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Background The measurement of physical fitness has a history that dates back nearly 200 years. Recently, there has been an increase in international research and surveillance on physical fitness creating a need for setting international priorities that could help guide future efforts. Objective This study aimed to produce a list of the top 10 international priorities for research and surveillance on physical fitness among children and adolescents. Methods Using a twin-panel Delphi method, two independent panels consisting of 46 international experts were identified (panel 1 = 28, panel 2 = 18). The panel participants were asked to list up to five priorities for research or surveillance (round 1), and then rated the items from their own panel on a 5-point Likert scale of importance (round 2). In round 3, experts were asked to rate the priorities identified by the other panel. Results There was strong between-panel agreement (panel 1: rs = 0.76, p rs = 0.77, p Conclusions The priorities identified in this study provide guidance for future international collaborations and research efforts on the physical fitness of children and adolescents over the next decade and beyond.

OBJECTIVE To investigate the associations of leisure-time physical activity with psychological distress and wellbeing, and potential mediators. METHODS We used data from the 1970 British Cohort Study (N = 5,197 - 2,688 men), including waves 34y (2004), 42y (2012), and 46y (2016) waves. Participants reported leisure-time physical activity frequency and intensity (exposure) at age 34 (baseline), cognition (vocabulary test), body mass index, disability, mobility and pain perception (potential mediators) at age 42, and psychological distress (Malaise inventory) and wellbeing (Warwick-Edinburgh scale) at age 46. Baseline confounders included sex, country, education, employment status, alcohol use, tobacco smoking, and psychological distress. Main analyses included logistic regression and mediation models. RESULTS Higher leisure-time physical activity intensity at baseline was associated with lower psychological distress at 46y [β: -0.038 (95%CI: -0.069 to -0.007)], but not leisure-time physical activity frequency. Baseline leisure-time physical activity frequency and intensity were associated with higher psychological well-being at 46y [frequency: β: 0.089 (95%CI: 0.002 to 0.176); intensity: β: 0.262 (95%CI: 0.123 to 0.401); and total: β: 0.041 (95%CI: 0.013 to 0.069)]. Only body mass index at 42y partially mediated the association between leisure-time physical activity frequency (15.7%) and total leisure-time physical activity (6.2%) at 34y, with psychological wellbeing at 46y. CONCLUSIONS These findings highlight the role of leisure-time physical activity in psychological distress and wellbeing, with greater effect sizes associated with higher frequency and intensity of leisure-time physical activity. Future interventions should consider examining potential mediators of the association of leisure-time physical activity with psychological wellbeing, such as body mass index.

[Extract] The world is entering a new phase of the coronavirus disease 2019 (COVID-19) health crisis with the lifting of social and physical distancing as well as lockdown restrictions to control the pandemic. Scientific evidence obtained during the COVID-19 pandemic to this point have brought clear themes to the forefront. One important theme pertains to who is at a higher risk for poorer outcomes if infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clearly, individuals with risk factors for chronic disease and one or more chronic disease diagnoses are at significantly higher risk for poor outcomes with SARS-CoV-2 infection.1,2 Moreover, unhealthy lifestyle behaviors (i.e., physical inactivity, poor nutrition, smoking and excess body mass) are the leading cause for the high incidence and prevalence of chronic disease the world was facing well before the COVID-19 pandemic.3 In fact, physical inactivity and chronic diseases were both characterized as pandemics prior to COVID-19.1,4,5 In this context, decades of unhealthy lifestyle behaviors, both independently and through the association with chronic disease risk factors, primed the pump for poor COVID-19 outcomes.1,6, 7, 8 Another emerging theme is the disproportionate burden of poor outcomes in underserved communities and underrepresented individuals.9, 10, 11 A higher prevalence of unhealthy lifestyle characteristics and chronic disease certainly contributes to this disparity.12, 13, 14 From an international perspective related to health inequalities, a common conclusion is that the burden of disease is usually highest in the lowest-income countries, especially countries in sub-Saharan Africa. This pattern is most starkly seen for a wide range of infectious diseases,15 though rates of non-communicable diseases are already substantial and are rising in the region.16,17 As such, since the early days of the pandemic, there has been grave concern for the disastrous impact the COVID-19 pandemic would have in sub-Saharan Africa.

City planning policies influence urban lifestyles, health, and sustainability. We assessed policy frameworks for city planning for 25 cities across 19 lower-middle-income countries, upper-middle-income countries, and high-income countries to identify whether these policies supported the creation of healthy and sustainable cities. We systematically collected policy data for evidence-informed indicators related to integrated city planning, air pollution, destination accessibility, distribution of employment, demand management, design, density, distance to public transport, and transport infrastructure investment. Content analysis identified strengths, limitations, and gaps in policies, allowing us to draw comparisons between cities. We found that despite common policy rhetoric endorsing healthy and sustainable cities, there was a paucity of measurable policy targets in place to achieve these aspirations. Some policies were inconsistent with public health evidence, which sets up barriers to achieving healthy and sustainable urban environments. There is an urgent need to build capacity for health-enhancing city planning policy and governance, particularly in low-income and middle-income countries.

Background: Our aim was to analyze the association of self-reported mentally-passive and mentally-active sedentary behaviors with different patterns (bouts and breaks) of device-measured sedentary time in adolescents. Methods: This was a cross-sectional study conducted among 375 adolescents (177 boys) aged 1015 years. Total time, bouts and breaks of sedentary time were measured through accelerometers. Self-reported sedentary behavior in different activities was summed and divided into mentally-active (playing electronic games, studying and reading) and mentally-passive (watching TV, watching DVD, and using computer for leisure). Bayesian linear regression models were used for association analyses. Results: Only mentally-passive sedentary behaviors were positively associated with longer bouts [1-4 minutes: mean posterior distribution: -0.431 (95% credible interval: -0.745 to -0.114); =15 minutes: 0.641 (0.122 to 1.222)] and lower number of breaks [-0.138 (-0.228 to -0.044)] of device-measured sedentary time. Conclusion: Self-reported mentally-passive sedentary behaviors are associated with longer bouts and lower breaks of device-measured sedentary time.

Background. The debate on whether participation in sports enhances or curtails risky sexual behavior among athletes continues. The purpose of the study was to establish the sexual behavior patterns and associated high risks among University student-athletes. Methods. A cross-sectional survey research design was used to collect self-report data on sexual behaviors from university student-athletes (n = 151) who participated in a University sports tournament. Descriptive statistics of frequencies and proportions and inferential statistics of chi-square test of independent measures were used to analyze the data. Majority (65%) of the student-athletes were taking part in Ball games and Racket games (13.9%). Results. About a third (33%) of the student-athletes had their first sexual debut while aged between 18 and 20 years, 60% had regular sexual partners, over 30% had more than one sexual partner and 67% would have sexual intercourse with strangers; only 58% of these would seek the sexual history of the strangers. More than half (55%) of the student-athletes frequently used condoms to prevent pregnancies and sexually transmitted diseases, but only 39% of them always used condoms with their sexual partners in the last six months. The participants’ sexual behaviors differed significantly (p < .05) by their gender. Males tended to start having sexual intercourse earlier (p < .002), had more than one sexual partner (p < 0.001) and would always use condoms (p < .001) than females, but more females than males would have sexual intercourse with a stranger (p < .001). Conclusions. Kenyan University student-athletes are sexually active and are faced with high risk sexual behaviors like multiple sexual partners and sexual intercourse with strangers. The difference in patterns of sexual behavior between male and female student-athletes calls for gender specific interventions by programmers, policy makers and health workers. Keywords: sexual behaviors, student-athletes, sexually transmitted diseases (STD’s).

Background: Low level of community reintegration among stroke survivors is a major obstacle to rehabilitation services post discharge from acute care. Few studies have assessed the impact of community reintegration on stroke survivors in Nigeria. This study investigates community reintegration and associated factors among stroke survivors in Maiduguri, Nigeria. Methodology: Purposive sampling technique was used to recruit 55 stroke survivors attending rehabilitation services from two public hospitals in Maiduguri. Community reintegration was assessed with the Reintegration to Normal Living Index (RNLI) questionnaire, while information on sociodemographics (e.g., age group, gender, employment status, educational status) and clinical characteristics (e.g., post stroke duration, types of stroke, side of affectation) was obtained using the data form. Logistic regression analyses with odd ratios were used to test the associations between community reintegration and sociodemographic and clinical characteristics. Results: The mean age and post stroke duration of the participants were 44.69±13.06 years and 17.25±24.90 months respectively. The participants’ community reintegration scores showed that 60%, 38.2% and 1.8% have no integration, mild to moderate reintegration and complete reintegration respectively. The results indicated that stroke survivors with a stroke duration greater than 8 months (OR=3.32, C.I=1.08-10.27) and those with haemorrhagic stroke (OR=4.67, C.I=1.05-20.66) were more likely to be reintegrated into the community than their counterparts with 6-8 months post stroke duration and ischaemic stroke, respectively. There was significant association between community reintegration and sociodemographic characteristics such as post stroke duration and type of stroke. Conclusions: Rehabilitation strategies should focus on clinical characteristics of the stroke survivors when planning and delivering effective community reintegration interventions.

Objective: To determine the cardiovascular responses and perceived exertion of young adults walking and carrying a load of 10 kg on shoulder and the head.Method: Healthy participants (n=50) between the ages of 21 and 27 were subjected to three testing sessions at self-selected normal pace without load, and carrying a 10 kg load on the shoulder and on the head for 10 minutes. Cardiovascular parameters and their ratings of perceived exertion (RPE) were measured before and after testing at each session.Results: Higher pulse pressure (correlates of stroke volume) and rate pressure product (index of myocardial oxygen uptake) values were observed following load on shoulder testing compared to no load testing values and a higher RPE value was observed for load on shoulder testing when compared to load on head testing.Conclusion: It is conceivable that carrying load on the head can potentially be more economical than carrying load on the shoulder for this cohort of young adults. Keywords: Cardiovascular responses, perceived exertion, load carrying, rural communities

Made available in DSpace on 2020-12-12T01:55:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-04-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) National Institute on Handicapped Research Aims: We analyzed the joint association of high ultra-processed food ingestion and sedentary behavior (SB) with anxiety-induced sleep disturbance among Brazilian adolescents. Methods: Data from the Brazilian Scholar Health Survey, a nationally representative survey of 9th grade adolescents [mean: 14.28 years (range: 11–18 years)] conducted in 2015 (n = 100,648) were used. Self-reported anxiety-induced sleep disturbance, SB (TV viewing and total sitting time), and frequency of ingestion of different ultra-processed foods were collected. Age, ethnicity, type of city (capital or interior), region of the country, and habitual physical activity (global scholar survey questionnaire) were covariates. Logistic regression analyses were conducted to assess the associations. Results: High ultra-processed food ingestion plus low SB [boys:OR:1.44(99%CI:1.16–1.79), girls:OR:1.41(99%CI:1.22–1.63)] were risk factors for anxiety-induced sleep disturbance. The highest risk of anxiety-induced sleep disturbance was observed among those who joint high ultra-processed food ingestion with high SB [boys:OR:1.85(99%CI:1.46–2.35), girls:OR:1.62(99%CI:1.39–1.89)]. In addition, the interaction of high ultra-processed food ingestion with TV-viewing substantially increased the odds of anxiety-induced sleep disturbance [boys:OR:2.03(99%CI:1.61–2.56), girls:OR:2.04(99%CI:1.76–2.36)]. Conclusions: Both the high consumption of ultra-processed foods and SB (especially TV-viewing) appear to be independently associated with anxiety-induced sleep disturbance in both sexes. However, the co-occurrence of both negative lifestyle behaviors is associated with a substantial increase in the risk of anxiety-induced sleep disturbance. Future longitudinal research is required to confirm/refute our findings and explore potential mechanisms. Department of Physical Education Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Roberto Símonsen, 305, 19060-900 Department of Rehabilitation Sciences KU Leuven – University of Leuven Department of Physiotherapy College of Medical Sciences University of Maiduguri Department of Psychological Medicine Institute of Psychiatry Psychology and Neuroscience King's College London United Kingdom South London Maudsley NHS Foundation Trust, De Crespigny Park Department of Physical Education Federal University of Sergipe - UFS Department of Physical Education Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Rua Roberto Símonsen, 305, 19060-900

Background: Motor impairment is a frequent presentation of stroke leading to partial or total loss of function of a body part usually limbs. Objective: This study investigated poststroke motor performance and its association with sociodemographic and clinical characteristics of stroke survivors. Materials and Methods: Ninety-four stroke survivors from two selected physiotherapy clinics in Maiduguri participated in this study. Data form was used to obtain information on sociodemographic and clinical characteristics of the participants while the Short-Form Fugl Meyer scale was used to obtain the information on motor performance of the participants. Descriptive statistics of mean, standard deviation, frequency, and percentage were used to summarize the data. Chi-square test of association was used to analyze motor performance and its association with sociodemographic and clinical characteristics of the participants. Results: The mean age and poststroke duration of the participants were 52.65 ± 12.70 years and 26.32 ± 32.70 months, respectively. Of the entire participants, 55 (58.5%) were male, 49 (52.1%) were employed, and 33 (35.1%) had Qur'anic education. Forty (42.6%) had a duration of stroke between 3 and 12 months. Gender (χ2 = 12.72, P = 0.002) and educational level (χ2 = 17.77, P = 0.023) were significantly associated with motor performance. Age, employment status, and duration of stroke showed no significant association with motor performance. Conclusion: The outcome of this study suggests that female gender and “no educational” attainment were associated with poor motor performance among stroke survivors in Maiduguri. Gender and educational level can influence motor impairment after stroke and should represent an essential part of assessment during stroke rehabilitation.

Background The IPEN International Physical Activity and Environment Network Adolescent project was conducted using common study protocols to document the strength, shape, and generalizability of associations of perceived neighborhood environment attributes with adolescents’ physical activity and overweight/obesity using data from 15 countries. Countries did not use identical versions of the Neighborhood Environment Walkability Scale for Youth (NEWS-Y) to measure perceived neighborhood environment attributes. Therefore, this study derived a measurement model for NEWS-Y items common to all IPEN Adolescent countries and developed a scoring protocol for the IPEN Adolescent version of the NEWS-Y (NEWS-Y-IPEN) that maximizes between-country comparability of responses. Additionally, this study examined between- and within-country variability, and construct validity of the NEWS-Y-IPEN subscales in relation to neighborhood-level socio-economic status and walkability. Methods Adolescents and one of their parents (N = 5714 dyads) were recruited from neighborhoods varying in walkability and socio-economic status. To measure perceived neighborhood environment, 14 countries administered the NEWS-Y to parents and one country to adolescents. Confirmatory factor analysis was used to derive comparable country-specific measurement models of the NEWS-Y-IPEN. Country-specific standard deviations quantified within-country variability in the NEWS-Y-IPEN subscales, while linear mixed models determined the percentage of subscale variance due to between-country differences. To examine the construct validity of NEWS-Y-IPEN subscales, we estimated their associations with the categorical measures of area-level walkability and socio-economic status. Results Final country-specific measurement models of the factor-analyzable NEWS-Y-IPEN items provided acceptable levels of fit to the data and shared the same factorial structure with five latent factors (Accessibility and walking facilities; Traffic safety; Pedestrian infrastructure and safety; Safety from crime; and Aesthetics). All subscales showed sufficient levels of within-country variability. Residential density had the highest level of between-country variability. Associations between NEWS-Y-IPEN subscales and area-level walkability and socio-economic status provided strong evidence of construct validity. Conclusions A robust measurement model and common scoring protocol of NEWS-Y for the IPEN Adolescent project (NEWS-Y-IPEN) were derived. The NEWS-Y-IPEN possesses good factorial and construct validity, and is able to capture between-country variability in perceived neighborhood environments. Future studies employing NEWS-Y-IPEN should use the proposed scoring protocol to facilitate cross-study comparisons and interpretation of findings.

Background This study examined the joint associations of leisure time physical activity and television (TV) viewing time with the prevalence of chronic diseases among Brazilian adults. Methods Data from the Brazilian Health Survey, a nationally representative survey conducted in 2013 (n = 60 202; ≥18 years), were used. Time spent in TV viewing and leisure physical activity, physician diagnoses of diabetes, hypertension and heart disease and information on co-variables (chronological age, education, ethnicity, candies/sweets consumption, sodium intake and tobacco smoking) were collected via interview. Descriptive statistics (mean and 95% confidence interval) and logistic regression models were used for etiological analyses. Results Physical activity attenuated but did not eliminate the risk associated with high TV viewing for at least one chronic disease in the general population [odds ratio [OR]: 1.29 (1.11–1.50)] and among women [OR: 1.31 (1.09–1.60)], adults [OR: 1.24 (1.05–1.46)] and older adults [OR: 1.63 (1.05–2.53)]. On the other hand, physical activity eliminated the risk associated with high TV viewing for at least one chronic disease among men [OR: 1.24 (0.98–1.58)]. Conclusions We conclude that physical activity can attenuate but not eliminate the negative effects of high TV viewing on chronic disease among subgroups of Brazilian adults.

This Series on urban design, transport, and health aimed to facilitate development of a global system of health-related policy and spatial indicators to assess achievements and deficiencies in urban and transport policies and features. This final paper in the Series summarises key findings, considers what to do next, and outlines urgent key actions. Our study of 25 cities in 19 countries found that, despite many well intentioned policies, few cities had measurable standards and policy targets to achieve healthy and sustainable cities. Available standards and targets were often insufficient to promote health and wellbeing, and health-supportive urban design and transport features were often inadequate or inequitably distributed. City planning decisions affect human and planetary health and amplify city vulnerabilities, as the COVID-19 pandemic has highlighted. Hence, we offer an expanded framework of pathways through which city planning affects health, incorporating 11 integrated urban system policies and 11 integrated urban and transport interventions addressing current and emerging issues. Our call to action recommends widespread uptake and further development of our methods and open-source tools to create upstream policy and spatial indicators to benchmark and track progress; unmask spatial inequities; inform interventions and investments; and accelerate transitions to net zero, healthy, and sustainable cities. BG-C was supported by an RMIT Vice-Chancellor's Fellowship. CH was supported through an NHMRC Centre for Research Excellence in Healthy Liveable Communities grant (number 1061404) and The Australian Prevention Partnership Centre (number 9100003). DA was supported by an Impact Acceleration Award from the Economic and Social Research Council and funding from the Global Challenges Research Fund administered by the Department for the Economy, Northern Ireland, UK. EC's research was supported by the Australian Catholic University. SL was supported by the experiential fellowships from College of Social Science and Humanities, Northeastern University. JFS was supported by Australian Catholic University. DS was supported by Washington University in St Louis (MO, USA), Center for Diabetes Translation Research (number P30DK092950 from the US National Institute of Diabetes and Digestive and Kidney Diseases of the US National Institute of Health) and by the Cooperative Agreement Number U48DP006395 from the US Centers for Disease Control and Prevention. SB was supported by an Australian Research Council Linkage Grant (LP160100324) and European Union's Horizon 2020 research and innovation programme under grant agreement #730426 (Urban GreenUP). We would like to thank Belinda Nemec and Judy Boyce. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions, or policies of the institutions with which they are affiliated.

Background: COVID-19 is a pandemic that ravaged the world in manners that were never seen in the recent past and one of the measures to stem the tide-off this ravaging pandemic is a stay-at-home order referred to as lockdown. This study compares the physical activity status and perceived health of Nigerians before and during the lockdown. ResultsSocial media platform users (n = 205) were surveyed using a two-part questionnaire. The 1st part elicited the socio-demographic characteristics of the subject. In the 2nd part, information about their exercise and physical activity, general health, and economic palliatives as offered by the government, non-governmental organizations, and philanthropists were elicited. The frequency of exercise was significantly more (p < 0.05) during the lockdown than before the lockdown. The duration and intensity of the exercise per week were comparable. There was also a negative relationship between the Body Mass Index, frequency, and duration of exercise before and during the lockdown. The subjects also perceived their health as worse during (3.70 ± 1.05) the lockdown than before (3.95 ± 0.97) lockdown (Z = -3.69, p = 0.00). Conclusion: Overall, for these cohorts of social media platform users, lockdown did not adversely affect their exercise routine. It is recommended that there should be specific admonition on exercise as an important Instrumental Activity of Daily Living (IADL). Therefore, while this pandemic lockdown lasts and beyond, the safety measures to follow while partaking in this IADL, should be included in the public health recommendation.

Background COVID-19 is a pandemic that ravaged the world in manners that were never seen in the recent past, and one of the measures to stem the tide of this ravaging pandemic is a stay-at-home order referred to as lockdown. This study compares the physical activity status and perceived health of Nigerians before and during the lockdown. Results Social media platform users (n = 205) were surveyed using a two-part questionnaire. The first part elicited the sociodemographic characteristics of the subject. In the second part, information about their exercise and physical activity, general health, and economic palliatives as offered by the government, non-governmental organizations, and philanthropists were elicited. The frequency of exercise was significantly more (p Z = − 3.69, p = 0.00). Conclusion Overall, for these cohorts of social media platform users, lockdown did not adversely affect their exercise routine. It is recommended that there should be specific recommendation on exercise as an important Instrumental Activity of Daily Living [IADL]. Therefore, while this pandemic lockdown lasts and beyond, the safety measures to follow while partaking in this IADL should be included in the public health recommendation.

Young people aged 10-24 years constitute 24% of the world's population; investing in their health could yield a triple benefit-eg, today, into adulthood, and for the next generation. However, in physical activity research, this life stage is poorly understood, with the evidence dominated by research in younger adolescents (aged 10-14 years), school settings, and high-income countries. Globally, 80% of adolescents are insufficiently active, and many adolescents engage in 2 h or more daily recreational screen time. In this Series paper, we present the most up-to-date global evidence on adolescent physical activity and discuss directions for identifying potential solutions to enhance physical activity in the adolescent population. Adolescent physical inactivity probably contributes to key global health problems, including cardiometabolic and mental health disorders, but the evidence is methodologically weak. Evidence-based solutions focus on three key components of the adolescent physical activity system: supportive schools, the social and digital environment, and multipurpose urban environments. Despite an increasing volume of research focused on adolescents, there are still important knowledge gaps, and efforts to improve adolescent physical activity surveillance, research, intervention implementation, and policy development are urgently needed.

BackgroundPhysical activity (PA) is associated with numerous health benefits among children and youth. However, few studies have examined how active transportation (AT) and device-based measures of PA vary within and between countries in sub-Saharan Africa.PurposeThis cross-sectional study sought to investigate the prevalence and correlates of AT and device-measured PA among children living in urban, peri-urban and rural areas in three African countries representing Eastern, Western and Southern regions of Africa.Methods3,205 participants (53.3% girls; 46.7% boys) aged 10–12 years were recruited in Kenya, Nigeria and Mozambique. Data were collected using a child questionnaire, a parent/guardian questionnaire and PiezoRx® pedometers. ANCOVA and binary logistic regression analyses were used to examine the correlates of AT and PA while controlling for gender, age, parent education and vehicle ownership.ResultsParticipants accumulated an average of 45.6±23.5 min/day of moderate-to-vigorous physical activity (MVPA) and 11,215±4,273 steps/day. Kenyan and Mozambican children were significantly more active than their Nigerian counterparts (pConclusionsMajority of children engaged in AT, but still failed to meet MVPA recommendations. Most correlates of AT and PA were country-specific, suggesting that strategies to encourage both behaviours should be informed by local evidence.

Background One of the strategic actions identified in the Global Action Plan on Physical Activity (PA) 2018–2030 is the enhancement of data systems and capabilities at national levels to support regular population surveillance of PA. Although national and international standardized surveillance of PA among children and adolescents has increased in recent years, challenges for the global surveillance of PA persist. The aims of this paper were to: (i) review, compare, and discuss the methodological inconsistencies in children and adolescents’ physical activity prevalence estimates from intercontinental physical activity surveillance initiatives; (ii) identify methodological limitations, surveillance and research gaps. Methods Intercontinental physical activity surveillance initiatives for children and adolescents were identified by experts and through non-systematic literature searches. Prevalence of meeting PA guidelines by country, gender, and age were extracted when available. A tool was created to assess the quality of the included initiatives. Methods and PA prevalence were compared across data/studies and against the methodological/validity/translation differences. Results Eight intercontinental initiatives were identified as meeting the selection criteria. Methods and PA definition inconsistencies across and within included initiatives were observed, resulting in different estimated national prevalence of PA, and initiatives contradicting each other’s cross-country comparisons. Three findings were consistent across all eight initiatives: insufficient level of PA of children and adolescents across the world; lower levels of PA among girls; and attenuation of PA levels with age. Resource-limited countries, younger children, children and adolescents not attending school, with disability or chronic conditions, and from rural areas were generally under/not represented. Conclusions There are substantial inconsistencies across/within included initiatives, resulting in varying estimates of the PA situation of children and adolescents at the global, regional and national levels. The development of a new PA measurement instrument that would be globally accepted and harmonized is a global health priority to help improve the accuracy and reliability of global surveillance.

Background Our aim was to analyze the association of the presence of public physical activity (PA) facilities and participation in public PA programs with leisure-time PA, with an emphasis on the moderating role of educational level and income. Methods We used data of 88,531 adults (46,869 women), with a mean age of 47.2 ± 17.1y, from the 2019 Brazilian National Health Survey. Leisure-time PA (dichotomized considering 150 min/week), the presence of a public PA facility near the household (yes or no), participation in public PA programs (yes or no), educational level (divided into quintiles) and per capita income (divided into quintiles) were all self-reported through interviews. Adjusted logistic regression models were used for the analyses. Results The presence of public PA facilities near the household and the participation in public PA programs were associated with higher leisure-time PA among all quintiles of income and educational level. However, multiplicative interactions revealed that participating in PA programs [Quintile (Q)1: OR: 13.99; 95%CI: 6.89–28.38 vs. Q5: OR: 3.48; 95%CI: 2.41–5.01] and the presence of public PA facilities near the household (Q1: OR: 3.07; 95%CI: 2.35–4.01 vs. Q5: OR: 1.38; 95%CI: 1.22–1.55) were more associated with higher odds of being active in the leisure-time among the lowest quintile of educational level. Conclusions The presence of public PA facilities and participation in public PA programs are environmental correlates that may be relevant for designing effective public health interventions to reduce social inequalities in leisure-time PA among adults in low-income areas.

Journal of Physical Activity and Health, 19 (12), ISSN:1543-3080, ISSN:1543-5474

Background: Research productivity is a measure of achievement of a scholar. The number of research publication in peer-reviewed journals and scholastic presentations in conferences and other gatherings of peers are important criteria for assessing productivity and prestige in the academia. Objective: This study aimed to explore the research productivity of the academic staff of a College of Medical Sciences in a Nigerian University. Materials and Methods: A cross-sectional design study was conducted among 51 academics at the College of Medical Sciences, University of Maiduguri, Nigeria. The participants completed a 31-item questionnaire that explored information on their research publication and conferences presentations in the past 3 years. The questionnaire also elicited information on their teaching load, and the time devoted to research per week. The questionnaire also elicited information on journals, in which the academics published their research, and on any institutional and departmental support for research that is available to them. Descriptive and inferential statistics were used to analyze the data. Results: Overall, the mean number of research publication in 3 years for this cohort of academics was 6.6 ± 6.8 (median = 4.0) papers, while that of conference presentation was 4.5 ± 4.0 (median = 4.0) papers in 3 years. Academics in the clinical sciences subgroup tend to have more research papers published and conference papers presented than their counterparts in the Basic and Allied Health Sciences subgroup. The overall subgroups combined number of research papers published increases absolutely but not significantly with age and rank. Conclusion: Using a productivity threshold set at six papers in 3 years, many academics in this cohort may not be considered to be highly productive. Future studies on an expanded scale are needed to elucidate on the present findings.

Background: The authors analyzed time trends and sociodemographic inequalities in different physical activity and sedentary behavior domains between 2003 and 2019. Methods: A secondary analysis of data from 5 cross-sectional Brazilian epidemiological surveys (World Health Survey—2003, National Household Sample Survey—2008/2015, and Brazilian Health Survey—2013/2019) conducted among a nationally representative sample of Brazilian adults. The authors used data on different domains of physical activity (leisure, commute, total transport, and total physical activity) and sedentary behavior (TV viewing and other types of screens) that were available in the different surveys. Gender, age group, country region, ethnicity, type of area and city, and quintiles of income and educational achievement were used as sociodemographic correlates. Results: The prevalence of leisure-time physical activity increased over time (2008: 7.0% vs 2019: 26.5%). There was also an increased trend of social inequality in leisure-time physical activity. A trend of reduction was observed for active commuting (2008: 35.0% vs 2019: 21.8%), while total transport physical activity was stable (2013: 49.5% vs 2019: 49.6%). Directions of findings were opposite for sedentary behavior, with reduced trend for >3 hours per day of TV viewing (2008: 34.8% vs 2019: 21.8%) and increased trend for >3 hours per day of other types of screen time (2008: 6.4% vs 2019: 22.2%). Conclusion: A positive trend exists in leisure-time physical activity, but there was also an increase in social inequalities for physical activity in Brazil.

IntroductionOnly international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese).Methods and analysisThe IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11–19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status.Ethics and disseminationEthical approval was received from each study site’s Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.

OBJECTIVE: Our aim was to analyze the association between sugar-sweetened beverage consumption and depressive symptoms, as well as the extent to which TV viewing and physical activity moderate this association. METHODS: We used cross-sectional data from the 2013 Brazilian National Survey (Pesquisa Nacional de Saúde) of 59,402 adults (33,482 women, mean age = 42.9 years, 95%CI 42.7-43.2 years). Depressive symptoms (Patient Health Questionnaire-9), physical activity, TV viewing, and sugar-sweetened beverage consumption, as well as potential confounders (chronological age, ethnicity, consumption of candy/sweets and fruit, multimorbidity, education, and employment status) were self-reported. Poisson regression models were used for association analyses. RESULTS: The consumption of 16 or more glasses/week of sugar-sweetened beverages was associated with higher levels of severe depressive symptoms among women compared to no consumption (prevalence ratio [PR] 1.71 [95%CI 1.38-2.11]). Consistent interactions were observed between 1-5 glasses and TV viewing (PR 2.09 [95%CI 1.06-4.12]) and between 11-15 glasses and TV viewing (PR 2.90 [95%CI 1.29-6.50]) among men compared to no consumption, given that the co-occurrence of sugar-sweetened beverage consumption and elevated TV viewing was associated with higher odds of severe depressive symptoms. Sugar-sweetened beverage consumption did not interact with physical activity, only presenting an independent association. CONCLUSION: Sugar-sweetened beverage consumption was independently associated with severe depressive symptoms among women and interacted with TV viewing, but not with physical activity among men. ispartof: Brazilian Journal of Psychiatry vol:43 issue:6 pages:574-583 ispartof: location:Brazil status: published

Made available in DSpace on 2020-12-12T01:36:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 Objective: To analyze the association between body mass index trajectories and non-communicable diseases (NCDs) in women, and the interaction effects of leisure time physical activity on this relationship. Methods: Sample was composed by 15 628 women (≥30 years old) who performed objective measurement of body mass, height, and blood pressure in the 2013 Brazilian Health Survey (2013). Information regarding the body mass at 20 years old, current type 2 diabetes (T2DM), dyslipidemia diagnosis, and leisure time physical activity were self-reported by the participants. Socio-demographic and behavioral covariates were considered. Logistic regression models were used for the statistical analysis. Results: Those who were obese in both moments and women who become obese showed similar high risk, however, the prevalence of NCDs among women who were no longer obese was similar to the consistently non-obese. Leisure time physical activity attenuated the general deleterious effect of obesity, especially among the consistently obese women for dyslipidemia (inactive: OR: 2.02 [95%CI: 1.69-2.43] vs active: OR: 1.05 [95%CI: 0.55-1.99]), T2DM (inactive: OR: 3.84 [95%CI: 2.72-5.43] vs active: OR: 4.38 [95%CI: 1.49-12.86]) and high blood pressure (inactive: OR: 2.00 [95%CI: 1.56-2.57] vs active: OR: 1.15 [95%CI: 0.57-2.52]). Conclusions: Changes in body mass index appear to be sensitive to detecting the risk of NCDs over lifespan. In addition, leisure time physical activity attenuates the negative effects of obesity on NCDs, but this appears more important for the consistently non-obese women. Department of Nutrition Universidade de São Paulo (USP) Department of Physical Education Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP) Department of Physiotherapy University of Maiduguri ICICT Fundação Oswaldo Cruz (Fiocruz) Exercise and Health Laboratory CIPER – Faculdade de Motricidade Humana Universidade de Lisboa Department of Physical Education Federal University of Sergipe - UFS Department of Physical Education Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP)

Physical activity (PA) has strong relevance for limiting the harms to human health and well-being due to the coronavirus disease-2019 (COVID-19) pandemic.1 Active muscles produce chemicals that improve immune functioning, which in turn reduces the extent of infections, and decreases inflammation, and these are the main causes of the lung damage from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PA is a powerful preventive and therapeutic intervention for the most common pre-existing chronic conditions that increase risk of severe COVID-19 infections and mortality.2,3 PA's effectiveness in preventing and treating anxiety and depression could have worldwide benefits during this stressful global crisis.2 PA enhances the efficacy of vaccines,4 so active lifestyles will continue to be relevant through every phase of the pandemic. Worldwide, about 23% of men and 32% of women are at risk for the underlying conditions of COVID-19, severe COVID-19 infections, and stress-related psychological symptoms, because they do not meet PA guidelines, based on self-report measures.5,6 It is likely that prolonged shelter-at-home measures will lead to reduced PA and increased sedentary behaviors that adversely affect immune function and enhance risk for chronic health conditions.7,8 Many people, especially with low incomes, do not have equipment, Internet access, or indoor space to make at-home PA realistic. Thus, the current pandemic is almost certain to exacerbate socioeconomic inequities in PA.9, 10, 11 The pandemic is changing the places where people can be physically active because many jurisdictions closed or restricted access to common indoor and outdoor places for PA.12, 13, 14 Though some jurisdictions allowed people to exercise outdoors on the streets, others did not, so for millions of people, being active at home was the only option. As limitations are eased, policies related to indoor and outdoor PA places vary across jurisdictions.15,16 If spikes occur in COVID-19 cases and deaths, movement restrictions may be put back in place. It is unknown how long this dynamic ebb and flow of limits on people's ability to be physically active will last and what the impact will be on PA. There are many unanswered questions about how pandemic-related policies in each jurisdiction are affecting PA. Therefore, it is important to identify the most pressing scientific questions that could be translated to policy and practice aimed at favorably impacting population health outcomes. There is ample evidence to justify making PA promotion a global public health priority during the coronavirus pandemic.1,17 One pathway to increasing the prominence of PA as a solution is to set a public health research agenda for promoting scientific studies to document any health and societal benefits during the COVID-19 pandemic, and to evaluate public health strategies for effectively promoting PA under crisis conditions. We consider research on PA and COVID-19 to be an urgent global public health need. Within this context, relevant PA research can span a broad range from basic science covering in vitro laboratory studies and human studies, to clinical studies with diagnosed patients, to public health studies focusing on prevention. Among the many research needs, the present paper focuses on studies with the potential to guide public health policy and practice, with a secondary focus on studies that could guide clinical practice. Our international author team has proposed priority areas for PA and public health research relevant to the COVID-19 pandemic. Although the current literature provides strong scientific premise for the public health relevance of PA for COVID-19,1,4,8 no research has specifically examined the impact of PA on SARS-CoV-2 infections or produced data directly related to the evaluation of infection control strategies that might impact PA. Evidence on these and other emergent topics is needed in a timely manner to inform PA policy and practice locally and internationally. The author team includes a senior researcher who has studied PA for decades (JFS) and 3 early-career investigators who bring research skills related to PA, the creativity of youth, and diverse geographic and cultural experience, having grown up in India (DA), Nigeria (AO), and Mexico (DS). We have interdisciplinary expertise in behavioral science, spatial epidemiology, urban health, physiotherapy, and health promotion. Our goal is to stimulate research studies that should be started now in multiple countries, especially among those countries most affected by the SARS-CoV-2 virus, to inform effective PA promotion strategies to be applied during the current pandemic, as well as to improve preparedness for future pandemics. Each author nominated study ideas, and consensus was reached on the highest priorities based on the need to conduct the study during the pandemic, direct relevance to practice or policy, and feasibility. The 7 research topics selected for inclusion in the present paper are just a few of those initially nominated by the authors. We encourage investigators to plan studies on the topics suggested here and identify additional questions related to PA and COVID-19 that deserve to be investigated. For each research topic below, we briefly explain the purpose of the study, though few methodological details are provided, on the assumption investigators will bring their own skills and creativity to each study. We provide a rationale for the importance of each topic and summarize the significance for policy or practice. We also highlight a few challenges likely to be encountered in conducting each type of study.

Made available in DSpace on 2020-12-12T01:26:07Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-05-01. Added 1 bitstream(s) on 2021-07-15T15:07:15Z : No. of bitstreams: 1 S1516-44462020000300245.pdf: 91288 bytes, checksum: 5cbdf28143b10d2de008776691352e62 (MD5) National Institute on Handicapped Research Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Objective: To analyze the association between severe mental illnesses and health behaviors among Brazilian adults. Methods: We used data from the Brazilian National Health Survey, a large nationally representative cross-sectional study conducted in 2013 among 60,202 adults (≥ 18 years). Clinical diagnoses (major depressive disorder, bipolar disorder and schizophrenia), lifestyle behaviors (leisure-time physical activity, TV viewing, tobacco use and the consumption of alcohol, sweets, and soft drinks) and potential confounders (chronological age, race, educational and employment status) were self-reported. Logistic regression models were used to examine the associations between severe mental illness and lifestyle behaviors, adjusting for confounders. Results: Schizophrenia (n=41) was associated with lower odds of physical activity (OR 0.08 [95%CI 0.01-0.58]). Major depressive disorder (n=4,014) was associated with higher odds of TV viewing (OR 1.34 [95%CI 1.12-1.61]), tobacco use (OR 1.37 (95%CI 1.18-1.58]), consumption of sweets (OR 1.34 (95%CI 1.15-1.55]) and consumption of soft drinks (OR 1.24 (95%CI 1.06-1.45]). There were no significant associations between bipolar disorder (n=47) and any lifestyle behaviors. Conclusions: Schizophrenia was associated with lower physical activity, while major depressive disorder was associated with increased TV viewing, tobacco use, and consumption of sweets and soft drinks. These findings reinforce the need for prevention and treatment interventions that focus on people with severe mental illness in Brazil. Departamento de Educac¸ão Física Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP) Department of Rehabilitation Sciences KU Leuven University of Leuven Department of Physiotherapy College of Medical Sciences University of Maiduguri Instituto de Comunicac¸ão e Informac¸ão Científica e Tecnológica em Saúde (ICICT) Fundac¸ão Oswaldo Cruz (Fiocruz) Department of Psychological Medicine Institute of Psychiatry Psychology and Neuroscience King’s College London South London and Maudsley NHS Foundation Trust Departamento de Educac¸ão Física Universidade Federal de Sergipe (UFS) Departamento de Educac¸ão Física Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP) FAPESP: 2017/27234-2

This study investigated whether physical activity (PA) influences the association between depression risk and low-grade inflammation. This was a cross-sectional study including 8,048 adults (18-59y). Depression symptoms were evaluated with the Beck depression inventory (BDI) and physical activity through the international physical activity questionnaire. Adults with infectious and inflammatory diseases were excluded. Blood samples were collected, including high sensitivity C-reactive protein (CRP), a marker of low-grade inflammation when ≥3mg/L. Additional measures of LDL-C, HDL-C, triglycerides and fasting glucose were also determined. Sex, chronological age, tobacco smoking, alcohol drinking, body mass index, dyslipidemia, high blood pressure and fasting glucose were used as covariates. Mediation models were conducted using the procedures of Karlson Holm Breen. Adults with elevated CRP (≥3mg/L) compared to those with low CRP (

Background There is currently a rapid physical activity transition taking place in developing countries that includes a decrease in active transportation. Building on findings from an earlier systematic review, this paper describes the development and convergent validity of self-administered child and parent questionnaires assessing active transportation of children in three African countries: Kenya, Mozambique and Nigeria. Methods A pilot study was conducted to examine the convergent validity of the developed questionnaires by comparing responses between children and their parents (N = 121; n = 43 for Mozambique, n = 24 for Kenya and n = 54 for Nigeria). After modification, the questionnaires were then administered to a larger convenient sample of both children and parents from Kenya (n = 1123), Mozambique (n = 1097) and Nigeria (n = 831) which defined the main study. The questionnaires assessed active transportation to/from 8 categories of destinations including school, friends’ and relatives’ home/houses, parks and playgrounds among others. Twenty items were used to assess child - and parent-perceived barriers to active transportation, and the parent questionnaire inquired about parent education and availability of cars, motorcycles, and bicycles. Spearman’s rho was used to compare children’s mode of travel in the pilot study while the prevalence-adjusted bias-adjusted kappa (PABAK) coefficient was used to compare convergent validity between children’s and parents responses on active transportation in the main study. Results Findings of the main study show that convergent validity for active transportation to and from each destination in the combined sample ranged from 0.472 (from school) to 0.998 (to other places). Convergent validity for challenges/barriers to active transportation to school ranged from fair (0.30 - The route does not have good lighting) to substantial (0.77 - My child has a disability). It varied between countries from fair (n = 11-items) to moderate (n = 9-items) agreement in Kenya and from poor (n = 2-items) to fair (n = 16-items) agreement in Nigeria. Data from Mozambique was however missing and therefore could be included. Conclusions The questionnaires provided valid information on the number of trips to/from various destinations and show acceptable and modest convergent validity for measuring barriers to active transport in a sample of children from three African countries. These questionnaires may be suitable for future research on active transport among school children in Sub-Saharan African countries. Electronic supplementary material The online version of this article (10.1186/s12889-018-5954-z) contains supplementary material, which is available to authorized users.

Our aim was to examine associations between depression and time spent in TV viewing in a representative sample of Brazilian adults.Data from the Brazilian National Health Survey (Pesquisa Nacional de Saúde - PNS in Portuguese) (n =60,202; ≥18 years) were used. Time spent TV viewing (h/day) was elicited via interview. Depression was evaluated through the Patient Health Questionnaire-9. Chronological age, educational status, employment status, alcohol use, tobacco smoking and body mass index were covariates. Descriptive statistics (mean and 95% confidence interval) and adjusted logistic regression models were applied.Five or more hours as well as less than 1 h of TV viewing was associated with increased depression (men:1 h OR = 1.89, 95%CI = 1.40-2.54; ≥5 h OR = 2.69, 95%CI = 1.88-3.83; women:1 h OR = 1.50, 95%CI = 1.25-1.81; ≥5 h OR = 1.65, 95%CI = 1.35-2.03) when compared to 2-2.99 h of TV viewing.More than 5 h/day seems to be associated with a higher risk for depression among Brazilian adults (except for older adults). Less than 1 h TV viewing might be a measure-of-proxy for a lower socio-economic status, which is a known risk factor for depression.

Background: This study aims to describe the regional prevalence and patterns of physical activity (PA) and sedentary behavior among Brazilian adolescents. Methods: Data from the Brazilian Scholar Health Survey, a nationally representative survey of ninth-grade adolescents [mean age: 14.29 y (14.27–14.29)] conducted in 2015 (n = 101,445), were used. Outcomes were television viewing, sitting time (ST), total PA, and active traveling collected via self-administered questionnaire. Information on frequency of physical education classes and type of school was collected from the school’s director. Frequencies with 95% confidence intervals were used to determine the prevalence and patterns of outcomes. Results: Higher prevalence of PA (≥300 min/wk) and ST (>4 h/d) was found in Midwest (PA = 38.0%; ST = 44.5%), South (PA = 37.6%; ST = 50.1%), and Southeast (PA = 36.1%; ST = 49.3%) compared with Northeast (PA = 29.7%; ST = 36.9%) and North (PA = 34.4%; ST = 34.8%) regions of Brazil. ST was higher among adolescents from private schools (51.5%) than public schools (42.9%), whereas active traveling was greater among students of public schools than private schools (62.0% vs 34.4%). Most inequalities in outcomes between capital and interior cities were in the poorest regions. Conclusions: The results indicate that national plans targeting regional inequalities are needed to improve PA and to reduce sedentary behavior among Brazilian adolescents.

With relatively few exceptions, the majority of evidence concerning the health benefits of physical activity (PA) has been gleaned from high-income countries (HICs).1 In the opening editorial to this special issue,2 the editors suggest that under-representation of lower and middle-income countries (LMICs, often referred to as ‘Global South’) in the PA literature is more than ‘just another research gap’. Arguably, this gap reflects very real differences in context, competing health and developmental priorities, available resources and undoubtedly, political will. Juxtaposed against the clear benefits of PA, most LMICs are characterised by the coexistence of both non-communicable and infectious chronic diseases, such as tuberculosis and HIV/AIDS.3 Obesity often coexists with maternal and childhood undernutrition and household food insecurity and health disparities have been exacerabated by the COVID-19 crisis. Political circumstances are often adverse, with many LMICs experiencing conflict, humanitarian crises, and/or social unrest and embedded inequalities (eg, the legacy of apartheid in South Africa). Lack of safety from crime and traffic, poorly designed and often overcrowded urban environments, low prioritisation of physical education in schools, and inequitable distribution of green space, are endemic to most LMICs.4 5 Thus, PA, even for transport, is difficult at best, and largely undertaken by necessity rather than by choice. Meanwhile, recreational PA is inaccessible for most in these settings.6 As such, and with rapid urbanisation in LMICs, often into poverty,7 we are required to view PA through the ‘lens’ of equity. This demands us to elevate the discussion for PA above health, and frame it as a …

Background:The Nigerian Report card on Physical Activity (PA) in Children and Youth was first developed in 2013 to inform practice and policy on healthy living and prevention of noncommunicable diseases among Nigerian children and youth. This article summarizes the results of the 2016 report card and provides updated evidence on the current situation in Nigeria.Methods:A comprehensive review of literature was undertaken by the Report Card Working Group. Grades were assigned to 10 PA indicators based on the criteria used for the 2013 edition.Results:Grades assigned to the indicators were Overall PA, D; Active Play and Leisure, C; Active Transportation, B; Sedentary Behaviors (screen-based, F and nonscreen-based, D); Overweight and Obesity, A; PA in Schools, C-; Government/Nongovernment Organizations/Private Sector/Policy, B. The following indicators were graded as Incomplete: Organized Sport and PA, Community and Built Environment, and Family and Peers.Conclusions:The overall PA levels of Nigerian children and youth seemed to be declining compared with the 2013 Report card but with slight improvement in active play and leisure, and PA in school settings. A substantial number of Nigerian children and youth still have high sedentary behaviors, overweight and obesity. Efforts are needed to promote PA among them.