= 0.01), parity (P= 0.017) and hysterectomy (P= 0.026) and number of visits to the general practitioner (P= 0.040) were less strongly associated with incontinence in the final longitudinal model. Incontinence was not significantly associated with area of residence (P = 0.344), education (P = 0.768), smoking (P = 0.055), diabetes (P = 0.072), attending support groups (P = 0.464) or attending social groups (P = 0.022). Conclusion: strong associations between BMI, dysuria and constipation indicate key opportunities to prevent incontinence among older women. [ABSTRACT FROM AUTHOR]

Objective: to identify minimum criteria to assist the prediction of decline in physical health-related quality of life in elderly. Study Design and Setting: participants were women from the Australian Longitudinal Study on Women's Health, who responded to three separate Surveys conducted in 1996 (when they were aged 70-75 years), 1999 and 2002. Using data from these Surveys, three categories were generated which described current physical health-related quality of rife and future physical decline as measured by the physical component summary score (PCS) of the MOS SF-36 quality of rife survey. Results: bivariate analyses reported a large number of variables significantly associated with physical decline (P<0.001), including age, falls, number of diagnoses, symptoms, doctor visits and medications, days spent in hospital, body mass index, living arrangements and social support. Multivariate analyses, using decision tree analysis, identified three items which accurately predicted 76% of the women who would exhibit physical decline according to our definition. Conclusions: this study identified a number of variables that may be useful in clinical screening for vulnerabirity to physical decline. [ABSTRACT FROM AUTHOR]