Results from Brazil's 2022 Report Card on Physical Activity for Children and Adolescents.

This research aims to summarize the process and results of the 2022 Report Card on Physical Activity for Brazilian children and adolescents. A group of experts led by 10 PhD researchers gathered the best possible evidence on physical activity indicators. The Report Card Brazil 2022 included the top 10 indicators of physical activity and sleep, obesity, and poor mental health variables, which made up four dimensions: (I) Daily Behaviors; (II) Settings and Sources of Influence; (III) Government Strategies and Investments; and (IV) Health Outcomes. Comprehensive searches, including peer-reviewed and gray literature searches, were performed for each indicator. Data were considered from systematic reviews, local and national surveys, websites, and official information from the Brazilian Federal Government. Grades from the indicators ranged from F (Active Play) to B (School). In addition, the results found for each indicator were Overall Physical Activity (D), Organized Sport Participation (C-), Active Transportation (C), Sedentary Behaviors (D), Sleep (C), Family and Peers (C-), Community and Environment (C), Government (D+), Physical Fitness (D+), Obesity (11.7%), and Poor Mental Health (37.8%). Successfully strategies for increasing physical activity among Brazilian children and adolescents should look at the different indicators presented in this report.

Clustering of Physical Activity, Diet and Sedentary Behavior among Youth from Low-, Middle-, and High-Income Countries: A Scoping Review.

BACKGROUND: The interaction between physical activity (PA), diet, and sedentary behavior (SB) plays an important role on health-related outcomes. This scoping review (Prospero CRD42018094826) aims to identify and appraise clusters of PA, diet, and SB among youth (0-19 years) according to country income. METHODS: Five databases were searched. Fifty-seven articles met the inclusion criteria. RESULTS: Fifty-five cluster types were identified, with greater variety in high-income than lower income countries. The most prevalent profiles were "High SB and consumption of sugar, salt, and beverages (SSB)" (n = 17) and "High PA" (n = 13-5), both of which presented in all income countries. The healthiest profile, "High PA and fruit and vegetables (F&V); Low SB and SSB" (n = 12), was present in upper-middle and high-income countries, while the unhealthiest "Low PA and F&V; High SB and SSB" (n = 6) was present only in high-income countries. CONCLUSIONS: High SB and unhealthy diet (SSB) were more prevalent in clusters, mainly in high-income countries. The results support the need for multi-component actions targeting more than one behavior at the same time.

Scoping Review on Interventions for Physical Activity and Physical Literacy Components in Brazilian School-Aged Children and Adolescents.

This scoping review mapped the existing evidence on interventions to promote physical activity (PA) and/or components of physical literacy (PL) in Brazilian school-aged children and adolescents. Nine electronic databases and gray literature were consulted in May 2020, with no limit on year or language. School-based intervention studies (6 to 18 years old, primarily) that assessed PA or PL components (PA-related factors or attributes) were eligible. The studies were stratified by children (<12 years of age) and adolescents (≥12 years of age). A total of 63 documents were included, which refer to 42 different intervention studies. Twenty-five interventions focused on adolescents and 17 on children. The most-used strategies in the interventions were changes in physical and environmental education classes, extracurricular PA sessions, and health education. No study has analyzed all components of PL or evaluated PL using specific protocols or instruments. PA attributes were the most studied components (30 studies). This review identified the need to conduct interventions with strategies that target all components of PL, representing important elements for a research agenda that underlies school interventions that contribute to an active lifestyle.

Scaling up of Eco-Bio-Social Strategy to Control Aedes aegypti in Highly Vulnerable Areas in Fortaleza, Brazil: A Cluster, Non-Randomized Controlled Trial Protocol.

Aedes aegypti is a cosmopolitan vector for arboviruses dengue, Zika and chikungunya, disseminated in all Brazilian states. The Eco-Bio-Social (EBS) strategy is vital in Aedes aegypti control as it mobilizes stakeholders (government, professionals, society, and academics) to promote healthy environments. This paper describes the rationale and methods of expanding the EBS strategy for Aedes aegypti control in Fortaleza, Northeast Brazil. A cluster, non-randomized controlled clinical trial was developed to analyze the strategy's effectiveness in vulnerable territories (high incidence of dengue and violent deaths; low HDI; substandard urban infrastructure, high population density, and water scarcity). We selected two intervention and two control groups, resulting in a sample of approximately 16,000 properties. The intervention consisted of environmental management by sealing large elevated water tanks, introduction of beta fish in waterholes, elimination of potential breeding sites, and mobilization and training of schoolchildren, endemic disease workers, health workers, social mobilizers, and community leaders; community surveillance of arboviruses; construction and validation of a booklet for the prevention of arboviruses in pregnant women. We analyzed the costs of arboviruses to government and households, the intervention cost-effectiveness, chikungunya's chronicity, and acceptance, sustainability, and governance of vector control actions. The primary outcome (infestation) was analyzed using the house, container, and Breteau indices. We hope that this study will help us understand how to scale up strategies to fight Aedes aegypti in vulnerable areas.

Evaluation of the impact of single-nucleotide polymorphisms on treatment response, survival and toxicity with cytarabine and anthracyclines in patients with acute myeloid leukaemia: a systematic review protocol.

INTRODUCTION: Acute myeloid leukaemia is the most common type of acute leukaemia in the world. Thus, the study of genetic alterations, such as single-nucleotide polymorphisms (SNPs), has contributed to a better understanding of the mechanisms underlying leukaemogenesis, to improve the prognosis and to increase the survival of these patients. However, there is no synthesis of evidence in the literature evaluating the quality of evidence and the risk of bias in the studies such that the results can be translated. Thus, this systematic review protocol aims to assess the impact of SNPs on genes involved in the metabolism of cytarabine and anthracyclines with respect to survival, treatment response and toxicity in patients with AML. METHODS: This systematic review protocol is based on PRISMA guidelines and includes searches in six electronic databases, contact with authors, repositories of clinical trials, and cancer research. Studies published in peer-reviewed journals will be included if they meet the eligibility criteria: (a) samples composed of individuals of any age, of both sexes, with a diagnosis of AML, regardless of the time of diagnosis of disease; (b) participants who have undergone or are undergoing cytarabine- and anthracycline-associated chemotherapy or cytarabine-only chemotherapy; and (c) in vivo studies. Studies that include patients with promyelocytic leukaemia (Fab type 3) will be excluded because this disease has different treatment. The process of study selection, data extraction, and evaluation/synthesis will be performed in duplicate. Assessment of methodological quality and risk of bias will be performed using the Cochrane Risk of Bias Tool for randomized clinical studies and the Downs-Black Checklist for cohort and case-control studies. The synthesis of evidence will include the level of evidence based on the GRADE protocol. A meta-analysis of the association between SNPs and outcomes may be performed based on Cochrane guidelines. DISCUSSION: It is expected that clinical decisions for AML patients will consider evidence-based practices to contribute to better patient management. In this way, we will be able to define how to treat patients with AML to improve their survival and quality of life. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018100750.

Association between socio-economic status and physical activity is mediated by social support in Brazilian students.

This study evaluated whether the relationship between socioeconomic status (SES) and moderate-to-vigorous physical activity (MVPA) is mediated by social support of peers and parents. A cross-sectional study included students (n = 1182) aged 11 to 18 years who were recruited in 2014 from public schools in Fortaleza, Brazil. Participants completed a questionnaire to assess all variables. Mediation analyses were performed to determine the role of parental support and peer support on the relationship between SES and MVPA. Also, moderated-mediation analyses with estimating of conditional indirect effects were performed in order to identify whether gender is a moderator of the mediating effect. A positive and significant association between SES and MVPA was found among Brazilian students, and social support of parents and peers were significant mediators of this relationship. Conditional indirect effects showed that both parental and peer support had a significant indirect effect among boys; only parental support had a significant indirect effect among girls. These results suggest that improving social support can help reduce the impact of SES on physical activity among Brazilian adolescents.

Effect of a multicomponent intervention on variables related to screen time in adolescents: a cluster-randomized controlled trial / Efeito de uma intervenção multicomponente sobre variáveis relacionadas ao tempo de tela em adolescentes: ensaio randomizado controlado por conglomerado

The aim of this study was to evaluate the effect of an intervention on screen time and on psychoso-cial factors (Attitude, self-efficacy, support of family and school members) associated with reduced screen time in students. A cluster-randomized controlled trial was conducted in three schools in the intervention group (n = 548) and three in the control group (n = 537). The intervention focused on teacher training, opportunities for practicing physical activity at school and reducing screen time, as well as health education. The questionnaire (applied in July and December 2014) included questions about time using TV and computer / video game on weekdays and weekend days (Combined in full-screen time). The psychosocial factors were obtained through scales. The control variables were school and income. The analysis included binary logistic regression models and generalized linear models. The effect size was calculated with analyzes stratified by sex and age (p < 0.05). The intervention group reduced TV (boys: OR = 2.86; CI95%: 1.06-7.71) time and computer/video game (girls: OR = 3.34; CI95%: 1.14-9.84; 11 to 13 years: OR = 3.08; CI95%: 1.17-8.08) for < 2 hours / day (p < 0.05). Positive effects of the intervention were observed on attitude (among girls and adolescents of both age groups) and school support (all subgroups), with effect sizes ranging from 0.21 to 0.54. We concluded that the intervention caused improvements in certain components of the screen time, as well as attitude and school support. Interventions in the school context can help reduce screen time in the young population

O objetivo desse estudo foi avaliar o efeito de uma intervenção sobre tempo de tela e em fatores psicossociais (atitude, autoeficácia, suporte da família e dos membros da escola) associados à redução do tempo de tela em escolares. Ensaio randomizado controlado por conglomerado realizado em três escolas no grupo intervenção (n = 548) e três no grupo controle (n = 537). A intervenção focou na capacitação de professores, oportuni-dades para prática de atividade física na escola e redução do tempo de tela, bem como educação em saúde. O questionário (aplicado em julho e dezembro de 2014) incluiu questões sobre tempo usando TV e computador/videogame em dias de semana e fim de semana (combinados em tempo de tela total). Os fatores psicossociais foram obtidos por meio de escalas. As variáveis de controle foram escola e classe econômica. A análise incluiu modelos de regressão logística binária e modelos lineares generalizados. O tamanho do efeito foi calculado, com análises estratificadas por sexo e faixa etária (p < 0,05). Após o acompanhamento, escolares da inter-venção tiveram maiores chances de reduzir o tempo de TV (rapazes: OR = 2,86; IC95%: 1,06-7,71) e computador/videogame (moças: OR = 3,34; IC95%: 1,14-9,84; 11 a 13 anos: OR = 3,08; IC95%: 1,17-8,08) para < 2 horas/dia (p < 0,05). Efeitos positivos da intervenção ocorreram sobre atitude (entre moças e adolescentes de ambas as faixas etárias) e suporte escolar (todos subgrupos), com tamanhos de efeito variando de 0.21 a 0.54. Conclui-se que a intervenção ocasionou melhoras em determinados componentes do tempo de tela, assim como na atitude e no suporte escolar. Intervenções no contexto escolar podem colaborar para a redução do tempo de tela na população jovem

[Anthropometric indices among schoolchildren from a municipality in Southern Brazil: a descriptive analysis using the LMS method]. / Índices antropométricos em escolares de um município no Sul do Brasil: análise descritiva utilizando o método LMS.

OBJECTIVE: To describe the percentile values for body mass index (BMI), waist circumference (WC) and waist-to-height (WHtR) of children from Colombo, Brazil, and compare them with data of children from other countries. METHODS: This was a cross-sectional study with a random sample of 2,035 children aged 6-11 years. Age-and sex-specific smoothed percentiles curves for BMI, WC and WHtR were created using the LMS method. Values of 10(th), 50(th) and 90(th) percentiles from Brazilian children were compared with data from other countries. RESULTS: There was a trend of increasing BMI and WC with age in both sexes. WHtR remained constant with advancing age in boys and girls. Comparison of the growth pattern among countries showed clear differences. Southern Brazil boys and girls had elevated 90(th) percentile values for BMI, which was similar to German children and higher than the North American and World Health Organization percentile values. However, children from this study had intermediate values for WC and WHtR in comparison to children from other countries. CONCLUSIONS: Elevated BMI values were observed among southern Brazilian children, but WC and WHtR percentile values were lower in southern Brazilian children than in children from other countries. Interventions at different levels should be made to avoid a probable increase of nutritional disorders (especially general obesity) in the next years.

Fatores associados ao excesso de peso corporal em escolares da tríplice fronteira: Argentina, Brasil e Paraguai / Factors associated with overweight in students from tri-border region: Argentina, Brazil and Paraguay

A região da Tríplice Fronteira apresenta diversos problemas sociais e de saúde na população jovem, contudo, não há informações sobre a proporção de adolescentes com excesso de peso corporal. Este estudo investigou a prevalência de excesso de peso corporal e os fatores associados em escolares da Tríplice Fronteira: Argentina, Brasil e Paraguai. Participaram do estudo 1.183 escolares, de 15 a 18 anos de idade. O excesso de peso corporal foi identificado segundo os pontos de corte do índice de massa corporal, propostos pela Organização Mundial de Saúde. O questionário do Global School-Based Student Health Survey foi utilizado para identificar fatores sociodemográficos (sexo e faixa etária) e comportamentais (atividade física fora da escola, deslocamento à escola, tempo assistindo TV e consumo de frutas, vegetais, doces e salgados) associados ao excesso de peso corporal. Utilizou-se a estatística descritiva, análise de variância, qui-quadrado e regressão logística binária, adotando-se p< 1 vez/dia) tiveram 2,2 e 2,9 vezes mais chances de ter excesso de peso corporal do que seus pares que realizavam deslocamento ativo e que consumiam vegetais diariamente, respectivamente. Estes resultados sugerem que políticas públicas de combate ao excesso de peso corporal devem focar a promoção hábitos saudáveis entre os jovens da Tríplice Fronteira.

The Tri-Border Region has several social and health problems among young people, however, there are no data about the overweight between adolescents. This study investigated the prevalence of overweight and associated factors in students from Tri-Border Region: Argentina, Brazil and Paraguay. Study participants were 1.183 students, ages from 15 to 18 years. The overweight was identified according to body mass index cut-off points proposed by the World Health Organization. The Global School-Based Student Health Survey questionnaire was used to identify sociodemographic (gender and age) and behavioral factors (physical activity outside of school, commuting to school, time watching TV and fruits, vegetables, sweet, and salty snack consumption) associated with overweight in adolescents. It was used the descriptive statistics, analysis of variance, chi-square and binary logistic regression, adopting p< 1 time/day) were 2,2 and 2,9 times more likely to have overweight than their counterparts who performed active commuting to school and consumed vegetables daily, respectively. These results suggest that public policies to combat overweight should attention on promoting healthy lifestyle among young people from Tri-Border Region.

[Factors associated with overweight in students from tri-border region: Argentina, Brazil and Paraguay]. / Fatores associados ao excesso de peso corporal em escolares da tríplice fronteira: Argentina, Brasil e Paraguai.

The Tri-Border Region has several social and health problems among young people, however, there are no data about the overweight between adolescents. This study investigated the prevalence of overweight and associated factors in students from Tri-Border Region: Argentina, Brazil and Paraguay. Study participants were 1.183 students, ages from 15 to 18 years. The overweight was identified according to body mass index cut-off points proposed by the World Health Organization. The Global School-Based Student Health Survey questionnaire was used to identify sociodemographic (gender and age) and behavioral factors (physical activity outside of school, commuting to school, time watching TV and fruits, vegetables, sweet, and salty snack consumption) associated with overweight in adolescents. It was used the descriptive statistics, analysis of variance, chi-square and binary logistic regression, adopting p < 0.05. Thirteen percent of students were overweight. Boys were approximately two times more likely to have overweight than girls, independently of nationality. Brazilian students that realized passive commuting to school and Argentineans students with low consumption of vegetables (< 1 time/day) were 2.2 and 2.9 times more likely to have overweight than their counterparts who performed active commuting to school and consumed vegetables daily, respectively. These results suggest that public policies to combat overweight should attention on promoting healthy lifestyle among young people from Tri-Border Region.