Child and adolescent patterns of commuting to school.

The World Health Organization stipulate children and adolescents should accumulate 60 min of physical activity (PA) daily; globally only 25% achieve this. Active travel to school (ATS) is a method of integrating PA into daily life with a documented health benefit accruing. Understanding factors associated with ATS is essential to inform a systems approach to increase ATS participation. This study described patterns of commuting to school and examined factors associated with ATS. Children's Sport Participation & Physical Activity Study 2018 data was used, an all-Ireland cross-sectional study of 6,650 students. Logistic regression analysis was performed to determine factors independently associated with ATS. Most common commute to school methods were private car for primary (57%) and public transport for secondary (39%) students. The recommended 60 min of daily PA a week prior to the survey was achieved by 19.5% for primary and 12.6% for secondary students. Republic of Ireland (ROI) nationality (OR 1.09 95 %CI 1.02-1.16), meeting PA guidelines (OR 1.26 95 %CI 1.08-1.46), attending a ROI school (OR 2.27 95 %CI 2.02-2.57), attending a non-Delivering Equality of Opportunity in Schools (DEIS) school (OR 2.47 95 %CI 1.87-3.24), attending an urban school (OR 3.96 95 %CI 3.41-4.59) were each independently statistically significantly associated with ATS. Living in a family with a car (OR 0.27 95 %CI 0.19-0.39), attending secondary school (OR 0.69 95 %CI 0.62-0.78), attending a small sized (<33rd percentile) school (OR 0.68 95 %CI 0.60-0.77), living >5 km from school (OR 0.22 95 %CI 0.2-0.24) were each significantly negatively associated with ATS. ATS is a means of increasing youth PA and health. Factors associated with ATS can inform further research and intervention to increase ATS participation.

Ciências da atividade física como protagonista de uma agenda multisetorial de pesquisa e advocacy na promoção da mobilidade ativa / Physical activity sciences as protagonist of a multisectoral agenda in the promotion of active transportation

No epicentro da pandemia, as cidades enfrentam desafios econômicos e na saúde. Para lidar com a crise e reduzir os riscos de infecção nos transportes coletivos, o uso de transportes ativos passou a receber atenção de governos locais. Adotando como referencial o conceito de "Saúde em Todas as Políticas", o presente ensaio teórico teve como objetivo discutir oportunidades causadas pela pandemia da COVID-19, considerando as relações entre o uso de transportes ativos e seus impactos sobre a prevenção de doenças crônicas não transmissíveis, a mobilidade urbana e o meio-ambiente. Dentro deste contexto, destacamos a importância de se mensurar as influências e externalidades da indústria automotiva, caracterizando-a como um ator a ser enfrentado nas políticas de promoção da saúde e mobilidade ativa. Neste sentido, acreditamos que as Ciências da Atividade Física podem exercer um protagonismo na formação de uma agenda multisetorial de pesquisa e advocacy, que objetivem reorientar os sistemas de transporte, de desenho urbano e de uso do solo

At the epicenter of the pandemic, cities face economic and health challenges. In order to deal with the crisis and reduce the risks of infection in public transport, the use of active modes of transportation has received attention from local governments. Adopting the concept of "Health in All Policies" as a reference, this theoret-ical essay aimed to discuss opportunities caused by the pandemic of COVID-19, considering the relationship between the use of active transportation and its impacts on the prevention of non-communicable diseases, urban mobility and the environment. Within this context, we highlight the importance of measuring the ex-ternalities of the automotive industry, characterizing it as an actor to be fought in policies to promote health and active transportation. In this sense, we believe that the Physical Activity Sciences can play a leading role in the formation of a multisectoral agenda for research and advocacy, which aims to reorient the transport, urban design and land use systems

Associations between social network properties and metabolic syndrome and the mediating effect of physical activity: findings from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) Cohort.

INTRODUCTION: Social isolation and loneliness are positively associated with metabolic syndrome. However, the mechanisms by which social isolation affects metabolic syndrome are not well understood. RESEARCH DESIGN AND METHODS: This study was designed as a cross-sectional study of baseline results from the Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) Cohort. We included 10 103 participants (8097 community-based low-risk participants, 2006 hospital-based high-risk participants) from the CMERC Cohort. Participants aged 65 years or older were excluded. Multiple imputation by chained equations was applied to impute missing variables. The quantitative properties of social networks were assessed by measuring the 'size of social networks'; qualitative properties were assessed by measuring the 'social network closeness'. Metabolic syndrome was defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria. Multivariate logistic regression analyses were conducted to assess association between social network properties and metabolic syndrome. The mediating effects of physical inactiveness, alcohol consumption, cigarette smoking and depressive symptoms were estimated. Age-specific effect sizes were estimated for each subgroup. RESULTS: A smaller social network was positively associated with higher prevalences of metabolic syndrome in all subgroups, except the high-risk male subgroup. There was no clear association between social network closeness and metabolic syndrome. In community-based participants, an indirect effect through physical activity was detected in both sexes; however, in hospital-based participants, no indirect effects were detected. Cigarette smoking, alcohol consumption and depression did not mediate the association. Age-specific estimates showed that the indirect effect through physical activity had a greater impact in older participants. CONCLUSIONS: A smaller social network is positively associated with metabolic syndrome. This trend could be partially explained by physical inactivity, especially in older individuals.

Self-reported and objectively measured physical activity levels among Hispanic/Latino adults with type 2 diabetes.

OBJECTIVE: In the USA, minority populations face a disproportionate burden from type 2 diabetes (T2D), in whom physical activity (PA) is recommended. The aim of this study was to determine levels of PA among a community of free-living Hispanic/Latino adults with T2D using a research accelerometer, a consumer device and a pictogram self-assessment questionnaire. RESEARCH DESIGN AND METHODS: This was a cross-sectional, observational study. Participants (57 women and 31 men, body mass index (kg/m2) 32.2±7.9 and 29.9±4.5, waist circumference 97.1±30.1 and 93.7±33.0 cm and hemoglobin A1c 8.0±2.0 and 8.1%±1.8%, respectively) wore an ActiGraph (AG) on the hip and a Fitbit (FB) on the wrist for 1 week to estimate daily steps and energy expenditure (EE). Participants reported type and intensity of PA using English-language or Spanish-language pictograms and a 10-point Likert scale (1='not active' to 10='very, very active'). RESULTS: Steps per day were not normally distributed; AG median steps/weekday (Monday-Friday) was 6990 (range 1091-25 884) compared with 9329 (288-31 669) using FB (p≤0.01). Both devices recorded significantly more steps on weekdays versus weekends (p≤0.05). EE was also higher during the week. AG and FB were highly correlated to each other (p<0.01). Men were more active than women and maintained their PA throughout the week, whereas women decreased theirs on weekends. Spanish-language pictograms were preferred and self-reported PA matched objective assessments by both devices. Participants perceived themselves to be active (7.1±2.0) due to work. CONCLUSIONS: Both objectively measured and self-reported levels of PA in Hispanic/Latino adults with T2D challenge the assumption that lack of PA may be commonplace for this group. AG and FB are different in their measurement of PA but are significantly correlated. New strategies, including use of pictograms, for interventions need to be considered if further increases or changes in PA are to be used as T2D therapy. TRIAL REGISTRATION NUMBER: NCT03736486.

Effect of dual-task and visual manipulation on the balance of older physical exercise practitioners and sedentary older and young adults / Efeito da dupla-tarefa e da manipulação visual no equilíbrio de idosos praticantes de exercícios físicos, idosos e adultos jovens não praticantes

The objective was to compare the effect of dual-task and visual manipulation on postural balance of older physical activity practitioners and older and young adult non-practitioners. Fifty-one subjects were divided into four groups: Older Practitioners of Karate (OPK), Older Practitioners of Func-tional Gymnastics (OPG), Non-practicing Older Adult Group (ONP), and Non-practicing Young Adult Group (YNP). The task was to remain in an upright, static position on a force platform, for 40 seconds, with and without a cognitive dual-task, by means of an arithmetic sum, and visual manipulation, with and without a blindfold. The analyzed variables of the Center of Pressure (COP) were: area of oscillation and mean amplitude of oscillation, in the mediolateral and anteroposterior directions. The results showed similar performances among the physical exercise groups (OPK and OPG) and the young adults (YNP), while the ONP presented greater postural oscillation in all conditions. In the visual condition, blindfolded, in the condition with the dual-task, the OPK, OPG, and YNP groups oscillated less, when compared to the condition without dual-task. Thus, it can be inferred that the practice of physical exercises, regardless of the modality, is effective in improving the postural control of older adults, with similar performances to the group of young adults, even in conditions with dual-task and sensory manipulation of vision

O objetivo do estudo foi comparar o efeito da dupla-tarefa e da manipulação visual no equilíbrio postural em idosos praticantes de diferentes modalidades de exercícios físicos, idosos e adultos jovens não praticantes. Participaram do estudo 51 indivíduos, subdivididos em quatro grupos: grupo de idosos praticantes de karatê (GPK), grupo de idosos praticantes de ginástica funcional (GPF), grupo de idosos não praticantes (GNP) e grupo de adultos jovens (GNP). A tarefa consistiu em permanecer, na posição ereta, sob plataforma de força, por 40 segundos, sem e com dupla-tarefa, por meio de soma aritmética e com manipulação visual, com e sem visão. As variáveis analisadas do Centro de Pressão (COP) foram: área de oscilação e amplitude média de oscilação, nos sentidos médio-lateral e ântero-posterior. Os resultados foram desempenhos semelhantes entre os grupos que praticavam exercícios físicos (OPK e OPG) e o de adultos jovens ( YNP), enquanto o ONP apresentou maior oscilação postural, nas variáveis área e amplitude de oscilação. Na condição visual, com vi-são e com a dupla-tarefa, os grupos OPK, OPG e YNP oscilaram menos, quando comparados a condição sem dupla-tarefa. Dessa forma, pode-se inferir que a prática de exercícios físicos, independente da modalidade, é eficaz no equilíbrio postural de idosos, com desempenho semelhante no grupo de adultos jovens, mesmo em condições com dupla-tarefa e manipulação sensorial da visão

Improving physical activity, pain and function in patients waiting for hip and knee arthroplasty by combining targeted exercise training with behaviour change counselling: study protocol for a randomised controlled trial.

BACKGROUND: Osteoarthritis often results in prolonged periods of reduced physical activity and is associated with adverse health outcomes, including increased risk of cardiovascular and metabolic diseases. Exercise interventions for patients on the waiting list for arthroplasty can reduce the risk of long-term adverse outcomes by increasing activity levels. However, uptake and ongoing positive rates of physical activity in this population are low and the impact of pre-operative behaviour counselling on exercise is not known. METHOD/DESIGN: The exercise and behaviour change counselling (ENHANCE) trial is a two-arm assessor-blind randomised controlled trial to assess the effectiveness of a 12-week exercise intervention designed to improve long-term physical activity and functional abilities for people awaiting arthroplasty. Participants on the waiting list for hip and knee arthroplasty are recruited from one clinical site in Australia. After collection of baseline data, participants are randomised to either an intervention or control group. The control group receive usual care, as recommended by evidence-based guidelines. The intervention group receive an individualised programme of exercises and counselling sessions. The 12-week exercise programme integrates multiple elements, including up to five in-person counselling sessions, supported by written materials. Participants are encouraged to seek social support among their friends and self-monitor their physical activity. The primary outcome is physical activity (daily step count and percentage of day spent in sedentary activities). Secondary outcomes include pain ratings, physical function, psychosocial factors and changes in clinical markers linked with potential common chronic diseases (diabetes and cardiovascular disease). All outcomes are assessed at baseline and 26 weeks later and again at 26 weeks post-surgery. DISCUSSION: This study seeks to address a significant gap in current osteoarthritis management practice by providing evidence for the effectiveness of an exercise programme combined with behaviour counselling for adults waiting for hip and knee arthroplasty. Theory-driven evidence-based strategies that can improve an individual's exercise self-efficacy and self-management capacity could have a significant impact on the development of secondary chronic disease in this population. Information gained from this study will contribute to the evidence base on the management of adults waiting for hip and knee arthroplasty. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12617000357358 . Registered on 8 March 2017.

Self-Reported Physical Activity is Not a Valid Method for Measuring Physical Activity in 15-Year-Old South African Boys and Girls.

Physical activity plays an important role in the prevention of chronic lifestyle-related diseases. The development of valid instruments for the assessment of physical activity remains a challenge in field studies. The purpose of the present study was therefore to determine the level of agreement between physical activity objectively measured by the ActiHeart® (Cambridge Neurotechnology Ltd, Cambridge, UK) device and subjectively reported physical activity by means of the International Physical Activity Questionnaire Short Form (IPAQ-SF) among adolescents attending schools in the Tlokwe Local Municipality, South Africa. A cross-sectional study design was used with a total of 63 boys and 45 girls aged 15 years who took part in the Physical Activity and Health Longitudinal Study (PHALS). Stature and weight were measured according to standard International Society for the Advancement of Kinanthropometry (ISAK) protocols. Objective physical activity (PA) was measured by a combined heart rate and accelerometer device (ActiHeart®) for seven consecutive days. Time spent in moderate-to-vigorous intensity physical activity (MVPA) was assessed. Subjective physical activity was assessed with the self-reported IPAQ-SF. Objective PA indicated that 93% of the participants were inactive and only 6% were highly active. The IPAQ-SF showed that 24% were inactive, with 57% active. A non-significant correlation (r = 0.11; p = 0.29) between the ActiHeart® measure of activity energy expenditure (AEE) and total physical activity (IPAQ-SF) was observed. The Bland⁻Altman plot showed no agreement between the two measurement instruments and also a variation in the level of equivalence. When Cohen’s kappa (κ) was run to determine the agreement between the two measurement instruments for estimated physical activity, a poor agreement (κ = 0.011, p < 0.005) between the two was found. The poor level of agreement between the objective measure of physical activity (ActiHeart®) and the IPAQ-SF questionnaire should be interpreted cautiously. Future physical activity research using a combination of subjective and objective assessment methods in a large-scale cohort in adolescents is recommended.

Predictors of Achieving Recommended Daily Physical Activity Among Anesthesiologists at a Large Tertiary Care Academic Center.

BACKGROUND: The goal of the current study was to determine if the daily work patterns of anesthesiologists meet the recommended daily levels of activity. METHODS: Attending and resident anesthesiologists at a tertiary academic center were invited to participate. The subjects wore a pedometer during five regular clinical days at work and recorded the number of steps walked. The participants also completed the International Physical Activity Questionnaire (IPAQ) during one regular week. The results were analyzed using analysis of variance, Chi-square test and multivariate linear regression using STATA 12.1. RESULTS: During work, attending, compared with senior and junior resident, anesthesiologists had the most steps (5,953 ± 1,213, 5,153 ± 905, and 5,710 ± 1,513 steps, respectively, P = 0.2). Outside work, senior residents had the highest level of activity (3,592 ± 1,626 metabolic equivalent of task (MET)-minutes/week) compared to junior residents (1,788 ± 1,089 MET-minutes/week) and attending (2,104 ± 1,594 MET-minutes/week, P = 0.005); the percentage of recommended daily level of activity represented by this outside activity was senior residents (78.5%), junior residents (27%) and attending (21%) anesthesiologists (P = 0.002). When activity at and outside work was combined, most anesthesiologists met the recommended 10,000 steps daily, P < 0.009. CONCLUSIONS: The daily physical activity of faculty and trainee anesthesiologists at work in a busy tertiary care is low active. However, when additional physical activity is pursued outside of work, most anesthesiologists met recommended daily levels of activity. These results highlight the inadequacy of daily activity at work, and the need to pursue additional physical activity outside of work; such awareness can assist in promoting a healthy lifestyle.

Association of physiological and psychological health outcomes with physical activity and sedentary behavior in adults with type 2 diabetes.

PURPOSE: To examine the association between change in moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) over a 6-month period with physiological and psychological factors in adults with type 2 diabetes (T2D). METHODS: Participants included 26 middle-aged (mean age=56.1±10.8 years; 42% women), overweight/obese (mean body mass index (BMI) =37.22±8.78 kg/m2) adults who had been diagnosed with T2D within the past 5 years (mean HbA1c=7.81%). Participants underwent a physical examination, blood tests, and psychological questionnaires, including a self-report questionnaire that assessed the consumption of high glycemic and low glycemic load foods. Participants wore an Actigraph accelerometer for 7 days to assess MVPA and SB. All measures were collected at baseline and at the 6-month follow-up. Spearman rank correlations and regression models were conducted to examine the relationship between activity variables, and the association of activity measures with health outcomes at the 6-month follow-up. RESULTS: Decreases in duration of SB bouts and increases in MVPA were associated with decreased levels of HbA1c (p<0.05). Over 50% of the variance in HbA1c levels could be attributed to changes in MVPA and SB. CONCLUSIONS: MVPA and SB were independently associated with diabetes-related health outcomes. Results suggest that emphasis should be placed on increasing MVPA while decreasing SB, particularly duration of SB bouts. This suggests that even small changes in daily behavior may contribute to improvement in diabetes-related health outcomes.

Are we missing the sitting? Agreement between accelerometer non-wear time validation methods used with older adults' data.

We used Bland Altman plots to compare agreement between a self-report diary and five different non-wear time algorithms [an algorithm that uses ≥60 min of consecutive zeroes (Troiano) and four variations of an algorithm that uses ≥90 min of consecutive zeroes to define a non-wear period] for estimating community-dwelling older adults' (n = 106) sedentary behaviour and wear time (min/day) as measured by accelerometry. We found that the Troiano algorithm may overestimate sedentary behaviour and wear time by ≥30 min/day. Algorithms that use ≥90 min of continuous zeroes more closely approximate participants' sedentary behaviour and wear time. Across the self-report diary vs. ≥90 min algorithm comparisons, mean differences ranged between -4.4 to 8.1 min/day for estimates of sedentary behaviour and between -10.8 to 1.0 min/day for estimates of wear time; all 95% confidence intervals for mean differences crossed zero. We also found that 95% limits of agreement were wide for all comparisons, highlighting the large variation in estimates of sedentary behaviour and wear time. Given the importance of reducing sedentary behaviour and encouraging physical activity for older adult health, we conclude that it is critical to establish accurate approaches for measurement.

Objectively assessed physical activity, adiposity, and inflammatory markers in people with type 2 diabetes.

OBJECTIVE: Inflammatory processes may play an important role in the development of acute coronary syndromes in people with type 2 diabetes; thus, strategies to control inflammation are of clinical importance. We examined the cross-sectional association between objectively assessed physical activity and inflammatory markers in a sample of people with type 2 diabetes. METHODS: Participants were 71 men and 41 women (mean age=63.9±7 years), without a history of cardiovascular disease, drawn from primary care clinics. Physical activity was objectively measured using waist-worn accelerometers (Actigraph GT3X) during waking hours for seven consecutive days. RESULTS: We observed inverse associations between moderate-to-vigorous physical activity (per 10 min) with plasma interleukin-6 (B=-0.035, 95% CI -0.056 to -0.015), interleukin-1ra (B=-0.033, 95% CI -0.051 to -0.015), and monocyte chemotactic protein-1 (B=-0.011, 95% CI -0.021 to 0.000). These associations largely persisted in multivariable adjusted models, although body mass index considerably attenuated the effect estimate. CONCLUSIONS: These data demonstrate an inverse association between physical activity and inflammatory markers in people with type 2 diabetes.

Patterns and predictors of changes in active commuting over 12 months.

OBJECTIVE: To assess the predictors of uptake and maintenance of walking and cycling, and of switching to the car as the usual mode of travel, for commuting. METHODS: 655 commuters in Cambridge, UK reported all commuting trips using a seven-day recall instrument in 2009 and 2010. Individual and household characteristics, psychological measures relating to car use and environmental conditions on the route to work were self-reported in 2009. Objective environmental characteristics were assessed using Geographical Information Systems. Associations between uptake and maintenance of commuting behaviours and potential predictors were modelled using multivariable logistic regression. RESULTS: Mean within-participant changes in commuting were relatively small (walking: +3.0 min/week, s.d.=66.7; cycling: -5.3 min/week, s.d.=74.7). Self-reported and objectively-assessed convenience of public transport predicted uptake of walking and cycling respectively, while convenient cycle routes predicted uptake of cycling and a pleasant route predicted maintenance of walking. A lack of free workplace parking predicted uptake of walking and alternatives to the car. Less favourable attitudes towards car use predicted continued use of alternatives to the car. CONCLUSIONS: Improving the convenience of walking, cycling and public transport and limiting the availability of workplace car parking may promote uptake and maintenance of active commuting.

Educação Física Escolar eEducação para a Saúde / School Physical Education and Education for Health

The work here presented has the objective of clarifying thehole that the Physical Education, as a global educativeprocess, may have in the promotion and prevention of thepopulation’s health. The work is structured in three partswith the following approaches: the first part presents theconception of the author about Physical Education, its hole inschool and the various orientations and conceptions acceptedthroughout time. The second moment is dedicated toexplanation and clarification of a view in health at amultidisciplinary dimension beyond the presentation of someof the current problems related to health, notedly those withgreater affinity to physical activities. The third and last partof the work presents the possible relations between theHealth and Physical Education dimensions; thus emphasizingthe potentialities of those as integrating the activitiescompound which integrate the health professions, givingprivilege to its occurrence in the space and in the “school”institution...