Nutritional and food education as a complementary treatment approach in severe obese individuals.

Background: The treatment for obesity, specifically severe obesity, is a challenge for health professionals and services. It requires a multidisciplinary and holistic approach covering the complexity and difficulties of incorporating healthy habits to prevent associated diseases and mortality. Individual intervention's methods are not enough to change eating habits. Objective: To describe and investigate the contribution of nutritional and food education as a complementary therapeutic approach in the treatment of individuals with severe obesity and their family members. Methods: A multidisciplinary team adopted a group approach. A different topic was addressed at each therapeutic meeting to assist in the nutritional treatment of obesity, such as diet and healthy habits i.e. barriers to lifestyle changes. The topics were developed based on different methodological and teaching approaches to facilitate adherence to non-drug treatment. Results: Overall, there was a greater understanding towards the adoption of healthy eating habits of the whole family, greater motivation to adhere to dietary changes and adoption of a more physical active lifestyle. This interventional educational support methodology had been accepted in such a positive way for patients and their relatives. Family member participation expands the possibilities of establishing necessary and lasting changes in the lifestyle of not only the patients, but their whole families. Conclusion: Health education actions constitute an important complementary therapeutic approach in promoting health and preventing complications in individuals with severe obesity. This article can be useful to enlarge the debate on the subject and face the challenges related to the effective treatment of obesity, notably severe obesity.

Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis.

BACKGROUND: Multimorbidity is defined as the presence of multiple chronic conditions in the same individual. Multimorbidity is more prevalent in older adults and can lead to several adverse health outcomes. METHODS: We systematically reviewed evidence from observational studies to verify the association between multimorbidity and hospitalization in older adults. Furthermore, we also aimed to identify whether it changes according to gender, advanced age, institutionalization, and wealth of the country of residence. We searched the PubMed, Embase and Scopus databases from December 2020 to April 2021. The analysed outcomes were as follows: hospitalization, length of stay and hospital readmission. RESULTS: Of the 6,948 studies identified in the databases, 33 were included in this review. From the meta-analysis results, it was found that multimorbidity, regardless of the country's wealth, was linked to hospitalization in older adults (OR = 2.52, CI 95% = 1.87-3.38). Both definitions of multimorbidity, ≥2 (OR = 2.35, 95% CI = 1.34-4.12) and ≥3 morbidities (OR = 2.52, 95% CI = 1.87-3.38), were associated with hospitalization. Regardless of gender, multimorbidity was associated with hospitalization (OR = 1.98, 95% CI = 1.67-2.34) and with readmission (OR = 1.07, 95% CI = 1.04-1.09). However, it was not possible to verify the association between multimorbidity and length of stay. CONCLUSIONS: Multimorbidity was linked to a higher hospitalization risk, and this risk was not affected by the country's wealth and patient's gender. Multimorbidity was also linked to a higher hospital readmission rate in older adults. PROSPERO Registration (Registration number: CRD42021229328).

Prevalence of constipation in adults with obesity class II and III and associated factors.

BACKGROUND: Constipation and obesity have common risk factors. However, little is known about the occurrence of constipation in individuals with severe obesity and the associated factors. OBJECTIVE: To evaluate the prevalence of intestinal constipation and its associated factors in adults with obesity class II and III. METHOD: This study analyzed baseline data from a randomized clinical trial with adults aged 18-64 with a Body Mass Index (BMI) ≥ 35 kg/m2, living in the metropolitan region of Goiânia, Brazil. Data were collected using a questionnaire containing sociodemographic, lifestyle, level of obesity, presence of comorbidities, water intake and food consumption variables. The outcome variable was constipation assessed by the Rome III criteria and the Bristol Stool Form Scale. Multiple Poisson regression analysis was used to assess the association between explanatory variables and the outcome. RESULTS: Among the 150 participants, the prevalence of constipation was 24.67% (95% CI: 17.69-31.64). After multiple regression analyses constipation was associated with polypharmacy (adjusted PR: 2.99, 95% CI: 1.18-7.57, p = 0.021), younger age group i.e. 18-29 years (adjusted PR: 3.12, 95% CI: 1.21-8.06, p = 0.019) and former smoking (adjusted PR: 3.24, 95% CI: 1.28-9.14, p = 0.014). There was no statistically significant association between constipation and daily consumption of fiber-rich foods, however, the non-consumption of whole grains was borderline significant (adjusted PR: 2.92, 95% CI: 1.00 to 8.49, p = 0.050). CONCLUSION: A high prevalence of constipation was found in adults with obesity class II and III. Constipation was significantly associated with the simultaneous use of five or more medications, younger age group and being a former smoker.

Prevalence of Low Back Pain and Associated Risks in School-Age Children.

BACKGROUND: Low back pain (LBP) is highly prevalent in children and adolescents, while psychosocial, anthropometric, developmental, and lifestyle factors have been associated. However, the evidence is inconsistent from a biological point of view, so identifying predictors of LBP in the 6-12 years children through physical examination should be appropriate. AIMS: To estimate the prevalence of LBP and associated factors in schoolchildren in a Brazilian population. DESIGN: Cross-sectional study. SETTING: Three schools in Botucatu, Brazil. PARTICIPANTS/SUBJECTS: 377 students from 6-12 years. METHODS: Data collection consisted of questions regarding personal history, socioeconomic and anthropometric information, kinesiologic evaluation with anthropometry, lumbar biophotogrammetry, and backpack weight and use. Descriptive analyses were performed, and simple and multiple logistic regression models were used for risk factors. RESULTS: The prevalence of LBP was 27.32% (confidence interval [CI] 95% = 23.07-32.03). The mean age was 8.85 years (± 1.83) in the group with LBP and 8 years (± 1.76) in the group without LBP (p = .006). Variables such as backpack weight (odds ratio [OR] = 1.45, CI 95% = 1.018-2.064) and exceeding 3 hours per day in front of the television (OR = 7.97, CI 95% = 1.957-32.515) increased the chance of LBP in these students. CONCLUSION: LBP is prevalent in younger schoolchildren, and the factors associated with this outcome can be effectively addressed through the promotion of health measures. LBP in schoolchildren is a musculoskeletal discomfort that negatively affects the quality of life of these individuals and persists in adulthood.

Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE).

BACKGROUND: Condom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use. AIM: Our aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey. METHODS: The study participants were 100,962 adolescents 13-18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed. RESULTS: Of the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use. CONCLUSION: High condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.

Visceral Obesity and Its Shared Role in Cancer and Cardiovascular Disease: A Scoping Review of the Pathophysiology and Pharmacological Treatments.

The association between obesity, cancer and cardiovascular disease (CVD) has been demonstrated in animal and epidemiological studies. However, the specific role of visceral obesity on cancer and CVD remains unclear. Visceral adipose tissue (VAT) is a complex and metabolically active tissue, that can produce different adipokines and hormones, responsible for endocrine-metabolic comorbidities. This review explores the potential mechanisms related to VAT that may also be involved in cancer and CVD. In addition, we discuss the shared pharmacological treatments which may reduce the risk of both diseases. This review highlights that chronic inflammation, molecular aspects, metabolic syndrome, secretion of hormones and adiponectin associated to VAT may have synergistic effects and should be further studied in relation to cancer and CVD. Reductions in abdominal and visceral adiposity improve insulin sensitivity, lipid profile and cytokines, which consequently reduce the risk of CVD and some cancers. Several medications have shown to reduce visceral and/or subcutaneous fat. Further research is needed to investigate the pathophysiological mechanisms by which visceral obesity may cause both cancer and CVD. The role of visceral fat in cancer and CVD is an important area to advance. Public health policies to increase public awareness about VAT's role and ways to manage or prevent it are needed.

Back Pain and Body Posture Evaluation Instrument for Adults: Expansion and Reproducibility.

BACKGROUND: The BackPEI questionnaire was developed and validated just exclusively to evaluate children. AIMS: To propose, validate, and test the reproducibility of an expanded version of the Back Pain and Body Posture Evaluation Instrument (BackPEI), originally designed to assess back pain in school-aged children, for use with adults. DESIGN: Validation Study. METHODS: Five questions from the original BackPEI were replaced, resulting in the revised instrument (BackPEI-A) containing 20 questions. Three experts checked the content validity of the revised instrument, and the reproducibility was tested by trialing the questionnaire with 154 adults. RESULTS: The reproducibility data for the questions regarding pain intensity, analyzed using the Wilcoxon test and intraclass correlation coefficient (ICC), indicated that (a) there was no difference between the medians and (b) the answers were highly correlated, both for lower back (p = .574) (ICC = 0.908) and cervical (p = .968) (ICC = 0.865) pain. The reproducibility data for the remaining questions analyzed using the κ coefficient were classified as moderate (0.4 < κ ≤ 0.6) or very good (κ > 0.8). CONCLUSION: The BackPEI-A is a reproducible, valid, and reliable instrument for use in the evaluation of back and neck pain and their associated risk factors. The instrument also facilitates the evaluation of postural habits in activities of daily living in adults.

Determinants of eating patterns and nutrient intake among adolescent athletes: a systematic review.

BACKGROUND: This review aims to update the influences of sport modalities, sport performance, and non-exercise-related determinant, on eating patterns and nutrient intake outcomes among adolescent competitive athletes. METHODS: The PubMed and Scopus databases were searched for the last 20 years. Observational and intervention studies of all languages on eating patterns and nutrient intake in adolescent (10- to 19-year-old) competitive athletes were included. Study quality and risk of bias were assessed using a Downs and Black instrument. Moreover, the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evidence system was used to assess the strength of the body of evidence. RESULTS: Regarding outcomes of 21 included articles, 95.2% of studies focused on nutrient analysis, whereas few of the included articles reported eating patterns. As determinants, most studies analyzed the influences of sport-related (n = 10) and demographic factors (n = 8), among which only sport modalities were significantly associated with nutrient intake. Age and sex were not significantly associated with nutrient intake. All studies were observational, and most were cross-sectional (n = 17) and conducted in developed countries such as the United States and European nations. Most studies evaluated boys, and the sport that received the most attention was soccer. CONCLUSIONS: Athletes do not adjust their nutrient intake or food choice to the demands of the training load or different training sessions, while sport modalities significantly influenced nutrient intake. Moreover, results concerning demographic determinants were inconsistent and thus remain inconclusive. TRIAL REGISTRATION: Prospero CRD42016043310 .

Layout for Assessing Dynamic Posture: Development, Validation, and Reproducibility.

PURPOSE: To determine the psychometric properties of the layout for assessing dynamic posture (LADy). METHODS: The study was divided into 2 phases: (1) development of the instrument and (2) determination of validity and reproducibility. The LADy was designed to evaluate the position adopted in 9 dynamic postures. RESULTS: The results confirmed the validity and reproducibility of the instrument. From a total of 51 criteria assessing 9 postures, 1 was rejected. The reproducibility for each of the criteria was classified as moderate to excellent. CONCLUSIONS: The LADy constitutes a valid and reproducible instrument for the evaluation of dynamic postures in children 11 to 17 years old. It is low cost and applicable in the school environment.

Effectiveness of the back school program for the performance of activities of daily living in users of a basic health unit in Porto Alegre, Brazil.

[Purpose] Primary care is considered the gateway to the Brazilian public health system and is responsible for managing the most prevalent problems in the population. In this study, the effects of Back School on pain, functionality, and the performance of activities of daily living (ADL) in users with chronic musculoskeletal pain were evaluated. [Subjects and Methods] Forty-four users (33 females and 11 males) participated in Back School, with five two-hour theoretical and practical meetings held once a week. The assessment instruments used were as follows: (a) a circuit evaluation of posture dynamics recorded on video, (b) an observational instrument of ADL using video, (c) anamnesis, (d) the visual analogue scale, and (e) the Oswestry Disability Index. [Results] The results showed decreased pain intensity, improved functionality, and the recovery of ADL. [Conclusion] The Back School program is an effective health education strategy for users with chronic musculoskeletal pain.

Monitoring the prevalence of postural changes in schoolchildren.

[Purpose] The aim of this study was to identify whether postural changes are prevalent with advancing age using a photogrammetric method performing one-year follow-up study. [Subjects and Methods] Thirty-eight schoolchildren were evaluated in 2011 and 2012 in this cohort study. The subjects underwent a postural evaluation, which involved palpation of reference anatomic points, placement of reflexive markers over the anatomic points, image acquisition, and point digitalization using the Digital Image-based Postural Assessment evaluation software. For data analysis, descriptive statistics and inferential statistics were analyzed by McNemar's test. [Results] The results showed a significant increase in postural change prevalence for the lumbar spine in the sagittal plane (from 42.2% to 81.6%) and the knees in the frontal plane (from 39.5% to 63.2%) and a significant decrease in the prevalence of scoliosis (from 68.5% to 42.2%). [Conclusion] The findings indicate an increase in the prevalence of postural changes in schoolchildren from Teutônia, RS, Brazil, in 2012 compared with 2011. The development of longitudinal investigations for long-term monitoring of the evolution of posture and of schoolchildren habits's representing a viable alternative to subsidize health actions.

Postural education and behavior among students in a city in southern Brazil: student postural education and behavior.

[Purpose] The aim of the present study was to assess the knowledge of the spine and posture among adolescent female students and to determine if they had access to postural education in or outside school. [Subjects and Methods] This was an epidemiological survey of a representative sample of 495 female students aged 14 to 18 years attending a regular secondary school in São Leopoldo, RS, Brazil. Data were collected through a questionnaire. [Results] The results showed that 16.8% of teens did not know what a spine was, 8.3% had no knowledge of posture, and 61% reported receiving no posture education. Posture awareness was associated only with posture while using a computer, while having postural education class was not associated with any postural behavior. [Conclusion] The results showed that, although most students are familiar with the spine and posture, a sizable group is not, and over half had no postural education. These findings suggest that inclusion of postural education programs in schools should be encouraged in order to promote health and prevent diseases related to the spine.

Intra and inter-rater reproducibility of the Remote Static Posture Assessment (ARPE) protocol's Postural Checklist.

With the enforcement of social distancing due to the pandemic, a need to conduct postural assessments through remote care arose. So, this study aimed to assess the intra- and inter-rater reproducibility of the Remote Static Posture Assessment (ARPE) protocol's Postural Checklist. The study involved 51 participants, with the postural assessment conducted by two researchers. For intra-rater reproducibility assessment, one rater administered the ARPE protocol twice, with an interval of 7-days between assessments (test-retest). A second independent rater assessed inter-rater reproducibility. Kappa statistics (k) and percentage agreement (%C) were used, with a significance level of 0.05. The intra-rater reproducibility analysis indicated high reliability, k values varied from 0.921 to 1.0, with %C ranging from 94% to 100% for all items on the ARPE protocol's Postural Checklist. Inter-rater reproducibility indicates reliability ranging from slight to good, k values exceeded 0.4 for the entire checklist, except for four items: waists in the frontal photograph (k = 0.353), scapulae in the rear photograph (k = 0.310), popliteal line of the knees in the rear photograph (k = 0.270), and foot posture in the rear photograph (k = 0.271). Nonetheless, %C surpassed 50% for all but the scapulae item (%C = 47%). The ARPE protocol's Postural Checklist is reproducible and can be administered by the same or different raters for static posture assessment. However, when used by distinct raters, the items waists (front of the frontal plane), scapulae, popliteal line of the knees, and feet (rear of the frontal plane) should not be considered.

Factors influencing the work of researchers in Scientific Initiation: A systematic review protocol.

INTRODUCTION: Scientific Initiation (SI) is an educational activity that allows students to begin their scientific training and research under the guidance of an experienced researcher. While several studies have examined students' perceptions of SI, research on the perspective of researchers working in this field is currently lacking. Thus, this study's aim is to describe the protocol design for conducting a systematic review. At the same time, the review aims also to identify factors influencing the work of researchers in SI and explore the motivations leading researchers to engage in research projects within institutions and their respective impacts. METHOD AND ANALYSES: Literature search will be done using the bibliographic databases, including Academic Search Premier, APA PsycNet, CINAHL Plus, ERIC, SocINDEX, Scopus, and Web of Science. The search strategy was guided by the PICo framework (Population, phenomenon of Interest, and Context). The preparation and development of this protocol following guidelines were employed: Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015), Peer Review of Electronic Search Strategies 2015 (PRESS 2015), and PRISMA-Search (PRISMA-S). Original, peer-reviewed articles that examine the factors related to the work of researchers in SI will be included without any language or publication date restrictions. Qualitative, quantitative, and mixed-methods studies will be screened by two independent researchers. The included studies will be analyzed to identify factors, policies, and their impacts obtained analytically. Findings will be objectively categorized and synthetically represented through figures, diagrams, and graphic models. The risk of bias will be assessed using the Critical Appraisal Skills Program (CASP) and the Downs and Black checklists. A third senior reviewer will resolve any discrepancies. DISCUSSION: We aim to understand the factors that drive researchers to engage in SI research through the dissemination of the findings of this systematic review. This may aid the development of institutional strategies and actions that can support the enhancement of SI programs and encourage greater researcher participation.

Analyzing the COVID-19 Transmission Dynamics in Acre, Brazil: An Ecological Study.

The north region of Brazil is characterized by significant vulnerabilities, notably surpassing national poverty indicators. These disparities exacerbated the impact of respiratory illnesses on the healthcare system during the COVID-19 pandemic, particularly in areas with limited healthcare resources, inadequate infrastructure, and barriers to healthcare access. The crisis was further influenced by multiple lineages that emerged as significant virus variants associated with increased transmissibility. Within this context, our ecological study focused on analyzing the epidemiological evolution of COVID-19 in the state of Acre. We constructed time-series trends in incidence, lethality, and mortality from March 2020 to December 2022 using the Prais-Winsten regression model. Our findings revealed that in 2020, there was an increasing trend in incidence, while mortality and lethality continued to decrease (p < 0.05). In the following year, both incidence and mortality decreased, while lethality increased at a rate of 1.02% per day. By the end of 2022, trends remained stationary across all rates. These results underscore the importance of ongoing surveillance and adaptive public health measures to bolster the resilience of healthcare systems in remote and vulnerable regions. Indeed, continuous monitoring of the most predominant SARS-CoV-2 lineages and their dynamics is imperative. Such proactive actions are essential for addressing emerging challenges and ensuring effective responses to adverse situations.

Thoracic Spine Pain in High School Adolescents: A One-Year Longitudinal Study.

Thoracic spine pain (TSP) is a common condition in the general adult population, with a similar prevalence in children and adolescents. An in-depth understanding of risk factors can assist in the identification of potential targets for effective prevention strategies. This study aimed to determine the incidence of TSP and ongoing TSP and identify its predictors in high school students. This longitudinal study was conducted in 2017 (baseline-T1), and follow-up surveys were completed in 2018 (T2). The variable "thoracic spine pain" was observed using the Nordic questionnaire, and associated variables were observed through the Baecke questionnaire and the Strengths and Difficulties Questionnaire. Statistical association methods were used for bivariate and multivariate logistic regression analysis. Among the participants, the one-year prevalence (ongoing TSP) was 38.4%, and the one-year incidence (new TSP) was 10.1%. Significant risk factors for ongoing TSP were adolescent females (RR = 2.14), in the age group of 15 to 18 years (RR = 1.41), clinical mental health problems (RR = 3.07), borderline mental health problems (RR = 2.02), mental health problems, sitting while using a tablet (RR = 1.93), distance of the eye from cell phone screen of or more than 20 cm (RR = 1.69), distance of the eye from the PC screen of or more than 30 cm (RR = 1.53), cell phone mobile use duration of or more than 3 h (RR = 1.60), tablet use time of or more than 3 h (RR = 2.08), and semi-lying prone position while using the cell phone (RR= 1.47), and these were also significant predictors of TSP episodes. Significant risk factors for new TSP were adolescent female sex (RR = 1.88), level, clinical mental health problems (RR = 4.26), borderline mental health problems (RR = 2.07), semi-lying prone position while using cell phone (RR = 1.71) or tablet (RR = 2.31), and mobile phone use duration equal to or greater than 3 h (RR = 1.72). We conclude that there is a high prevalence of TSP in high school students, which is associated with the female sex, mental health problems, and use of electronic devices for an inappropriate duration in an improper position.

Osteosarcopenia later in life: Prevalence and associated risk factors.

BACKGROUND AND AIMS: The identification of risk factors for osteosarcopenia in older adults is important for planning preventative strategies in clinical practice. Therefore, our study aimed to investigate the prevalence and risk factors associated with osteosarcopenia in older adults using different diagnostic criteria. METHODS: The sample included 171 community-dwelling older adults with a mean age of 79.4 ± 5.9 years and mean body mass index of 25.67 ± 4.70 kg/m2. We analyzed sociodemographic, biomarkers, lifestyle, and health condition data from participants of the "Projeto Idosos - Goiânia" cohort study. The outcome osteosarcopenia was defined as the simultaneous occurrence of sarcopenia and osteopenia. Osteopenia was diagnosed by low lumbar spine bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA). Sarcopenia was diagnosed using handgrip dynamometry and appendicular skeletal mass index assessed by DEXA following the criteria of the two European consensuses on sarcopenia (2010 and 2018). Two osteosarcopenia outcome variables were evaluated: OsteoSarc1 and OsteoSarc2 using the 2010 and 2018 European sarcopenia consensus criteria, respectively. Multivariate Poisson regression analysis was used to calculate the prevalence ratios (PRs). RESULTS: The prevalence of OsteoSarc1 and OsteoSarc2 were 12.8% and 7.2%, respectively, with no significant gender differences. OsteoSarc1 was associated with low potassium (PR: 3.39, 95% confidence interval [CI]: 1.10-10.43) and malnutrition (PR: 3.84, 95% CI: 1.78-8.30). OsteoSarc2 was associated with being ≥80 years (PR: 7.64, 95% CI: 1.57-37.07), >4 years of education (PR: 3.25, 95% CI: 1.03-10.22), alcohol consumption (PR: 2.41, 95% CI: 1.01-5.77), low potassium (PR: 2.22, 95% CI: 1.45-6.87), low serum vitamin D (PR: 4.47, 95% CI: 1.68-11.88), and malnutrition (PR: 5.00, 95% CI: 1.06-23.51). CONCLUSIONS: OsteoSarc1 had a higher prevalence. The risk factors associated with the two outcomes were malnutrition and potassium level, as well as other risk factors, such as alcohol consumption and low vitamin D level. These findings may contribute to the prevention or treatment of this health condition in older adults.

Back Pain and Body Posture Evaluation Instrument for Adults (BackPEI-A): Updating and an online application.

INTRODUCTION: Back Pain and Body Posture Evaluation Instrument for Adults (BackPEI-A) lags the most recent literature, as it does not assess issues related to activity increasingly present in the daily lives of people of all ages. PURPOSE: (1) to update the BackPEI-A by including four new questions regarding the use of mobile devices; (2) to present a new graphic design of the issues related to back and neck pain to facilitate understanding of the location of these pains; (3) to test the content validity and the reliability of the new questions; and (4) to identify whether the BackPEI-A version in online form has adequate reliability. METHODS: The content validation by evaluation of eight experts, and the reliability of the new questions and of the online version were assessed. The new questions were translated to English. Content validation was assessed by the content validity index (CVI). Reliability was assessed using the agreement percentage (%C), the kappa statistic (k), and the intraclass correlation coefficient (ICC). k > 0.4 and %C > 0.5 were assumed to include new questions. RESULTS: The new questions showed good agreement among the experts, k > 0.4 and %C > 0.5. Both forms applied presented an average kappa of total sample ranging from moderate to good, and moderate ICC values, showing an adequate reliability. CONCLUSION: The updated BackPEI-A is valid and reliable and allows the identification of aspects related to back and neck pain, as well as possible risk factors.

Impact of type, intensity, frequency, duration and volume of physical activity on dementia and mild cognitive impairment in older adults: protocol for a systematic review and meta-analysis.

INTRODUCTION: Worldwide, the prevalence of degenerative diseases such as dementia and mild cognitive impairment (MCI) is increasing with population ageing and increasing life expectancy. Both conditions share modifiable risk factors. Physical inactivity is one of these modifiable risk factors, and research points to the protective effect of physical activity on the incidence of dementia and MCI. However, this association tends to change according to type, intensity, frequency, duration and volume of physical activity. Furthermore, it remains unclear which of these characteristics offers the greatest protective effect. Therefore, this study aims to evaluate the impacts of different types, intensities, frequencies, duration and volume of physical activity on dementia and cognitive decline in older adults. METHODS AND ANALYSIS: The search will be carried out from October 2023, using the following databases: PubMed, Embase, Scopus, CINAHL and Web of Science. Cohort studies with a follow-up time of 1 year or longer that have investigated the incidence of dementia and/or MCI in older adults exposed to physical activity will be included. There will be no limitations on the date of publication of the studies. Studies published in English, Spanish or Portuguese will be analysed. Two researchers will independently screen the articles and extract the data. Any discrepancies will be resolved by a third reviewer. Association measures will be quantified, including OR, HR, relative risk and incidence ratio, with a 95% CI. If the data allow, a meta-analysis will be performed. To assess the methodological quality of the selected studies, the Grading of Recommendations, Assessment, Development and Evaluations instrument, and the Downs and Black instrument to assess the risk of bias, will be used. ETHICS AND DISSEMINATION: Ethical approval is not required. The results will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42023400411.

Interventions towards barriers to the practice of physical activity in adolescence: A systematic review protocol.

INTRODUCTION: Lack of regular physical activity is recognized as a global public health issue. Three out of every four adolescents do not adhere to physical activity recommendations. Thus, this systematic review will evaluate interventions employed to minimize barriers to physical activity among adolescents. Herein, we present the study protocol. To the best of our knowledge, this will be the first systematic review to assess the interventions implemented to minimize barriers to the practice of physical activity among adolescents. A systematic understanding of the most effective interventions to reduce the barriers to physical activity is essential. METHOD AND ANALYSIS: We will search five databases: two multidisciplinary (Scopus and Web of Science) and three other health-related databases (Embase, SPORTDiscus, and PubMed). The search will be limited to original peer-reviewed articles published in English, with no time restrictions. The search strategy will use MeSH terms and their variations to maximize the search strategy. Two reviewers will independently read the included articles, extract the data, and evaluate the methodological quality using the Grading of Recommendations, Assessment, Development, and Evaluation scale and the risk of bias using the Critical Appraisal Skills Programme checklist and Downs and Black scale. Discrepancies will be resolved by a third reviewer. This systematic review will follow the guidelines outlined in the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses. DISCUSSION: The outcomes of this study are expected to enhance the current understanding of the obstacles to physical activity among adolescents and aid in the development or modification of programs to combat physical inactivity in this population. Consequently, these findings should have a positive impact on current and future adolescent health outcomes. ETHICS AND DISCLOSURE: Ethical approval will not be required for this study as it is an analysis of previously published articles (i.e., secondary data). The results will be published in a peer-reviewed journal. PROSPERO registration: CRD42022382174.