Stress and coping among elderly during the COVID-19 pandemic in Sulaimanya city in Kurdistan region of Iraq

This study aimed to find out the level of stress and coping methods among elderly in Sulaimanya city during the pandemic COVID-19. Through the snowballing sampling method, 394 elders were included to this study. After validation, two scales were used in this study;stress subscale from Depression, Anxiety and Stress Scale (DASS-21) and a culture-bound scale for determining coping methods. The results of this study showed that participants experienced a mild level of stress. Male participants, elders who live with their family, unvaccinated elders, physically passive elders have had higher stress level than female, elderly home, vaccinated, physical active elders. The findings also indicated that spiritual connection was the most common coping method used by the sample. Results of this study are the first and foremost way to share elder's unexpressed messages;it also can be a way for verbalizing their unspoken feelings. These results may also inform the elder's caregivers that elder's stress level and illness anxiety was not very high, strengthening their social support and spiritual connection may help them to reduce their distress into a lesser degree.

Changes in sexual thoughts and behaviors in a clinical sample of child sexual abuse material users under the COVID-19 pandemic

LAY SUMMARYUsers of child sexual abuse material were interviewed about changes in their daily lives as well as sexual thoughts and behaviors during the COVID-19 restrictions. The changes found, such as in general mental health and sexual urges, can increase the risk for sexual offending and are therefore important to consider regarding possible future lockdowns. In this article, we describe a qualitative study in which we examined perceived effects of the COVID-19 pandemic on help-seeking individuals who access child sexual abuse material (CSAM, legally referred to as child pornography). The study recruited 18 participants who were part of the internet based Prevent It Cognitive Behavior Therapy (CBT) clinical trial, which aims to reduce CSAM use and child exploitation, and were willing to answer questions during a semi-structured interview about the perceived impact of the pandemic restrictions on their lives, including their sexual thoughts and behaviors. Key themes that were identified from the participants' answers included changes in day-to-day life, mental health, sexual thoughts, behaviors or urges, responses and coping strategies used to deal with sexual urges, changes on the forums, positive changes, and how they could best be assisted with coping in this situation. Our qualitative analysis also suggested that the pandemic affected urges to use CSAM, therefore potentially increasing the risk of online sexual offending. These results support that there is a need to investigate this potential negative side effect of quarantines or lockdowns before future pandemics.

Association of health behaviors with mental health problems in adolescents during COVID-19

Aim: Adolescents have experienced disruption in their daily routines, including changes in health behaviors such as an increased sedentary behavior and increased smartphone usage. The aim of this study was to assess the association of health behaviors with mental health problems. Method(s): Five cross-sectional surveys (February 2021 to May 2022) were performed during the pandemic assessing physical activity, smartphone usage, depressive symptoms (Patient Health Questionaire-9 (PHQ-9)), anxiety symptoms (Generalized Anxiety Disorder Scale 7 (GAD-7)), sleep quality (Insomnia Severity Index 7 (ISI-7)), and stress (Perceived Stress Scale 10 (PSS-10)). In total, N = 7201 adolescents (age: 14-20 years ((MW +/- SD): 16.63 +/- 1.49 years);70.2% female, 18.8% migration background) participated. Result(s): A strong increase in mobile phone usage as well as a decrease in physical activity as compared to pre-pandemic data were observed (p < 0.001). Compared to the lowest smartphone user group (<1 h/d), the adjusted odds ratios (aOR) for depressive symptoms increased with increasing smartphone usage to 1.98 (3-4 h/d), 3.30 (5-6 h/d), 4.96 (7-8 h/d), and 6.79 (>8 h/d). High utilizers (>8 h/d) were also more likely to experience clinically relevant anxiety, insomnia, or stress symptoms (aORs 3.23-5.75) compared to those using the smartphone less than 1 h/d. Conclusion(s): Results highlight the need for measures to promote responsible smartphone usage as well as to increase physical activity, so as to promote mental health in adolescence.Copyright © 2023

Correlation between physical activity practice and mortality from COVID-19: an ecological study

Background and objective: new population-level studies are needed to better assess the relationship between physical inactivity and mortality from COVID-19. The aim of the study was to evaluate the correlation between population prevalence of physical activity and standardized mortality rates by COVID-19 in Brazilian capital cities and the Federal District. Methods: this is an ecological study, whose analysis is secondary. The prevalence of physical inactivity, insufficient physical activity, and physical activity during free time was obtained from the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey 2019 (VIGITEL), according to minutes spent on leisure, commuting, and household activities. The COVID-19 mortality data was obtained from the Influenza Epidemiological Surveillance Information System (SIVEP-Gripe), adding the accumulated deaths until December 31, 2020. The resident population was estimated from the Instituto Brasileiro de Geografia e Estatistica (IBGE) for the year 2020. Pearson Correlation evaluated the correlation between the prevalence of different physical activity practices and the standardized mortality rate from COVID-19, in total, and according to age groups. Results: there was a significant positive correlation (r = 0.420;p = 0.029) between the overall prevalence of insufficient physical activity and the standardized COVID-19 mortality rate. No correlation was observed between the other prevalence of physical activity and the standardized mortality rate from COVID-19. Conclusion: there was a correlation between insufficient levels of physical activity and the standardized mortality rate from COVID-19 in people living in Brazilian capital cities.

Herders Mobility, Food Security and Covid-19 Pandemic Challenges during Lockdown in Nigeria

Climate change is one of the cores of the herders' movement in Nigeria. Some other variable is the classification of the Fulanis as indigenous peoples that have no specific abode of their own;they roam around looking for water and foliage for their animals. During the dry season, they move towards the southern part of Nigeria where they would find foliage and water for their animals because of their status under international law. A notion that in a bid to look for food for their animals, these herders sometimes feed their animals with grown corn, cassava, millet, sweet potato and even yam of the sedentary farmers. One of the geneses of food insecurity in many communities of the southern part of Nigeria. Food availability, affordability and accessibility in the country was compromised in 2020 due to these challenges by the urban dwellers which was compromised due to the activities of mobile herders. With general lockdown in Nigeria, many farmers were unable to go to farm while the Fulanis who were hardly affected by lockdown had their field-days in feeding their animals on crops planted by small scale farmers, the only source of food security in the country. The core of this paper is to interrogate Fulanis mobility as indigenous peoples based on relevant international law and its impact on small-scale farmers' sources of income and food availability for the teeming population of Nigeria. We contextualised this based on the COVID-19 pandemic that restricts the movement of people between March and December 2020. We conclude that the rights of the indigenous peoples at the domestic level need further interrogation to create an atmosphere of peaceful co-existence through aversion of herders-farmers clashes that envelope southern Nigeria.

Effect produced by physical activity and inactivity during covid-19 according to physical education pedagogy students

During the last years, physical activity and physical education classes in all age groups have been affected by the Sars-Cov-2 pandemic. The objective of this research was to reveal the perceptions about the effect that physical activity produces during COVID-19 according to the discourse of students of the Physical Education Pedagogy career of the Autonomous University of Chile, Temuco campus. The method was qualitative with a case study design, where the participants were 21 Physical Education Pedagogy students. The information collection instrument was the semi-structured interview and the grounded theory was used for its analysis. It is concluded that COVID 19 increased a very high level of physical inactivity in people, which translates into a decrease in energy expenditure, a high level of stress, anxiety, which were caused by the isolation that occurred at some point. © Copyright: Federación Española de Asociaciones de Docentes de Educación Física (FEADEF).

Special Issue: The relationship between nutrition and COVID-19. (Special Issue: The relationship between nutrition and COVID-19.)

This special issue contains 8 articles that discuss and highlights the importance of nutrition in mitigating the mental and health-related issues associated with the pandemic, as well as its effects on diet quality and physical activity levels. Topics include: (1) a systematic literature review that emphasizes the role of nutrition in minimizing mental and health-related issues during COVID-19. The review concludes that a healthy diet rich in essential nutrients can play a crucial role in supporting mental health, immune function and overall well-being during the pandemic. In addition, it highlights the need for public health interventions that promote healthy eating habits and provide access to nutritious foods, (2) adherence to the Mediterranean diet in Greek adolescents during COVID-19, (3) a randomized, double-blind, placebo-controlled clinical trial investigated the effect of synbiotics on inflammatory markers and white blood cell count in COVID-19 patients, (4) COVID-19 pandemic anxiety was reflected in nutritional habits in adults, (5) investigation of the link between metabolic risks, dietary patterns and COVID-19 prognosis, (6) exploration of the factors related to sedentary lifestyle in a Brazilian sample during the COVID-19 initial quarantine.

Time trends and COVID-19 post-pandemic changes in physical activity and sedentary behavior prevalence among Brazilian adults between 2006 and 2021 / Tendências temporais e mudanças pós-pandemia de COVID-19 na prevalência de atividade física e comportamento sedentário em adultos brasileiros entre 2006 e 2021

ABSTRACT Objective: To analyze time trends and prevalence of physical activity and sedentary behavior among adults of Brazilian capitals between 2006 and 2021, including the pandemic period. Methods: This is a time-series of cross-sectional surveys based on the National Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey. Trends of sufficient leisure-time physical activity, sufficient physical activity while commuting, insufficient practice of physical activity, and total screen time were estimated by using Prais-Winsten regression. Annual prevalences and time trends were estimated for each indicator by sex, age group and education. Results: For total population, significant time trends were found for leisure-time physical activity (β=0.614) and total screen time (β=1.319). As for prevalence, leisure-time physical activity increased from 29% in 2009 to 39% in 2019, followed by a reduction of 2.3% between 2020 and 2021. Total screen time prevalence increased considerably between 2019 and 2020 (4.7%). Though physical inactivity tended to reduce along the series, its prevalence increased by 3.4% between 2019 and 2021, as well as physical activity while commuting decreased by 3,7% in the same time period. Conclusion: Whereas leisure-time physical activity increased over the years, it is uncertain whether this trend will be the same in the years following COVID-19. Not only did people alter their leisure-time habits, but also there was an increasing dominance of screen time due to the change in work and social patterns. More strategies need to be addressed to tackle physical inactivity and sedentary behavior, and to review the post-pandemic national targets.

RESUMO Objetivo: Analisar as tendências temporais e a prevalência dos indicadores de atividade física e comportamento sedentário em adultos das capitais brasileiras entre 2006 e 2021, incluindo o período de pandemia. Métodos: Trata-se de estudo de série temporal de inquéritos transversais baseado no Sistema de Vigilância Telefônica de Doenças Crônicas. As tendências de atividade física suficiente no lazer, atividade física suficiente no deslocamento, prática insuficiente de atividade física e tempo total de tela foram estimadas por meio da regressão de Prais-Winsten. As tendências temporais e as prevalências anuais foram calculadas por sexo, faixa etária e escolaridade. Resultados: Na população total, foram encontradas tendências temporais significativas para atividade física suficiente no lazer (β=0,614) e tempo total de tela (β=1,319). Quanto à prevalência, a atividade física suficiente no lazer aumentou de 29% em 2009 para 39% em 2019, seguida de redução de 2,3% entre 2020 e 2021. A prevalência do tempo total de tela aumentou consideravelmente entre 2019 e 2020 (4,7%). Embora a inatividade física tendesse a diminuir ao longo da série, sua prevalência aumentou 3,4% entre 2019 e 2021, assim como a atividade física no deslocamento diminuiu 3,7% no mesmo período. Conclusão: Enquanto a atividade física suficiente no lazer aumentou ao longo dos anos, é incerto se essa tendência se manterá nos anos seguintes à COVID-19. Não apenas as pessoas alteraram seus hábitos de lazer, mas também há um domínio crescente do tempo de tela em razão da mudança nos padrões sociais e de trabalho. Mais estratégias precisam ser abordadas para o enfrentamento da inatividade física, do comportamento sedentário e para a revisão das metas nacionais pós-pandemia.

The impact of the covid-19 pandemic on lifestyle behaviors in U.S. college students.

OBJECTIVE: To investigate COVID-19's impact on college student health behaviors. PARTICIPANTS: 189 college students. METHODS: Participants completed an online survey on behaviors relating to sleep, sedentary activities, and physical activity before and during the COVID-19 pandemic. Comparisons utilized Students' dependent t-test or Wilcoxon signed-rank tests. RESULTS: There was an increase in time to fall asleep (before: 23.4 ± 18.0 vs. during: 42.8 ± 44.3 min·day-1, p < 0.001), time spent in bed (before: 7.8 ± 1.5 vs. during: 8.5 ± 1.5 hr·day-1, p < 0.001), as well as shifts in later bed and awake time (p < 0.001). Total sedentary time increased during the pandemic (before: 9.0 ± 3.8 vs. during: 9.9 ± 4.1 hr·day-1, p = 0.016); and time spent using a TV, computer, or phone (before: 3.1 ± 1.9 vs. during: 4.2 ± 2.3 hr·day-1, p < 0.001). There was a significant decrease in moderate-vigorous activity (before: 123.8 ± 96.0 vs. during: 108.9 ± 75.5 min·week-1, p = 0.028) and resistance training days (before: 2.4 ± 2.1 vs. during: 1.7 ± 2.1 days·week-1, p < 0.001). CONCLUSIONS: COVID-19 negatively influenced health behaviors in college students.

Sedentary behavior is associated with poor sleep quality during the COVID-19 pandemic, and physical activity mitigates its adverse effects.

BACKGROUND: We aimed to evaluate the association of sedentary behavior (SB) and moderate to vigorous leisure-time physical activity (MVPA) with sleep quality during the COVID-19 pandemic. METHODS: Cross-sectional, population-based study in adults, conducted from October to December 2020 in the Iron Quadrangle region, Brazil. The outcome was sleep quality, evaluated with the Pittsburgh Sleep Quality Index. SB was assessed by self-report of total sitting time, before and during the pandemic. Individuals with ≥ 9 h of total sitting time were classified as SB. In addition, the ratio of time spent in MVPA to time in SB was analyzed. A contrasted directed acyclic graph (DAG) model was constructed to adjust logistic regression models. RESULTS: A total of 1629 individuals were evaluated, the prevalence of SB before the pandemic was 11.3% (95%CI: 8.6-14.8), and during the pandemic 15.2% (95%CI: 12.1-18.9). In multivariate analysis, the chance of poor sleep quality was 77% higher in subjects with SB ≥ 9 h per day (OR: 1.77; 95% CI: 1.02-2.97). Furthermore, a one-hour increase in SB during the pandemic, increased the chance of poor sleep quality by 8% (OR: 1.08; 95%CI 1.01-1.15). In the analysis of the ratio of MVPA per SB in individuals with SB ≥ 9 h, practicing 1 min of MVPA per hour of SB reduces the chance of poor sleep quality by 19% (OR: 0.84; 95%CI: 0.73-0.98). CONCLUSION: SB during the pandemic was a factor associated with poor sleep quality, and the practice of MVPA can reduce the effects of SB.

The impact of the COVID-19 pandemic on inequalities in lifestyle behaviours and mental health and wellbeing of elementary school children in northern Canada.

Objectives: The COVID-19 pandemic has negatively affected children's lifestyle behaviours and mental health and wellbeing, and concerns have been raised that COVID-19 has also increased health inequalities. No study to date has quantified the impact of COVID-19 on health inequalities among children. We compared pre-pandemic vs. post-lockdown inequalities in lifestyle behaviours and mental health and wellbeing among children living in rural and remote northern communities. Methods: We surveyed 473 grade 4-6 students (9-12 years of age) from 11 schools in rural and remote communities in northern Canada in 2018 (pre-pandemic), and 443 grade 4-6 students from the same schools in 2020 (post-lockdown). The surveys included questions on sedentary behaviours, physical activity, dietary intake, and mental health and wellbeing. We measured inequality in these behaviors using the Gini coefficient, a unitless measure ranging from 0 to 1 with a higher value indicating greater inequality. We used temporal changes (2020 vs. 2018) in Gini coefficients to assess the impact of COVID-19 on inequalities in lifestyle behaviours and mental health and wellbeing separately among girls and boys. Results: Inequalities in all examined lifestyle behaviours increased between 2018 and 2020. Inequalities in watching TV, playing video games, and using a cell phone increased among girls, while inequalities in playing video games, using computers and tablets, and consumption of sugar, salt, saturated fat and total fat increased among boys. Changes in inequalities in mental health and wellbeing were small and not statistically significant. Conclusion: The findings suggest that the COVID-19 pandemic has exacerbated inequalities in lifestyle behaviours among children living in rural and remote northern communities. If not addressed, these differences may translate into exacerbated inequalities in future health. The findings further suggest that school health programs can help mitigate the negative impact of the pandemic on lifestyle behaviours and mental health and wellbeing.

Discrepancies Between Self-reported and Objectively Measured Smartphone Screen Time: Before and During Lockdown.

Screen time shows higher health risks compared to other types of sedentary behaviors. A lockdown may simultaneously increase screen time, reduce physical activity (PA), and change time perception. Our goal was to compare self-reported against objectively measured smartphone screen time (SST) in a sample of active and inactive Portuguese adults before and during a social lockdown. This study was a cross-sectional analysis with 211 Portuguese adults (57.8% males), aged 25.2 ± 8.5 years, from two cohorts, one before the social lockdown and the other during the lockdown. SST was self-reported (SR-SST) and objectively measured using a smartphone (OM-SST). PA was self-reported. Linear regressions were performed to determine the association between SR-SST and OM-SST. A Bland and Altman analysis was used to assess agreement. Independent T-tests were performed for comparisons between cohorts and paired sample T-tests for comparisons within each cohort. The cohort assessed during the lockdown showed a higher SST than the cohort assessed before the lockdown (OM-SST; p < 0.001 and SR-SST; p = 0.009). Before the lockdown, there was no difference between SR-SST and OM-SST (p = 0.100). However, during the social lockdown, although the agreement between SR-SST and OM-SST was good (ICC = 0.72), participants systematically underestimated their SST by ~ 71 min/day (p < 0.001), and this underestimation was higher in inactive participants (~ 85 min/day) than in active individuals (~ 49 min/day). The general population needs to be aware of the benefits of limiting screen time, especially during periods of societal modifications, such as a generalized lockdown. There was a tendency to underestimate SST, meaning a lack of awareness of the actual time spent in this potentially deleterious behavior. This underestimation was more pronounced during the lockdown period and for the inactive participants, thus posing a greater health risk. The findings from this investigation entail relevant information for policy makers to delineate strategies for reducing population screen time from a preventive health perspective.

Parents' Perceptions of Changes in Sleep Duration, Physical Activity, and Sedentary Behavior in Arab Israeli Children during the COVID-19 Outbreak.

The COVID-19 pandemic led many countries to apply lockdown measures that could prevent children from achieving the physical activity, sedentary behavior, and sleep levels suggested for their psychophysical health. The current study tested changes in physical activity, sedentary behavior, and sleep length of children and the incidence of achieving the 24 h movement standards through the limitations of COVID-19. A total of 490 Arab Israeli parents were surveyed. An electronic cross-sectional survey was performed, including questions addressing engagement in physical activities, use of screens, and sleep duration. Throughout the COVID-19 outbreak, time spent participating in physical activity was reduced, sedentary behavior and sleep duration were increased, and the percentage of the sample who met the physical activity and sedentary behavior suggestions lessened. The percentage of participants who attained the overall 24 h movement recommendations was very low during the pandemic; school children met the guideline recommendations for physical activity and sleep duration more than preschool children, and girls spent more time in physical activity. These findings highlight the need for strategies to enhance physical activity and decrease sedentary behavior in children to prevent long-term effects of limitations imposed by COVID-19. Efforts to perceive and encourage healthy routines in Arab Israeli children in the case of pandemic limitations are expected to serve as a precedence.

Changes in physical activity, sedentary behavior, and self-reported cognitive function in cancer survivors before and during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Physical activity (PA) and reductions in sedentary behavior (SED) may mitigate cancer-related cognitive impairment. The purpose of this study was to examine (a) the associations between changes in PA, SED, and cognitive function in cancer survivors before and during the coronavirus disease 2019 (COVID-19) pandemic; and (b) clinical subgroups that moderate this association. METHODS: A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020. This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic. Self-reported Questionnaires assessed moderate-to-vigorous PA (MVPA) using the modified Godin Leisure Time Exercise Questionnaire, cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale, and SED using the Domain-specific Sitting Time questionnaire. Cancer survivors were classified into no change in behavior, desirable change (i.e., increase MVPA to meet PA guidelines or decrease SED by ≥60 min/day), and undesirable change (i.e., decrease MVPA to <150 min/week or increase SED by ≥60 min/day). Analysis of covariance examined differences in FACT-Cog scores across the activity change categories. Planned contrasts compared differences in FACT-Cog scores between cancer survivors with (a) no meaningful change vs. any change, and (b) a desirable change vs. an undesirable change. RESULTS: There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors (n = 371; age = 48.6 ± 15.3 years (mean ± SD)). However, cancer survivors who were diagnosed ≥5 years ago (t(160) = -2.15, p = 0.03) or who received treatment ≥5 years ago (t(102) = -2.23, p = 0.03) and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change. CONCLUSION: PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.

Physical Activity and Nutrition Education Programs Changes Body Mass Index and Eating Habits of 12th Grade Students: An Intervention during the COVID-19 Pandemic

Background. The importance of physical activity (PA) for maintaining and improving health status increases with each passing day. Objectives. The present study aimed to examine the effects of PA and nutritional education programs applied to 12th-grade students on body mass index (BMI), PA level, and eating habits during the COVID-19 pandemic. Methods. One hundred fifty-nine 12th grade students were randomly assigned to the experimental group (EG) (n=87, 42 male and 45 female) and control group (CG) (n=72, 39 male and 33 female). At first, physical characteristics, PA level, and eating habit questionnaires were completed by students. Then, EG received a single session face-to-face PA and healthy nutrition-themed programs. After an 8-week follow-up, questionnaires were completed by students again. Also, the number of daily steps of EG was recorded during the 8-week follow-up. Differences between pre and post-BMI, PA level, and eating habits of the groups were analyzed using the mixed model ANOVA test. Results. Results showed that educational programs had a positive effect on BMI, PA level, and eating habits of EG (p<.05). There was no improvement in CG (p>0.05). Qualitative findings of EG revealed that the educational program is a beneficial process not only for a short period but also for a lifelong learning structure. Conclusion. In conclusion, PA and healthy nutrition-themed educations are effective methods to improve youths' awareness to be more active and healthier in their daily life, including during the pandemic processes.

Challenges and strategies to stay physically active in the face of COVID-19 pandemic: A review

The pandemic caused by the COVID-19 has influenced peoples' lifestyles. Home-confinement scenario might impair physical activity practice, resulting in new challenges for maintaining health during the pandemic of the COVID-19. The aim of this study was to present the current context of COVID-19 pandemic, its impact on the practice of physical activity, and the strategies available to remain active during home-confinement according to international recommendations. The narrative review was conducted based on studies that analyzed themes related to physical activity and COVID-19. Virtual Health Library (VHL), CINAHL, Cochrane, PsycINFO, PubMed, ScienceDirect, Scientific Electronic Library Online (SciELO), Scopus, SPORTDiscus, and Web of Science databases were searched for relevant papers. Although an increased number of experimental studies are still necessary, people should devote more time to physical activity during social isolation. Guidelines were adjusted by international entities in order to encourage people to remain active, through practice regular physical activity, using alternative strategies such as fitness program applications, exergames, online exercise classes, and even chores. Reduction of prolonged sedentary behavior could contribute to maintain health and improve quality of life during the COVID-19 pandemic.Copyright © Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado. All Rights Reserved.

Physical activity, sedentary behaviour and quality of life in children with autism: insights from Romania and Greece.

Background: The COVID-19 pandemic has accentuated sedentarism in children, including those with autism. Given the importance of the topic for long-term health, this study aimed to explore the post-pandemic relationship between physical activity, sedentary behaviours and quality of life (QOL) in children with autism from Romania and Greece. Methods: An online questionnaire collected information regarding physical activity levels in children and their parents, children's sedentary behaviours and QOL from 83 Romanian parents (m1age = 40.1; sd1age = 6.37) and 42 Greek parents (m2age = 39.5; sd2age = 5.45) between March and July 2022. Results: Most Greek children (95%) had 2 or 3 weekly hours of physical education at school/kindergarten, while only 64% of Romanian children had the same level of physical education. Romanian parents reported being more active (χ2weekdays= 33.7, df = 3, p < .001; (χ2leisure= 41.8, df = 2, p < .001) than the Greek counterparts. Contrary to expectations, the parents' physical activity did not correlate with the child's physical activity. Sedentary behaviour time was significantly higher in Greek than Romanian children during working days and the weekends. Sedentary behaviour during weekdays predicted the child' QOL. Conclusions: This exploratory study offers insight into Romanian and Greek children's patterns of physical and sedentary activities. The results stress the need to increase physical activity and decrease sedentary behaviours in children with autism from Romania and Greece. The practical implications and limits of this exploratory approach were further discussed.

Physical activity during COVID-19 lockdown: relationship with sedentary behaviour, health-related quality of life, loneliness, and sleep quality among a sample of Nigerian adults

COVID-19 lockdown, targeted at preventing the spread of coronavirus, had deleterious effects on physical and psychosocial health. This study examined the association between physical activity (PA), sedentary behaviour, health-related quality of life (HRQoL), loneliness and quality of sleep of 507 Nigerian adults during the COVID-19 lockdown. Five hundred and seven respondents (aged 18-67 years) from 12 States completed an online survey on RedCap. Questionnaires comprising the Stages of Change scale, Pittsburgh Sleep Quality Index, International Sedentary Assessment Tool, UCLA Loneliness Questionnaire, Short Form-12 Health Survey, and International Physical Activity Questionnaire were used. Respondents were categorised based on exercise behaviour as non-exercisers, non-regular exercisers, or regular exercisers;and based on age into 18-24, 25-34, 35-44 and > 44 years categories. Descriptive and inferential statistics were used to analyse the data. About 33.1% of respondents did not meet moderate-to-vigorous PA levels. The physical component of HRQoL was positively associated with total PA (p = 0.04). Among the non-exercisers, the odds of being regular exercisers during pre-COVID-19 lockdown were significantly higher for the 35-44 (odds ratio [OR] = 3.49;95% CI = 1.44, 8.48, p = 0.01) and > 44 years age groups (OR = 2.98;95% CI: 1.16, 7.62, p = 0.02) relative to 18-24 years age category. During COVID-19 lockdown, > 44 (OR = 3.65;95% CI: 1.47, 9.07, p = 0.005), 35-44 (OR = 6.42;95% CI 2.75, 14.96, p = 0.001) and 25-34 (OR = 2.35;95% CI: 1.15, 4.80, p = 0.02) years age categories had significant higher odds of being regular exercisers compared to the 18-24 years age group. There was a high rate of physical inactivity among Nigerian adults during the COVID-19 lockdown, which was directly influenced by the physical components of HRQoL. Older age was an independent predictor of exercise behaviour before and during the COVID-19 lockdown among Nigerian adults.

Providing choice in pulmonary rehabilitation

Introduction/Aim: Pulmonary rehabilitation (PR) is a vital component in the management of chronic respiratory disorders (CRDs). New models of delivering PR are emerging to increase the uptake and completion of this important intervention. The aim of this study is to evaluate participant rate of attendance to PR delivered via two different delivery modes (centre based and mobile technology (mPR)). Secondary aims are to evaluate the patient preference for mode of delivery, and if mPR is non -inferior to centre-based PR in health outcomes. Method(s): A multi-centre, two-arm parallel preference based clinical trial was conducted. Participants with a chronic respiratory disorder referred for PR were offered the choice of centre-based or web-based (mPR) PR. Both programmes were 8 weeks in duration. The primary outcome was attendance. Result(s): 105 participants were recruited to the study with 67 opting for centre-based and 38 preferring web-based PR (mPR). The attendance rate was higher in the centre-based group than mPR. Results showed mPR was not inferior in terms of changes in symptom scores (CAT) or time spent in sedentary behaviour (SBQ) but inferiority could not be confirmed for changes in dyspnoea scores (mMRC) or health related quality of life (EQ5D-3L). Changes in exercise capacity could not be determined due to COVID-19 restrictions. Conclusion(s): This pragmatic study has shown that mPR was preferred by 38% of participants and a significant percentage were younger, working, with higher education inferring the demand will likely increase over time. The attendance rate with mPR was lower than anticipated. Further research with larger sample size is required to assess efficacy of mPR.

Economic burden of excessive sedentary behaviour in Canada.

OBJECTIVE: To estimate health care and health-related productivity costs associated with excessive sedentary behaviour (> 8 h/day and > 9 h/day) in Canadian adults. METHODS: Three pieces of information were used to estimate costs: (1) the pooled relative risk estimates of adverse health outcomes consistently shown to be associated with excessive sedentary behaviour, gathered from meta-analyses of prospective cohort studies; (2) the prevalence of excessive sedentary behaviour in Canadian men and women, obtained using waist-worn accelerometry in a nationally representative sample of adults (Canadian Health Measures Survey 2018-2019); and (3) the direct (health care) and indirect (lost productivity due to premature mortality) costs of the adverse health outcomes, selected using the Economic Burden of Illness in Canada 2010 data. The 2010 costs were then adjusted to 2021 costs to account for inflation, population growth, and higher average earnings. A Monte Carlo simulation was conducted to account for uncertainty in the model. RESULTS: The total costs of excessive sedentary behaviour in Canada were $2.2 billion (8 h/day cut-point) and $1.8 billion (9 h/day cut-point) in 2021, representing 1.6% and 1.3% of the overall burden of illness costs, respectively. The two most expensive chronic diseases attributable to excessive sedentary behaviour were cardiovascular disease and type 2 diabetes. A 10% decrease in excessive sedentary behaviour (from 87.7% to 77.7%) would save an estimated $219 million per year in costs. CONCLUSION: Excessive sedentary behaviour significantly contributes to the economic burden of illness in Canada. There is a need for evidence-based and cost-effective strategies that reduce excessive sedentary behaviour in the population.

RéSUMé: OBJECTIF: Estimer le coût des soins de santé et le coût de productivité lié à la santé associés au comportement sédentaire excessif (> 8 heures/jour et > 9 heures/jour) chez les Canadiennes et les Canadiens adultes. MéTHODE: Trois informations ont servi à estimer ces coûts : 1) les estimations combinées du risque relatif des résultats sanitaires indésirables uniformément associés au comportement sédentaire excessif, collectées à partir de méta-analyses d'études prospectives de cohortes; 2) la prévalence du comportement sédentaire excessif chez les Canadiennes et les Canadiens, obtenue à l'aide d'un accéléromètre porté à la taille par un échantillon représentatif national d'adultes (Enquête canadienne sur les mesures de la santé 2018-2019); et 3) les coûts directs (soins de santé) et indirects (perte de productivité due à la mortalité prématurée) des résultats sanitaires indésirables sélectionnés, d'après les données du Fardeau économique de la maladie au Canada de 2010. Les coûts de 2010 ont ensuite été ajustés aux coûts de 2021 pour tenir compte de l'inflation, de la croissance démographique et de la hausse moyenne des revenus. Nous avons effectué une simulation de Monte-Carlo pour tenir compte de l'incertitude du modèle. RéSULTATS: Les coûts totaux du comportement sédentaire excessif au Canada étaient de 2,2 milliards de dollars (point de coupure de 8 heures/jour) et de 1,8 milliard de dollars (point de coupure de 9 heures/jour) en 2021, ce qui représente 1,6 % et 1,3 % du fardeau global des coûts des maladies, respectivement. Les deux maladies chroniques les plus chères imputables au comportement sédentaire excessif étaient les maladies cardiovasculaires et le diabète de type 2. Une baisse de 10 % du comportement sédentaire excessif (de 87,7 % à 77,7 %) économiserait environ 219 millions de dollars de coûts par année. CONCLUSION: Le comportement sédentaire excessif contribue de façon significative au fardeau économique de la maladie au Canada. Il nous faut des stratégies fondées sur les preuves et efficaces par rapport au coût pour réduire le comportement sédentaire excessif dans la population.