Poor self-rated health is associated with sedentary behavior regardless of physical activity in adolescents - PeNSE study.

ObjectivesTo analyze the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) in a large sample of adolescents.MethodsData from 100,873 students with mean age of 14.3 (±1.1) years were analyzed. SRH, PA and SB were assessed by questionnaires. Age, ethnicity, maternal education, geographical region of country, type of city, industrialized and sugary foods consumption were covariates. Logistic regression models were used to analyze the data according to gender.Results≥300 min/week of PA [OR:1.12 (95%CI:1.04–1.21)] and <4 h of sitting time [OR:1.42 (95%CI:1.32–1.54)] were associated with good SRH among boys, while only lower sitting time was associated with good SRH among girls [OR:1.32 (95%CI:1.23–1.41)]. Physically active and with low sitting time adolescents were more likely to have good SRH [Boys OR:1.57 (95%CI:1.41–1.75); Girls OR:1.32 (95%CI:1.18–1.46)], than inactive and with high sitting time counterparts. However, high sitting time was associated with poor SRH independently of ≥300 min/week of PA.ConclusionPA and sitting time were independently associated with SRH in Brazilian adolescents. Moreover, reaching ≥300 min/week of PA was not sufficient to attenuate the negative association between high sitting time and SRH.     

Violencia de pareja y depresión en mujeres que trabajan en una institución de salud de México

ObjectiveTo assess the effect of intimate partner violence on the risk of depression and depressive symptoms among adult women.MethodWe analyzed data from the Mexican Health Workers’ Cohort study (n = 470). Type and severity of intimate partner violence was ascertained between 2004 and 2011. Self-reported medical diagnosis of depression (2011) was the main outcome; depressive symptoms ascertained with the Centre for Epidemiologic Studies-Depression (CES-D) scale was the secondary outcome. Random-effects regressions were run to model the risk of depression (logistic) and depressive symptoms (linear) in relation to intimate partner violence.Results41.9% women experienced intimate partner violence at baseline. The incidence of depression was 7.2%. The risk of depression increased with any type of IPV (adjusted odds ratio [aOR] = 2.9; 95% confidence interval [95%CI]: 1.4–6.2) and with physical (aOR = 4.3; 95%CI: 1.8–10.1), psychological (aOR = 3.1; 95%CI: 1.4–6.6) and sexual (aOR = 3.1; 95%CI: 1.2–8.2) violence. Depressive symptoms (CES-D) increased slightly with physical and sexual intimate partner violence.ConclusionsIntimate partner violence was associated with a higher risk of depression in this sample of women working in a Mexican health facility. Our results indicate the need to develop infrastructure, to implement strategies of attention and counselling, and to provide a safe environment in the workplace for women who experience intimate partner violence.     

Ethnic differences in all-cause and cardiovascular mortality by physical activity levels among older adults in the US

Aims: This study sought to determine whether the association between varying levels of physical activity (PA) and all-cause and cardiovascular mortality differ by race/ethnicity in older adults.

Methods: The sample comprised 2520 women and 2398 men drawn from National Health and Nutrition Examination Survey III (1988–1994) aged?≥?60 years. We used the metabolic equivalent (MET) of self-reported PA levels to define activity groups (inactive: those who did not report any PA; active: those who reported 3–6 METs for ≥5 times/week or >6 METs, ≥3 times/week; insufficiently active: those meeting neither criteria). Racial/Ethnic differences were modeled using proportional hazard regression (HR) adjusting for age, education, smoking, diabetes, and hypertension.

Results: Among those classified as inactive, Non-Hispanic Blacks (NHB) (HR: 0.72, 95% CI: 0.58–0.90) and Mexican Americans (HR: 0.59, 95%CI: 0.45–0.78) had a lower risk of all-cause mortality when compared to non-Hispanic Whites (NHW). Among those classified as insufficiently active, Mexican Americans (HR: 0.63, 95% CI: 0.51–0.77), but not NHB (HR: 0.81, (95% CI: 0.64–1.02) had a lower risk of all-cause mortality when compared to NHWs Similar results were observed for cardiovascular mortality.

Conclusion: Overall, PA in the elderly (either insufficient or active) is associated with a lower all-cause mortality across all race/ethnic groups as compared to NHW. Further investigation, including studies with larger sample, is needed to address the health consequences of varying degrees of PA in ethnically diverse populations.     

Frequency of complications and the effects of pneumococcal vaccination in young children with acute respiratory tract infection

BackgroundAcute respiratory infection (ARI) is the most frequent reason for children being seen by doctors worldwide. We aimed to estimate the frequency of complications in children aged 6–23 months during ARI episode and to evaluate risk factors present on recruitment associated with complications after the universal implementation of pneumococcal vaccine (PCV10) in our region.MethodsThis prospective cohort enrolled children who had shown ARI for up to 7 days and who were subsequently followed up 14–21 days after, in Salvador, Brazil. Data on recruitment were registered. The vaccine card was personally checked. Complication was defined when hospitalization, pneumonia or acute otitis media (AOM) were informed during the follow-up visit. Pneumonia and AOM were diagnosed by a doctor. Multiple logistic regression analysis was performed.ResultsOf 576 children, 422 (73%) returned and 79 (19%; 95%CI: 15–23%) had complications. The mean interval between admission and follow-up was 23 ± 13 days. Pneumonia (n = 47; 11%), hospitalization (n = 28; 7%), and AOM (n = 17; 4%) were reported. Most of the patients presented one complication (n = 66; 84%) followed by two (n = 13; 16%). Report of fever (92% versus 79%; OR [95%CI]: 2.90 [1.18–7.14]), bird at home (24% versus 14%; OR [95%CI]: 2.13 [1.07–4.26]), ronchi (48% versus 36%; OR [95%CI]: 2.06 [1.16–3.67]) or crackles (17% versus 7%; OR [95%CI]: 2.36 [1.04–5.38]) on auscultation were directly associated with complications whereas PCV10 (59% versus 75%; OR [95%CI]: 0.46 [0.26–0.82]) was inversely associated. Bird at home (OR [95%CI]: 5.80 [1.73–19.38]) and ronchi (OR [95%CI]: 6.39 [1.96–20.85]) were associated with AOM; PCV10 was inversely associated with AOM (OR [95%CI]: 0.16 [0.05–0.52]). Crackles were associated with pneumonia (OR [95%CI]: 2.55 [1.01–6.40]).ConclusionsOne fifth of the children presented complications. PCV10 was independently associated with lower odds of development of AOM. Bird at home and ronchi are risk factors of otitis. Crackles are associated with pneumonia.     

Time Trends of Physical Activity Among Brazilian Adolescents Over a 7-Year Period

PurposeTo evaluate time trends in physical activity among adolescents aged 10 to 19 years living in southern Brazil over a 7-year period.MethodsTwo population-based cross-sectional surveys with similar methodologies were carried out in the city of Pelotas, Brazil, in 2005 and 2012. Leisure-time and transport-related physical activity were measured using a validated questionnaire. A cut-off point of 300 minutes per week was used to classify adolescents as active or not. We also analyzed the two domains of physical activity (leisure time and transportation) separately.ResultsThe prevalence of physical inactivity was 69.6% (95% CI 66.5–73.2) in 2005 and 69.9% (95% CI 66.5–72.7) in 2012. The percentage of active adolescents in leisure time also remained stable in the period (26.3% in 2005 [95% CI 23.3–29.2] vs. 28.1% in 2012 [95% CI 24.9–31.4]). Among boys, we observed an increase in the practice of some leisure-time activities—weight lifting (87%) and running (78%)—and a decline in others—volleyball (61%) and basketball (56%). Among girls, the only significant difference was an increase in the practice of weight lifting (271%). The prevalence of active commuting to and from school declined from 69% (95% CI 65.6–72.4) in 2005 to 56.5% (95% CI 52.5–60.2) in 2012.ConclusionsThere was a significant decline in active commuting to school among adolescents. Interventions promoting active commuting modes to school are urgently needed in Brazil.     

Physical Activity,Diet Quality,and Mortality among Community-Dwelling Prefrail and Frail Older Adults

It is unknown if physical activity and diet quality are associated with the risk of poor outcomes, such as mortality, among prefrail and frail older adults. This was a population-based cohort study among 1487 prefrail and frail older-adults from the Third National Health and Nutrition Survey. Compared to participants who were sedentary (0 bouts of physical activity per week), those who were physically inactive (1–4 bouts of physical activity per week) were 24% less likely to die [HR: 0.76 (95% CI: 0.58–0.98)], and those who were physically active (≥5 bouts of physical activity per week) were 34% less likely to die [HR: 0.66 (95% CI: 0.51–0.86); P_trend?=?0.002]. Compared to participants with poor diet quality, those with fair diet quality were 26% less likely to die [HR: 0.74 (95% CI: 0.52–0.98)], and those with good diet quality were 33% less likely to die [HR: 0.67 (95% CI: 0.55–1.00); P_trend?=?0.050]. There was a synergistic interaction between physical activity and diet quality on the risk of mortality (P_interaction?=?0.058). Participation in physical activity and consumption of a healthy diet is associated with a lower risk of mortality among prefrail and frail older adults.     

Physical and social environmental factors related to co-occurrence of unhealthy lifestyle behaviors

Previous work identifying determinants of co-occurrence of behavioral risk factors have focused on their association with individuals' characteristics with scant attention paid to their relationship to contextual factors. Data came from 21,007 individuals ≥15 years of age who participated in the cross-sectional 2011–2012 Spanish National Health Survey. Two indicators were defined by tobacco consumption, alcohol intake, diet, physical activity, and body mass index. The first indicator, based on dichotomized measures, ranges from 0 to 5. The second one (unhealthy lifestyle index), ranges from 0 to 15, with 0 denoting the healthiest score. Among the determinants, we examined social support, five perceived characteristics of the neighborhood, and the socioeconomic deprivation index of the census tract of residence. Data were analyzed using multilevel linear and logistic regression models adjusted for the main sociodemographic characteristics. Using the dichotomized indicator, the probability of having 3–5 risk factors versus <3 factors was associated with low social support (Odds Ratio [OR] 1.50; 95% Confidence Interval [CI]: 1.25–1.80). Issues surrounding neighborhood cleanliness (OR = 1.18; 95%CI: 1.04–1.33), air pollution (OR = 1.38; 95%CI: 1.16–1.64), and street crime (OR = 1.21; 95%CI: 1.03–1.42) were associated with determinants of co-occurrence. Risk factors co-occurrence increased as deprivation level increased: the OR for the highest deprivation quintile versus the lowest was 1.30 (95%CI: 1.14–1.48). Similar results were observed when using the unhealthy lifestyle index. Poorer physical and social environments are related to greater co-occurrence of risk factors for chronic diseases. Health promotion interventions targeting the prevention of risk factors should consider the contextual characteristics of the neighborhood environment.     

The Association Between Gestational Diabetes Mellitus and Recreational Physical Activity

We aimed to investigate the association of recreational physical activity before pregnancy with gestational diabetes mellitus (GDM). A cross-sectional study was performed using self-reported data from the Pregnancy Risk Assessment and Monitoring System. The study population included 1,052 self-reported GDM cases and 10,351 non-GDM controls. Recreational physical activity in the 3 months before pregnancy was recalled in postpartum structured interviews. Compared to women exercising less than 1 day per week, women who exercised >5 days per week in the 3 months before pregnancy had a 31% lower odds of GDM (adjusted odds ratio [aOR]: 0.69; 95% confidence interval [CI]: 0.46, 1.03). Women who exercised 1–4 days per week had a 7% lower odds of GDM (aOR: 0.93; 95%CI: 0.72, 1.19). We did not observe statistically significant associations between pre-pregnancy physical activity and GDM risk. However, the magnitude and direction of association are consistent with previous observational studies. These studies collectively suggest a role of physical activity in GDM prevention.     

Different social contexts of leisure-time physical activity: Does the association with depressive symptoms differ?

Our aim was to analyze the association between different social contexts of physical activity (PA) and depressive symptoms. Data from the Brazilian National Health Survey (PNS) (n = 59,722; ≥18 years) were used. The social context of leisure-time PA [classified according to the higher probability of being practiced in group (group PA) or individually (individual PA)] and total PA time were self-reported. Depressive symptoms were evaluated through the Patient Health Questionnaire-9. Chronological age, ethnicity, educational status, employment status, tobacco smoking, alcohol ingestion, and soft drink consumption were co-variables. Logistic regression models were applied for association analyses. Among men, individual and group PA were associated with lower depressive symptoms compared with the no PA group among men [Individual: OR:0.59 (95%CI:0.40 to 0.86); Group: OR:0.42 (95%CI:0.29 to 0.59)]. Sensitivity analysis revealed that men involved in group PA were 40% [OR:0.60 (95%CI:0.38 to 0.94)] less likely to present elevated depressive symptoms when compared with individual PA. In females, no differences in depressive symptoms were observed comparing individual PA [OR:0.89 (95%CI:0.71 to 1.11)] and group PA [OR:0.86 (95%CI:0.54 to 1.37)] with the no PA group. Activities that are more likely to be a group PA demonstrated a stronger association with low depressive symptoms among men, but not women.     

Lifetime total physical activity and prostate cancer risk: a population-based case–control study in Sweden

The etiologic role of physical activity in prostate cancer development is unclear. We assessed the association between lifetime total physical activity and prostate cancer risk in a Swedish population-based case–control study comprising 1,449 incident prostate cancer cases and 1,118 unaffected population controls. Information regarding physical activity was obtained via a self-administered questionnaire assessing occupational, household, and recreational activity separately at various ages throughout an individual’s lifetime. Clinical data (TNM-classification, Gleason sum and PSA) was obtained from linkage to the National Prostate Cancer Registry. Overall, we observed no association between lifetime total physical activity and prostate cancer risk (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 0.77–1.41 for ≥49.7 vs. <41.9 metabolic equivalent-hours per day). There was a significantly increased risk of prostate cancer in the most active men compared with the least active men in household (OR = 1.44, 95% CI = 1.08–1.92) and recreational physical activity (OR = 1.56, 95% CI = 1.16–2.10). Comparing the most active with the least active men, total physical activity was not associated with either localized disease (OR = 0.95, 95% CI = 0.67–1.34) or advanced disease (OR = 1.19, 95% CI = 0.83–1.71). These findings do not support the hypothesis that physical activity uniformly protects against prostate cancer development.     

Levels of physical activity among adults 18–64 years old in 28 European countries

BackgroundSedentary lifestyle is associated with more than three million deaths annually. Data from the 2013 Eurobarometer survey were analyzed to assess levels of physical activity across the European Union (EU) and to explore factors associated with adequate and high physical activity.MethodsA representative sample of n = 19,978 individuals aged 18–64 years from the 28 EU countries (sub-sample of the Eurobarometer survey, wave 80.2) was analyzed. Frequency and average duration of walking, moderate and vigorous physical activity was assessed with a self-reported questionnaire. Participants were then classified as physically inactive or adequately/highly active, based on the World Health Organization's (WHO) recommendations. The total amount of MET-minutes (MET-min) per week was also calculated for each respondent.ResultsThe proportion of physically inactive individuals was 28.6%, (12.4% in Sweden to 53.7% in Cyprus), while 59.1% of the respondents (37.9% in Portugal and Cyprus to 72.2% in Sweden) were classified as highly active. The mean total weekly physical activity was 2151 MET-min (95%CI: 2095–2206), of which 891 MET-min (95%CI: 858–924) were contributed by vigorous exercise, 559 MET-min (95%CI: 540–578) by moderate exercise (excluding walking) and 690 MET-min (95%CI: 673–706) by walking. Male gender, younger age, residence in rural areas and Northern Europe, higher education level and ability to pay bills were independently associated with higher physical activity.ConclusionOne fourth of the EU population did not meet the WHO's recommendations for physical activity, with wide inequalities between and within countries. Wide-reaching environmental approaches are required to promote physical activity and address these inequalities.     

Impact of physical activity category on incidence of cardiovascular disease: Results from the 10-year follow-up of the ATTICA Study (2002–2012)

The aim of the study was to examine the effects of physical activity (PA) level on 10-year cardiovascular disease (CVD) incidence, taking into consideration several clinical and lifestyle risk factors along with the potential moderating role of gender. An analysis was undertaken on data from the ATTICA prospective cohort study (10-year follow-up, 2002–2012), which followed a Greek adult population (aged 18–89 years). A total n = 317 of fatal and nonfatal CVD events occurred among the 2020 participants. After adjusting for the lifestyle and clinical risk factors as potential confounders, odds ratio (ORs) of CVD risk of individuals who reported being sufficiently active and highly active were decreased by 58% (95% CI: 0.30, 0.58) and 70% (95% CI: 0.15, 0.56), when compared to those who were inactive/insufficiently active, respectively. Men had nearly two-fold increase in risk of CVD (95% CI: 1.62, 2.18) versus women. Stratified analysis by gender, revealed that sufficiently active men, had 52% (95% CI: 0.24, 0.97) reduced risk of CVD incidence when compared to inactive males, while, for women, the role of PA lost significance following adjusting for lifestyle factors. The current data suggests a beneficial effect of even moderate physical activity levels on 10-year incidence of CVD, reinforcing the importance of physically activity, especially for men.     

Changes in physical activity in leisure time and the risk of myocardial infarction, ischemic heart disease, and all-cause mortality

Physical activity is associated to a lower risk of mortality from all-causes and from coronary heart disease. The long-term effects of changes in physical activity on coronary heart disease are, however, less known. We examined the association between changes in leisure time physical activity and the risk of myocardial infarction (MI), ischemic heart disease (IHD), and all-cause mortality as well as changes in blood pressure in 4,487 men and 5,956 women in the Copenhagen City Heart Study. Physical activity was measured in 1976–1978 and 1981–1983 and participants were followed in nation-wide registers until 2009. Men who decreased physical activity by at least two levels and women who decreased by one level had a higher risk of MI relatively to an unchanged physical activity level (hazard ratio [HR] = 1.74, 95% confidence interval [95% CI]: 1.17–2.60 and HR = 1.30, 95% CI: 1.03–1.65). Similar associations were found for IHD although only significant in women. In all-cause mortality, men who increased physical activity had a lower risk and both men and women who reduced physical activity had a higher risk compared to an unchanged physical activity level. No association between changes in physical activity and blood pressure was observed. Findings from this prospective study suggest that changes in physical activity affect the risk of MI, IHD and all-cause mortality. A decrease in physical activity was associated to a higher risk of coronary heart disease.     

Longitudinal associations of subjectively-measured physical activity and screen time with cognitive development in young children

PurposeTo examine the longitudinal associations of subjectively-measured physical activity (PA) and screen time with multiple domains of cognitive development in a sample of young children.MethodsParticipants were 96 children (baseline age: 3.69 ± 0.78 years) and their parents from Edmonton, Canada in the Physical Activity and Cognition in Early Childhood (PACE) study. Different types of PA (organized, non-organized) and screen time (television viewing, video games) were measured using a parental questionnaire at baseline and at 6- and 12-month follow-ups. Total proxy-reported PA, total screen time, and meeting/not meeting the screen time recommendations (2–4 years: ≤1 h/d; 5 years: ≤2 h/d) of the Canadian 24-Hour Movement Guidelines were also calculated. Working memory (Nebraska Barnyard task) and inhibitory control (Fish-Shark Go/No-Go task) were assessed at the three time points. Intellectual ability, including language development, inductive reasoning, and perceptual speed, were assessed using the Woodcock-Johnson III test battery at 6- and 12-month follow-ups. Multilevel growth modeling was conducted.ResultsOrganized PA (B = 1.26; 95%CI: 0.19,2.33), non-organized PA (B = 0.89, 95%CI: 0.08, 1.71), and total proxy-reported PA (B = 1.03, 95%CI: 0.41,1.66) were positively associated with intellectual ability. In particular, positive associations in regard to language development and inductive reasoning were observed. As for screen time, most associations were not significant, except for positive associations of meeting the screen recommendation with intellectual ability (B = 3.19; 95%CI: 0.002,6.38) and language development (B = 4.32; 95%CI: 0.34,8.30).ConclusionFor young children, promoting PA participation in organized and non-organized activities, as well as meeting the screen time recommendations, appears important for cognitive development.     

Mental wellbeing and physical activity levels: A prospective cohort study

BackgroundAlthough much research has been devoted to examining the relationship between negative mental health states (e.g., depression) and physical activity, the literature is scarce in terms of associations between positive mental health states (e.g., mental wellbeing) and physical activity. The objective of this study was to examine the association between mental wellbeing measured in 2019 and physical activity measured in 2020 (including bi-directionality).MethodsData stem from a Danish nationally-representative panel of 5000 adults (aged 15+ years) conducted in 2019 and 2020, which was linked to register data. The SWEMWBS scale was used to assess mental wellbeing. The outcome was ≥150 min of physical activity per week (self-reported). Logistic regression models were performed, adjusting for covariates and physical activity at baseline.ResultsEach point increase in mental wellbeing in 2019 positively predicted ≥150 min of physical activity per week in 2020 (OR = 1.03, 95%CI 1.01–1.05). Compared to low mental wellbeing, moderate wellbeing was associated with higher odds (OR = 1.51, 95%CI 1.10–2.08) of engaging in ≥150 min of physical activity, while the odds among those with high mental wellbeing were even higher (OR = 1.93, 95%CI 1.37–2.72). The results reflected a dose-response pattern. Finally, the reverse pathway was noted as well, i.e., physical activity in 2019 positively predicted mental wellbeing in 2020.ConclusionsThe results show that favorable mental health status – beyond the absence of mental illness – positively predicts adherence to recommended physical activity levels in the following year. Initiatives to promote mental wellbeing may be instrumental as a means to protect and enhance general health by positively influencing engagement in physical activity. Conversely, increasing physical activity levels may protect against mental illness and further enhance population mental wellbeing.     

Physical activity,sedentary behaviour,and psychosocial well‐being among young South Korean children

Objective

To examine associations between television (TV) viewing, reading, physical activity (PA), and psychosocial well‐being among a representative sample of young South Korean children aged 0–5 years.

Methods

Findings are based on 1,774 children who participated in the Korea Children and Youth Survey. All measures were questionnaire‐derived. Psychosocial well‐being included social, interactive, and emotional skills (α = .7–.9), and the top quartile denoted high psychosocial well‐being. Multiple logistic regressions were performed to examine relationships after controlling for several confounders.

Results

Compared to children who participated in PA for <1 hr/week, those who participated in PA for 1‐ <3 hr/week were more likely to show high emotional skills (odds ratio [OR]: 1.40, 95% confidence interval [CI] [1.02, 1.93]), and those who participated ≥3 hr/week were more likely to show high social (OR: 2.01, 95% CI [1.45, 2.78]) and interactive skills (OR: 1.39, 95% CI [1.01, 1.92]). During weekdays, children who read 1– <3 hr/day and ≥3 hr/day, compared to <1 hr/day, were more likely to show high social (OR: 1.61, 95% CI [1.20, 2.16] and OR: 2.47, 95% CI [1.31, 4.67]) and emotional skills (OR: 1.57, 95% CI [1.16, 2.13] and OR: 2.58, 95% CI [1.34, 4.98]). In addition, children who read 1– <3 hr/day, compared to <1 hr/day, were more likely to show high interactive skills (OR: 1.44, 95% CI [1.08, 1.92]). Similar findings for reading on weekends were observed. TV viewing was not associated with social skills or interactive skills. TV viewing for 1– <3 hr/day, compared to <1 hr/day, was associated with increased odds of high emotional skills (OR: 1.71, 95% CI [1.28, 2.27] on weekdays; OR: 1.90, 95% CI [1.39, 2.61] on weekends).

Conclusion

PA and reading primarily showed favourable associations with psychosocial well‐being, whereas TV viewing did not; thus, PA or reading may be a better option over TV viewing for optimal psychosocial well‐being among young South Korean children. These findings should be confirmed with stronger study designs.     

体力活动与结肠癌关系前瞻性研究的Meta分析

目的 索体力活动与结肠癌发生的病因学联系.方法 集和整理1979-2009年国内外公开发表的体力活动与结肠癌关系的队列研究文献,开展Meta分析.其中,各文献RR值的合并采用倒方差法或DerSimonian-Laird method(D-L)法,剂量-反应关系的评价采用方差加权的最小二乘法.结果 入Meta分析的文献共28篇.与低体力活动者相比,男、女性高体力活动者结肠癌RR值分别为0.75(95%CI:0.66～0.86)、0.85(95%CI:0.76～0.95).高质量文献分析显示体力活动与结肠癌,男性RR=0.74(95%CI:0.61～0.90)、女性接近统计学意义的RR=0.99(95%CI:0.95～1.02).男、女性中均未观察到明显的剂量-反应关系,趋势检验分别为P=0.142和P=0.417.结肠亚部位分析结果显示,增加体力活动与男性近端(右侧)结肠癌与远端(左侧)结肠癌发生均有关联,合并RR值分别为0.62(95%CI:0.45～0.85)和0.74(95%CI:0.56～0.99).结论 增加体力活动可以降低结肠癌发生的危险性.     

Unravelling the drivers behind COVID-19 vaccination hesitancy and refusal among teachers: A nationwide study

This study aims to assess the determinants of the coronavirus disease 2019 (COVID-19) vaccination hesitancy and refusal (VHR) among teachers, from pre-school to higher education, through an online survey. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge, and attitudes) per 1-point increase in the Likert scale, and VHR.Concerns about the vaccines’ efficacy and safety increase the risk of VHR (OR = 6.97, 95 %CI: 4.82–10.09 and OR = 8.71, 95 %CI: 5.52–13.73, respectively). Higher risk perceptions of getting infected (1/OR = 3.94, 95 %CI: 2.93–5.29), trust in the effectiveness of vaccines in reducing this risk or protecting against suffering complications (OR = 3.52, 95 %CI: 2.72–4.55 and OR = 10.94, 95 %CI: 7.16–16.68, respectively), and higher trust levels on the information transmitted regarding COVID-19 vaccination, are associated to lower VHR.As VHR appears to be highly influenced by perceptions, knowledge, and attitudes, it is crucial to promote and design interventions targeted to transforming these determinants.     

Physical Activity is Associated With Fewer Subjective Cognitive Complaints in 47 Low- and Middle-Income Countries

ObjectivesTo determine the association between physical activity (PA) and subjective cognitive complaints (SCCs), and the influential factors in this association.DesignCross-sectional study.Setting and ParticipantsCommunity-based data of the World Health Survey, which included 248,504 individuals from 47 low- and middle-income countries (LMICs), were analyzed [mean age = 38.6 (standard deviation 16.1) years; 50.7% female].MethodsPA was assessed with the International Physical Activity Questionnaire. Participants were grouped into those who meet (high PA) the 150 minutes of moderate-to-vigorous intensity PA per week recommendation, and those who do not (low PA). Two questions on subjective memory and learning complaints in the past 30 days were used (scales ranged from 1 to 5, with higher scores representing more severe SCC). Multivariable ordinal logistic regression and mediation analyses were performed.ResultsOverall, after adjusting for sociodemographic and a wide range of behavioral, psychological, and physical factors, low PA was associated with a higher risk for having more severe subjective memory complaints [odds ratio (OR) = 1.10, 95% confidence interval (CI) = 1.04-1.23] and learning complaints (OR = 1.18, 95% CI = 1.12-1.26). Significant associations were only observed among the middle-aged (45-64 years; learning complaints OR = 1.19, 95% CI = 1.06-1.33) and older populations (≥65 years; memory complaints OR = 1.31, 95% CI = 1.15-1.49, and learning complaints OR = 1.41, 95% CI = 1.24-1.60). Chronic physical conditions, sleep problems, depression, and anxiety explained between 7.7% and 29.4% of the PA-SCC association among those aged ≥45 years.Conclusions and ImplicationsLow PA was associated with increased odds for more severe SCCs in middle-aged and older adults in LMICs. Given the particularly rapid increase in dementia in LMICs, more longitudinal research is warranted from this setting to understand the utility of PA promotion in the prevention of cognitive impairment.