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Hypertension which impacts over 1.5 billion people globally is a crucial health challenge accountable for more than 10.8 million early deaths yearly. Our study used an experimental design to investigate the effects of aerobic dance programme on diastolic blood pressure levels in stage one hypertensive adults over a 12-week period. The study participants were randomly allocated into either the experimental or control groups. Diastolic blood pressure measurements were collected using a mercury sphygmomanometer at baseline and post programme. The 12-week aerobic dance programme entailed three 45-minute sessions per week, at a moderate intensity. The paired samples t-test was used to compare mean differences within the groups with the significance level set at P

A fatality is the most detrimental incident that can occur in mountaineering. It is important to study previous cases and learn from circumstances surrounding fatal incidences in programmes sharing some common elements. This paper is set to investigate the occurrences of fatal incidences in mountaineering, the case of Mt. Kenya. It captures the qualitative findings on fatality occurrences. Respondents consisted of porters, guides, instructors, facilitators and key stakeholders involved in outdoor adventure activities on Mt. Kenya. The study used snowballing approach to identify the participants. Focus group discussions involving 52 respondents were conducted, in-depth interviews took place with four key informants and additional records were sought through desk reviews. The study found out that occurrence of fatalities was not well documented in a structured database. Deep grieving and regrets were noted. Predisposing factors leading to fatalities during mountaineering included; The “I MUST summit mentality”, lack of proper acclimatization, lack of visitor education, and lack of early diagnosis of altitude sicknesses. With the inherent risks and dangers that lead to fatalities in the mountaineering industry, the study recommends the need for providers to be keen on risk assessment and management as well as develop response strategies for various eventualities.

Introduction: Mountaineering activities have potential risks for injuries and illnesses. Extreme weather conditions, high altitude, limited resources and accessibility to transport and definitive medical services calls for mountaineering practitioners to be well prepared through training and certification in first responder care. This is useful in cases when they have an injured climber and need to offer support in the tier-one emergency system care before accessing further care in a medical facility. The study sought to establish the first responder care training status of mountaineering practitioners and the associations of mountaineering practitioners’ first responder care training levels and gender, age, years of work experience, and designation. Methods: The study used cross-sectional analytical research design with a purposive sample of one hundred and thirty six (136) mountaineering practitioners in East Africa. Snowball sampling procedure was used to identify the respondents since there were no records indicating the population size or specific location of these mountaineering practitioners. A self-administrated questionnaire was used to collect data on whether they were trained or not; status of their up-to-date certification; institutions where they did their training and recertification; and their training levels in first responder care, which would cover the aim of the study. Results: Majority of mountaineering practitioners (91.2%) had received some form of training. However, 47.1% had received training in basic first aid, which did not involve mountain related components. Outdoor practitioners’ up-to-date training was dependent on their age (p = 0.005), and years of work experience (p= 0.014). Discussion: There is need for mountaineering practitioners to have standardized minimum training in wilderness specific first responder care. The study recommends that the training and recertification should be undertaken on a regular basis by the mountaineering practitioners in East Africa.

Abstract Background Existing sedentary behaviour guidelines for children and youth target overall sedentary behaviour and recreational screen time, without any specific recommendations regarding school-related sedentary behaviours (i.e., sedentary behaviours performed during the school day, or within the influence of school). The purpose of this paper is to describe the development of international evidence-based recommendations for school-related sedentary behaviours for children and youth, led by the Sedentary Behaviour Research Network (SBRN). Methods A panel of international experts was convened by SBRN in November 2020 to guide the development of these recommendations for children and youth aged ~ 5–18 years. The recommendations were informed by 1) age-relevant existing sedentary behaviour guidelines, 2) published research on the relationship between overall sedentary behaviour and health, 3) a de novo systematic review on the relationship between school-related sedentary behaviours and health and/or academic outcomes, and 4) a de novo environmental scan of the grey literature to identify existing recommendations for school-related sedentary behaviours. Draft recommendations were presented to the Expert Panel in June 2021. Following thorough discussion and modifications, updated recommendations were distributed for stakeholder feedback from July 9–26. Feedback was received from 148 stakeholders across 23 countries, leading to additional updates to the recommendations. Following further rounds of discussion and updates with the Expert Panel in August and September 2021, consensus was achieved on the final recommendations. Results A healthy day includes breaking up extended periods of sedentary behaviour and incorporating different types of movement into homework whenever possible, while limiting sedentary homework. School-related screen time should be meaningful, mentally or physically active, and serve a specific pedagogical purpose that enhances learning. Replacing sedentary learning activities with movement-based learning activities, and replacing screen-based learning activities with non-screen-based learning activities, can further support students’ health and wellbeing. Discussion This paper presents the first evidence-based recommendations for school-related sedentary behaviours for children and youth. These recommendations will support the work of parents, caregivers, educators, school system administrators, policy makers, researchers and healthcare providers interested in promoting student health and academic success.

Abstract Background The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5–18 years) attending school. Methods This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results. Results Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries. Conclusions Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.

Introduction: The enjoyment of nature and other benefits of outdoor activities happen amid inherent hazards. This calls for knowledge and competency in emergency and risk management. Practitioners in outdoor activities, such as mountaineering, thus need to be knowledgeable on how to manage risks and attend to emergencies in their practice. The study sought to establish the preparedness of East African mountaineering practitioners in prehospital emergency and risk management. It sought to establish their knowledge on prehospital emergency and risk management, based on their age, gender, level of education and refresher training. Methods: The study purposively sampled one hundred and thirty six (N = 136) outdoor adventure practitioners from the Afro-alpine mountain areas in East Africa. It was hypothesized that there would be no significant relationship between the outdoor practitioners' knowledge in prehospital emergency risk management and their age, gender, level of education, refresher training. Somers' d was used to test the hypotheses. Results: It was established that the knowledge scores of prehospital emergency and risk management for the mountaineering practitioners was low. It was also established that the knowledge scores of outdoor practitioners were not dependent on their age, gender, and work experience. However, there was a significant relationship between the outdoor adventure practitioners' knowledge scores and their highest level of education as well as refresher training. Conclusions: The study concluded that there were gaps in the knowledge of prehospital risk management of the East African Afro-alpine mountaineering practitioners. It recommends frequent and regular training and re-certification among outdoor adventure practitioners in order to raise the knowledge in prehospital emergency risk management.

Background Physical 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. Purpose This 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. Methods 3,205 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. Results Participants 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 (pConclusions Majority 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.

BackgroundLike many countries in sub-Saharan Africa, Kenya has experienced rapid urbanization in recent years. Despite the distinct socioeconomic and environmental differences, few studies have examined the adherence to movement guidelines in urban and rural areas. This cross-sectional study aimed at examining compliance to the 24-hour movement guidelines and their correlates among children from urban and rural Kenya.MethodChildren (n = 539) aged 11.1 ± 0.8 years (52% female) were recruited from 8 urban and 8 rural private and public schools in Kenya. Physical activity (PA) and sleep duration were estimated using 24-h raw data from wrist-worn accelerometers. Screen time (ST) and potential correlates were self- reported. Multi-level logistic regression was applied to identify correlates of adherence to combined and individual movement guidelines.ResultsCompliance with the combined movement guidelines was low overall (7%), and higher among rural (10%) than urban (5%) children. Seventy-six percent of rural children met the individual PA guidelines compared to 60% urban children while more rural children also met sleep guidelines (27% vs 14%). The odds of meeting the combined movement guidelines reduced with age (OR = 0.55, 95% CI = 0.35-0.87, p = 0.01), was greater among those who could swim (OR = 3.27, 95% CI = 1.09-9.83, p = 0.04), and among those who did not engage in ST before school (OR = 4.40, 95% CI = 1.81-10.68, pConclusionsPrevalence of meeting movement guidelines among Kenyan children is low and of greatest concern in urban areas. Several correlates were identified, particularly influential were features of the school day, School is thus a significant setting to promote a healthy balance between sleep, sedentary time, and PA.

Background: Physical fitness in childhood and adolescence is associated with a variety of health outcomes and is a powerful marker of current and future health. However, inconsistencies in tests and protocols limit international monitoring and surveillance. The objective of the study was to seek international consensus on a proposed, evidence-informed, Youth Fitness International Test (YFIT) battery and protocols for health monitoring and surveillance in children and adolescents aged 6–18 years. Methods: We conducted an international modified Delphi study to evaluate the level of agreement with a proposed, evidence-based, YFIT of core health-related fitness tests and protocols to be used worldwide in 6- to 18-year-olds. This proposal was based on previous European and North American projects that systematically reviewed the existing evidence to identify the most valid, reliable, health-related, safe, and feasible fitness tests to be used in children and adolescents aged 6–18 years. We designed a single-panel modified Delphi study and invited 216 experts from all around the world to answer this Delphi survey, of whom one-third are from low-to-middle income countries and one-third are women. Four experts were involved in the piloting of the survey and did not participate in the main Delphi study to avoid bias. We pre-defined an agreement of ≥80% among the expert participants to achieve consensus. Results: We obtained a high response rate (78%) with a total of 169 fitness experts from 50 countries and territories, including 63 women and 61 experts from low- or middle-income countries/territories. Consensus (>85% agreement) was achieved for all proposed tests and protocols, supporting the YFIT battery, which includes weight and height (to compute body mass index as a proxy of body size/composition), the 20-m shuttle run (cardiorespiratory fitness), handgrip strength, and standing long jump (muscular fitness). Conclusion: This study contributes to standardizing fitness tests and protocols used for research, monitoring, and surveillance across the world, which will allow for future data pooling and the development of international and regional sex- and age-specific reference values, health-related cut-points, and a global picture of fitness among children and adolescents.

The prevalence of non-communicable diseases is increasing in lower-middle-income countries as these countries transition to unhealthy lifestyles. The transition is mostly predominant in urban areas. We assessed the association between wealth and obesity in two sub-counties in Nairobi City County, Kenya, in the context of family and poverty. This cross-sectional study was conducted among of 9-14 years old pre-adolescents and their guardians living in low- (Embakasi) and middle-income (Langata) sub-counties. The sociodemographic characteristics were collected using a validated questionnaire. Weight, height, mid-upper arm circumference, and waist circumference were measured using standard approved protocols. Socioeconomic characteristics of the residential sites were accessed using Wealth Index, created by using Principal Component Analysis. Statistical analyses were done by analysis of variance (continuous variables, comparison of areas) and with logistic and linear regression models.A total of 149 households, response rate of 93%, participated, 72 from Embakasi and 77 from Langata. Most of the participants residing in Embakasi belonged to the lower income and education groups whereas participants residing in Langata belonged to the higher income and education groups. About 30% of the pre-adolescent participants in Langata were overweight, compared to 6% in Embakasi (p