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The study of the physical activity engagement (PA) has given rise to a relevant research agenda in a wide range of fields, such as its close relationship with subjective well-being, self-perceived health and social capital. Previous evidence has identified interrelationships among these variables, but without considering different levels of physical activity. We have thus considered three levels of activity: light (walking), moderate and vigorous. Structural Equation Modelling (SEM) is undertaken on data from Spain's National Health Survey in 2011–2012 to analyse these interrelationships. The SEM shows a simultaneous and bidirectional relationship between different levels of PA (moderate and vigorous activities) and happiness, with a more robust association stemming from happiness to PA than vice versa. This relationship is mediated through health. From a policy perspective, this implies a virtuous circle: involvement in different levels of PA increases happiness and self-perceived health, while happiness involves higher PA and subsequent positive increases in health and happiness. Nevertheless, this virtuous circle does not always run successfully when social capital is considered to mediate the relationship between PA and happiness, which might explain why it has proven to be very difficult for health policymakers to fight against inactivity and a sedentary lifestyle within a great part of the population. Highlights We investigate bidirectional interrelationships between different levels of physical activity (PA) and happiness. We consider the mediation role played by self-perceived health (SPH) and social capital. Our results highlight a network of association between different levels of PA, SPH, social capital and happiness. SPH positively mediates this relationship for any type of PA level, whereas social capital only mediates positively when vigorous PA is developed. From a health policy perspective, the simultaneity between PA levels and happiness implies a virtuous circle. [ABSTRACT FROM AUTHOR]

Involvement in sports is considered a powerful way to generate social capital. However, the role of sport engagement in the development of social relationships of older adults has not received much attention. Remarkably, there is a lack of empirical evidence on the quality and diversity of social relations built through active sport participation and spectatorship. This paper attempts to assess the relationship between sport engagement and various measures of network social capital, including the extension and quality of social networks and the heterogeneity of personal relationships. Also, it proposes new and more informative measurements of an individual's quantity and quality of social ties. By analysing data from a survey in Spain (N = 600) and applying logistic regressions, the results show that sport participation and attendance at sporting events are closely related to different dimensions of network social capital. Concerning people who are not actively engaged in sports, more extensive social networks characterise those who frequently attend sporting events. In contrast, active sport participation is associated with the extensity and quality measures of social connectedness, the level of satisfaction with friends and the opportunity to enjoy close relationships. Therefore, this paper provides new evidence on how sport engagement may result in tighter and extensive networks for older adults and serve as support for emphasising sports, physical activity and leisure as strategies for maintaining and boosting older people's social and psychological health. [ABSTRACT FROM AUTHOR]

Purpose:People with fibromyalgia experience a disagreement between patient-reported (i.e., subjective) and performance-based (i.e., objective) status. This study aimed to (i) corroborate the discordance between subjectively and objectively measured physical function and (ii) examine whether catastrophizing (worrying, pain magnifying, and helpless cognitions) and self-efficacy (believing capable to manage pain) are independently associated with this discordance. Methods:This population-based cross-sectional study included 405 women with fibromyalgia and 193 age-matched female controls. Participants completed the Pain Catastrophizing Scale, Chronic Pain Self-efficacy Scale, and physical functioning subscales of the Revised Fibromyalgia Impact Questionnaire and Short Form-36 (SF-36) health survey. Objective physical function was measured with the Senior Fitness Test battery. Subjective and objective physical functions were expressed as deviation from the general population in standard deviation (SD) units using means andSDof the control group. Results:In fibromyalgia, subjective physical function was worse than objective physical function (p < 0.001). Higher catastrophizing was consistently associated with greater discordance between subjective and objective physical function, while self-efficacy was only significantly associated with this discordance when subjective physical function was assessed by means of the SF-36. Conclusions:Subjective physical function is more impaired than objective physical function in fibromyalgia, yet both are markedly impaired. Catastrophizing cognitions are associated with this discordance. In particular, high catastrophizing may promote a feeling of reduced ability to do meaningful activities of daily living (i.e., restrictions) that people with fibromyalgia are actually able to. Therefore, catastrophizing should be assessed and potentially targeted when focusing on improving physical function in fibromyalgia.Implications for rehabilitationRehabilitation should focus on physical exercise programs to help women with fibromyalgia to improve their reduced physical function.In rehabilitation settings, physical function of people with fibromyalgia should be evaluated by both subjective and objective assessments to fully understand physical functioning and to test the existence of discordance between both assessments.In case of a large discordance between subjective and objective physical function, a physical exercise program might be better complemented with cognitive management techniques to reduce catastrophizing and subjective physical dysfunction.When people with fibromyalgia experience high levels of catastrophizing, subjective assessments seem to be poor indicators of physical function. [ABSTRACT FROM PUBLISHER]

Objective. The aim of this study was to examine the association between physical fitness and depressive symptoms in women with fibromyalgia (FM). We also assessed whether different fitness components present independent relationships with depressive symptoms. Design. Cross-sectional study. Setting. University facilities and FM associations. Subjects. Four hundred and forty-four patients with FM according to the 1990 American College of Rheumatology criteria. Methods. Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Physical fitness (aerobic fitness, muscle strength, flexibility, and motor agility) was assessed using the standardized Senior Fitness Test battery and the handgrip strength test. A standardized composite score for fitness was computed and divided intoquintiles. Results. Overall, the fitness tests presented inverse associations with the total BDI-II score (P<0.05). The patients in the highest fitness quintile had 8.4% lower depressive symptoms than the patients in the lowest fitness quintile (P = 0.014). The odds of severe symptoms of depression were between 3.7% and 16.9% lower for each performance unit in the back-scratch, handgrip, arm-curl, and eight-feet up-and-go tests. When all the fitness tests were simultaneously considered, the back-scratch test was the only one independently associated with the total BDI-II score (P = 0.001; R² = 0.023). Conclusions. Although higher physical fitness was generally associated with lower symptoms of depression in women with FM, the observed associations were somewhat weak and inconsistent, differing from those previously observed in healthy adults. Further research to determine the clinical relevance of the association between physical fitness and depression in FM is warranted. [ABSTRACT FROM AUTHOR]

This paper addresses R&D portfolio selection in social institutions, state-owned enterprises, and other nonprofit organizations which periodically launch a call for proposals and distribute funds among accepted projects. A nonlinear discontinuous bicriterion optimization model is developed in order to find a compromise between a portfolio quality measure and the number of projects selected for funding. This model is then transformed into a linear mixed-integer formulation to present the Pareto front. Numerical experiments with up to 25 000 projects competing for funding demonstrate a high computational efficiency of the proposed approach. The acceptance/rejection rules are obtained for a portfolio using the rough set methodology. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests that participation in physical activity may support young people's current and future mental health. Although previous reviews have examined the relationship between physical activity and a range of mental health outcomes in children and adolescents, due to the large increase in published studies there is a need for an update and quantitative synthesis of effects. Objectives: The objectives of this study were to determine the effect of physical activity interventions on mental health outcomes by conducting a systematic review and meta-analysis, and to systematically synthesize the observational evidence (both longitudinal and cross-sectional studies) regarding the associations between physical activity and sedentary behavior and mental health in preschoolers (2–5 years of age), children (6–11 years of age) and adolescents (12–18 years of age). Methods: A systematic search of the PubMed and Web of Science electronic databases was performed from January 2013 to April 2018, by two independent researchers. Meta-analyses were performed to examine the effect of physical activity on mental health outcomes in randomized controlled trials (RCTs) and non-RCTs (i.e. quasi-experimental studies). A narrative synthesis of observational studies was conducted. Studies were included if they included physical activity or sedentary behavior data and at least one psychological ill-being (i.e. depression, anxiety, stress or negative affect) or psychological well-being (i.e. self-esteem, self-concept, self-efficacy, self-image, positive affect, optimism, happiness and satisfaction with life) outcome in preschoolers, children or adolescents. Results: A total of 114 original articles met all the eligibility criteria and were included in the review (4 RCTs, 14 non-RCTs, 28 prospective longitudinal studies and 68 cross-sectional studies). Of the 18 intervention studies, 12 (3 RCTs and 9 non-RCTs) were included in the meta-analysis. There was a small but significant overall effect of physical activity on mental health in children and adolescents aged 6–18 years (effect size 0.173, 95% confidence interval 0.106–0.239, p < 0.001, percentage of total variability attributed to between-study heterogeneity [I2] = 11.3%). When the analyses were performed separately for children and adolescents, the results were significant for adolescents but not for children. Longitudinal and cross-sectional studies demonstrated significant associations between physical activity and lower levels of psychological ill-being (i.e. depression, stress, negative affect, and total psychological distress) and greater psychological well-being (i.e. self-image, satisfaction with life and happiness, and psychological well-being). Furthermore, significant associations were found between greater amounts of sedentary behavior and both increased psychological ill-being (i.e. depression) and lower psychological well-being (i.e. satisfaction with life and happiness) in children and adolescents. Evidence on preschoolers was nearly non-existent. Conclusions: Findings from the meta-analysis suggest that physical activity interventions can improve adolescents' mental health, but additional studies are needed to confirm the effects of physical activity on children's mental health. Findings from observational studies suggest that promoting physical activity and decreasing sedentary behavior might protect mental health in children and adolescents. PROSPERO Registration Number: CRD42017060373. [ABSTRACT FROM AUTHOR]

Objective: To analyze changes over time and the predictive value of baseline and changes of sedentary time (ST) and physical activity (PA) on pain, disease impact, and health‐related quality of life (HRQoL) at 2‐ and 5‐year follow‐up in women with fibromyalgia. Methods: This is a longitudinal and exploratory study with three time points. A total of 427 women with fibromyalgia (51.4 ± 7.6 years) were followed after 2 (n = 172) and 5 years (n = 185). ST and PA (light and moderate‐to‐vigorous [MVPA]) were assessed using triaxial accelerometers. Pain, disease impact, and HRQoL were measured using: pressure pain threshold, the pain subscale of the revised fibromyalgia impact questionnaire (FIQR), the bodily pain subscale of the 36‐item short‐form health survey (SF‐36), a visual analog scale (VAS), the FIQR, and the SF‐36 physical and mental components. Results: Over 5 years, pressure pain threshold, ST, light PA, and MVPA variables were worsened, while FIQR and SF‐36 variables were improved (Cohen's d < 0.1–0.3). Baseline ST or light PA were not associated with future outcomes, whereas greater MVPA at baseline was associated with better SF‐36 bodily pain at 5‐year follow‐up (β = 0.13). Reducing ST and increasing light PA were associated with better bodily pain (β = −0.16 and 0.17, respectively) and SF‐36 physical component (β = −0.20 and 0.17, respectively) at 5‐year follow‐up. Increasing MVPA was associated with less pain (pressure pain threshold, VAS, and FIQR‐pain) and better SF‐36 physical component at 2‐ and 5‐year follow‐up (β's from −0.20 to 0.21). Conclusions: Objectively measured variables slightly worsened over years, while for self‐reported outcomes there was a trend for improvement. Reductions in ST and increases in light PA and MVPA were associated with better HRQoL at 5‐year follow‐up, and increases in MVPA were additionally associated with better pain and HRQoL at 2‐year follow‐up. [ABSTRACT FROM AUTHOR]

Aim To assess the association between baseline urinary incontinence and long-term, all-cause mortality. Background Urinary incontinence is a common disorder among older institutionalised adults, with important consequences for morbidity and quality of life. Moreover, while it is a consistent mortality marker, the extent to which this association might be causal remains controversial. Design A cohort study. Methods We conducted a mortality follow-up study on a cohort of 675 nursing-home residents in the city of Madrid (Spain), from their 1998-1999 baseline interviews to September 2013. Study subjects or their caregivers were asked whether the resident had experienced any involuntary leakage of urine in the preceding 14 days, with subjects being subsequently defined as continent, mildly incontinent, or severely incontinent. Hazard ratios for all-cause mortality were estimated using Cox proportional hazards models. Results After a 4061 person-year follow-up (median/maximum of 4·6/15·2 years), 576 participants had died. In fully-adjusted models, urinary incontinence was associated with a 24 per cent increased risk of all-cause mortality. There was a graded relationship across severity levels, with hazard ratios 7% higher for mild and 44% higher for severe incontinence as compared with the continent group. The adjusted mortality fraction attributable to urinary incontinence was 11 per cent. Conclusion It would appear that urinary incontinence is not only a marker but also a real determinant of survival in the institutionalized population. This finding, which seems plausible in a population of frail older adults, warrants further research into mechanisms that could help to elucidate this hypothesis. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the associations of different levels of depression with pain, sleep quality, fatigue, functional exercise capacity, overall fibromyalgia (FM) severity, and health-related quality of life (HRQoL) in women with FM.Methods: A total of 451 women with FM participated in this cross-sectional study. Depressive symptoms (Beck Depression Inventory; BDI-II), pain intensity (numerical rating scale; NRS), pain sensitivity (algometry), sleep quality (Pittsburgh Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), functional exercise capacity (6-min walk test), FM severity (revised Fibromyalgia Impact Questionnaire), and HRQoL (SF-36) were assessed.Results: Participants with severe depressive symptoms had significantly higher pain intensity (NRS = 1.1; 95 % CI 0.3-1.8), fatigue (12.6-units; 95 % CI 8.2-17.1) and overall FM severity (12.6-units; 95 % CI 11.4-23.7), as well as poorer sleep quality (3.2-units; 95 % CI 1.7-4.7) and mental component of HRQoL (-17.0-units; 95 % CI -21.0 to -12.9) than participants with minimal signs of depression. There was no association of signs of depression with pain sensitivity, exercise capacity, or the physical component of HRQoL (P > 0.05).Conclusions: These results extend current knowledge on the association of signs of depression with FM severity and quality of life in women with FM, and suggest that severity of depressive symptoms could potentially be a prognostic factor to be considered in future prospective intervention studies. [ABSTRACT FROM AUTHOR]

Objective To characterize the levels of objectively measured time spent in sedentary activities (sedentary time) and physical activities in female patients with fibromyalgia and compare them with the levels in age-matched healthy control women. Methods The study comprised 413 female patients with fibromyalgia (mean ± SD age 51.9 ± 7.4 years) and 188 female control subjects (age 50.9 ± 7.5 years). Sedentary time, the amount of time spent engaged in physical activity, and step counts were measured using triaxial accelerometry. The amounts of time (minutes/day) during which the participants were engaged in sedentary behaviors as well as in physical activity of different intensities (light, moderate, and moderate-to-vigorous) and the step counts were calculated. Results The amount of time spent in sedentary behavior was longer in patients with fibromyalgia compared with controls (estimated mean ± SEM difference 39 ± 8 minutes/day; P < 0.001). The patients with fibromyalgia spent less time than controls engaged in light physical activity (mean ± SEM difference −21 ± 7 minutes/day; P = 0.005), moderate physical activity (mean ± SEM difference −17 ± 3 minutes/day; P < 0.001), and moderate-to-vigorous physical activity (mean ± SEM difference −19 ± 3 minutes/day; P < 0.001). The patients with fibromyalgia took fewer steps/day compared with the control subjects (mean ± SEM difference −1,881 ± 262 steps/day; P < 0.001). Only 20.6% of the patients with fibromyalgia and 46.3% of the control subjects fulfilled the recommendation for 150 minutes/week of moderate-to-vigorous physical activity in bouts of at least 10 minutes/bout (χ2 = 41.8, P < 0.001). Similarly, only 16.0% of the patients fulfilled the recommendation for ≥10,000 steps/day compared with 44.7% of the control subjects (χ2 = 56.8, P < 0.001). Both the patients and the control subjects were more active (physical activity of all intensities and numbers of steps) on weekdays than on weekend days (all P ≤ 0.001). Conclusion Female patients with fibromyalgia spent more time in sedentary behaviors and were less physically active than age-matched controls. The low proportions of female patients with fibromyalgia and control subjects who met the physical activity and step count recommendations is worrisome. [ABSTRACT FROM AUTHOR]

To find modifiable factors that are related to subjective well-being would be valuable for improving interventions in fibromyalgia. Physical activity, sedentary behaviour, and physical fitness may represent potential areas to optimize treatment regimens. In fibromyalgia, there is a discordance between clinical observations and patient-reported outcomes (objective and subjective assessments). Therefore, the present study aims at analyzing the associations of objective and subjective evaluations of physical activity, sedentary behaviour, and physical fitness with subjective well-being and determine if and how objective and subjective associations differ. In this population-based cross-sectional study participated 375 women with fibromyalgia from the al-Ándalus project (Spain). Physical activity, sedentary behaviour, and physical fitness were objectively (accelerometers and performance testing) and subjectively (questionnaires) measured. Participants self-reported their levels of positive affect, negative affect, and life satisfaction. In the most conservative multivariate analysis, we found independent associations of the objective measures of physical activity with positive affect and life satisfaction and sedentary behaviour with positive affect. No such relationship was seen with subjective measures of the same behaviours. Moreover, we observed that objective and subjective physical fitness evaluations were independent of each other related to subjective well-being. Independent associations of the objective measures (but not the subjective assessments) of physical activity with positive affect and life satisfaction, and of sedentary behaviour with positive affect were observed. However, objective measures and subjective appraisals of physical fitness appear to be independently related to well-being, which should be considered when developing physical exercise interventions for fibromyalgia. The analysis of concurrent associations of objective and subjective evaluations of physical functioning with subjective well-being offers indications for modifiable targets in rehabilitation that can improve well-being in fibromyalgia. Exercise-based rehabilitation may help women with fibromyalgia to improve subjective well-being, particularly positive affect. Rehabilitation should focus on both the objective physical performance of women with fibromyalgia and on their perceptions of what they can do physically. When rehabilitation aims at enhancing positive affect or life satisfaction by changing the lifestyle of women with fibromyalgia, physical activity and sedentary behaviour should be objectively monitored. [ABSTRACT FROM AUTHOR]

Background Physical fitness is a marker of health and is associated with health-related quality of life (HRQoL). Identifying which components of physical fitness are associated with HRQoL in people with fibromyalgia may contribute to the development of more specific therapeutic strategies. Objective The 2 aims of this study were to examine the association of different components of physical fitness (ie, flexibility, muscle strength, speed and agility, and cardiorespiratory fitness) with HRQoL and to determine the extent to which any association between the components of physical fitness and HRQoL were of clinical relevance to women with fibromyalgia. Design A cross-sectional design was used. Methods This study included 466 women with fibromyalgia from southern Spain (Andalusia). The Senior Fitness Test battery and the handgrip test were used to assess physical fitness, and the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL. Tender points, cognitive impairment, anthropometric measurements, and medication usage were also measured. First, multivariate linear regression was used to assess the individual relationship of each physical fitness test with the 8 dimensions of the SF-36. Second, a standardized composite score was computed for each component of physical fitness (flexibility, muscle strength, speed and agility, and cardiorespiratory fitness). A 1-way analysis of covariance to assess the differences in each of the 8 dimensions of the SF-36 across each physical fitness composite score was conducted. Forward stepwise regression was performed to analyze which components of physical fitness were independently associated with the SF-36 physical and mental component scales. Results Overall, higher levels of physical fitness were associated with higher levels of HRQoL (regardless of the SF-36 subscale evaluated). The effect sizes for HRQoL between participants with the lowest and the highest physical fitness levels ranged from moderate to large (Cohen d  = 0.53–0.90). The muscle strength composite score was independently associated with the SF-36 physical component scale, whereas the flexibility composite score and cardiorespiratory fitness were independently associated with the SF-36 mental component scale. Limitations A limitation was that the cross-sectional design precluded the establishment of causality. Additionally, only women were included in the study, because fibromyalgia predominantly affects women. Conclusions High levels of physical fitness were consistently associated with better HRQoL in women with fibromyalgia; clinically relevant differences were demonstrated between those at extreme physical fitness levels. Muscle strength, flexibility, and cardiorespiratory fitness were independent indicators of HRQoL. These results warrant further prospective research on the potential of fitness to predict HRQoL in this population. [ABSTRACT FROM AUTHOR]

This study assessed the association of fitness and fatness with cognitive function in women with fibromyalgia, and the independent influence of their single components on cognitive tasks. A total of 468 women with fibromyalgia were included. Speed of information processing and working memory (Paced Auditory Serial Addition Task), as well as immediate and delayed recall, verbal learning and delayed recognition (Rey Auditory Verbal Learning Test) were assessed. Aerobic fitness, muscle strength, flexibility and motor agility were assessed with the Senior Fitness Test battery. Body mass index, percent body fat, fat-mass index and waist circumference were measured. Aerobic fitness was associated with attention and working memory (all,p < 0.05). All fitness components were generally associated with delayed recall, verbal learning and delayed recognition (all,p < 0.05). Aerobic fitness showed the most powerful association with attention, working memory, delayed recall and verbal learning, while motor agility was the most powerful indicator of delayed recognition. None of the fatness parameters were associated with any of the outcomes (all,p > 0.05). Our results suggest that fitness, but not fatness, is associated with cognitive function in women with fibromyalgia. Aerobic fitness appears to be the most powerful fitness component regarding the cognitive tasks evaluated. [ABSTRACT FROM PUBLISHER]

Physical activity attenuates the symptoms of fibromyalgia, and its level is oftentimes associated with the perceived environment of fibromyalgia patients. Within this context, we aimed to study the reliability of the Spanish version of the Assessing Levels of Physical Activity (ALPHA) environmental questionnaire and the mode of commuting questionnaire. We also studied the association between the perceived environment and mode of commuting with physical activity levels among female fibromyalgia patients in Spain. Test–retest reliability was judged by the intra-class correlation coefficient (ICC), weighted kappa statistic, Spearman correlations and the proportion of agreement. We calculated bivariate Pearson’s correlations between environmental sum scores and physical activity measured by both International Physical Activity Questionnaire (IPAQ) and accelerometry. More than 70% of the scales and items showed a good reliability regarding the ICC, the weighted kappa, the Spearman correlation and the percentage of inter-agreement (higher than 50%). The perceived environment assessed with the ALPHA showed a low correlation with both IPAQ and accelerometry. The Spanish version of the ALPHA environmental questionnaire proved to be reliable and showed a weak degree of association with physical activity in female fibromyalgia patients. [ABSTRACT FROM PUBLISHER]

Objective. The aim of this study was to validate the modified 2010 ACR preliminary criteria for FM in a Spanish population.Methods. Five hundred and seventy-nine (550 women) FM and 294 (240 women) control participants were enrolled in the study. FM patients were previously diagnosed by a rheumatologist. All participants underwent both the 1990 ACR criteria (1990c) and the modified 2010 ACR criteria (m-2010c).Results. The tender points count showed correlations of 0.69, 0.65 and 0.71 with the widespread pain index (WPI), symptoms severity (SS) and polysymptomatic distress (PSD) scales, respectively (all P < 0.001). The WPI, SS and PSD showed greater correlations with impact of FM health-related quality of life, general fatigue and depression than the tender points count. The 1990c showed sensitivity and specificity values of 84.1 and 97.6, respectively, whereas the m-2010c showed values of 88.3 and 91.8, respectively. Both criteria showed the same overall accuracy, with a value of 0.89. When the 1990c and m-2010c were combined and patients had to satisfy one of two criteria to be diagnosed with FM, the sensitivity, specificity and accuracy of questionnaires were 96.7, 89.8 and 0.94, respectively. The original cut-off points (WPI ≥ 7, SS ≥ 5 and PSD ≥ 12) showed the best test characteristics in the present study.Conclusion. The m-2010c, with the same cut-off points as the original version, are a valid tool for the diagnosis of FM in our population. Whenever possible, the combination of the 1990c and m-2010c is recommended (patients have to meet one of the two criteria to be diagnosed), since this approach showed the best diagnostic characteristics. [ABSTRACT FROM PUBLISHER]