Time spent on social media and depressive symptoms in university students: The mediating role of psychoactive substances.

BACKGROUND AND OBJECTIVES: Although some studies have related social media use and depressive symptoms, little is known about the role of psychoactive substance use in this relationship. Therefore, this study aimed to estimate the association between time spent on social media (TSSM) and depressive symptoms and to examine whether this relationship is mediated by psychoactive substances in students. METHODS: Our cross-sectional analysis included a sample of students from a university in a large city in southern Brazil. The TSSM and tobacco frequency of consumption were self-reported. Depressive symptoms were assessed with the Patient Health Questionnaire. Alcohol and illicit drug-related risks were assessed with the Alcohol, Smoking and Substance Involvement Screening Test. Hayes's PROCESS macro was used for mediation analyses, adjusted for age, sex, body mass index and physical activity. RESULTS: A total of 3161 students were included, of which, 69.0% reported moderate to severe depressive symptoms. The association between TSSM and depressive symptoms was statistically significant and partially mediated by tobacco consumption (indirect effect [IE] = 0.05; 95% CI: 0.02-0.08), alcohol-related risk (IE = 0.19; 95% CI: 0.14-0.25), and illicit drug-related risk (IE = 0.08; 95% CI: 0.05-0.12). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Our data suggest a direct relationship between TSSM and depressive symptoms, with a partial mediation effect of psychoactive substance use. This study highlights the importance that public health initiatives aimed at preventing depressive problems in young adults should focus not only on TSSM, but also on controlling and reducing psychoactive substance use.

Trends in mortality from cardiovascular diseases in Chile, 2000-2020.

Objective: To analyze trends in mortality caused by cardiovascular diseases (CVD) in Chile during the period 2000-2020. Methods: Data on age-adjusted mortality rates (AAMR) from CVD per 100 000 population in Chile for 2000-2020 were extracted from the World Health Organization Mortality Database. Joinpoint regression was used to analyze the trends and compute the average annual percent change (AAPC) in Chile. In addition, analyses were conducted by sex and type of CVD. Results: Between 2000 and 2020, the AAMR from CVD decreased in Chile from 159.5 to 94.6 per 100 000 population, with a statistically significant decrease in the AAPC of 2.6% (95% CI [-2.8, -2.4]). No joinpoints were identified. The AAMR from CVD decreased annually by 2.6% (95% CI [-2.8, -2.4]) and 2.8% (95% CI [-3.5, -2.6]) in men and women, respectively. The AAMR from ischemic heart disease reduced annually by 3.6% (95% CI [-4.6, -2.7]) with two joinpoints in 2011 and 2015. In the case of stroke, the mortality rate decreased annually by 3.7% (95% CI [-4.5, -3.0]), with two joinpoints in 2008 and 2011. Conclusions: Cardiovascular disease mortality rates have decreased significantly in Chile, in both sexes, especially in women. This decrease could be explained mainly by a significant reduction in the case fatality in recent decades. These results could be a reference for developing primary prevention and acute management of CVD policies focused on populations with higher mortality.

[Features of patients admitted for COVID-19 at a regional hospital in the Chilean Araucania Region]. / Características clínicas de pacientes ingresados por COVID-19 en un Hospital de alta complejidad de la región de la Araucanía-Chile.

BACKGROUND: The Araucania region in Chile had the greatest COVID-19 incidence and lethality in Chile Aim: To describe the clinical characteristics and evolution of patients admitted for COVID-19 in a high complexity Hospital in the region of La Araucanía-Chile. MATERIAL AND METHODS: Review of medical records of the first 169 patients aged 55 ± 17 years (50% women) admitted for COVID-19 between march and may, 2020 at a regional hospital in Temuco Chile. RESULTS: The most common comorbidities of these patients were hypertension, diabetes, and obesity. The symptom triad of cough, dyspnea and fever was present in 85%. Less frequent symptoms were diarrhea and vomiting. Biomarkers at admission such as ferritin, D-dimer, among others, were significantly higher among patients who required admission to the Intensive Care Unit. The presence of cough, dyspnea and fever were significantly associated with longer hospitalization time and requirement for mechanical ventilation. Hypertension and obesity were significantly associated with longer hospitalization stay. Eight percent of patients died. CONCLUSIONS: Symptoms such as cough, dyspnea and fever and specific biomarkers on admission were associated with a worse evolution of adult inpatients with COVID-19.

Low vitamin intake is associated with risk of frailty in older adults.

Background: the association between vitamin intake and frailty has hardly been studied. The objective was to assess the association of dietary vitamin intake with incident frailty in older adults from Spain. Methods: data came from a cohort of 1,643 community-dwelling individuals aged ≥65, recruited in 2008-10 and followed up prospectively throughout 2012. At baseline, 10 vitamins were assessed (vitamin A, thiamine, riboflavin, niacin, vitamins B6, B12, C, D, E and folates) using a validated face-to-face diet history. Incident frailty was identified using Fried's definition as having ≥3 of the following five criteria: unintentional weight loss of ≥4.5 kg, exhaustion, weakness, slow walking speed and low physical activity. Nonadherence to the recommended dietary allowances (RDA) was considered when the intake of a vitamin was below the recommendation. Analyses were performed with logistic regression and adjusted for main confounders. Results: during a 3.5-year follow-up, 89 (5.4%) participants developed frailty. The odds ratios (95% confidence interval) of frailty for those in the lowest versus the highest tertile of vitamin intake were 2.80 (1.38-5.67), P-trend: 0.004, for vitamin B6; 1.65 (0.93-2.95), P-trend: 0.007, for vitamin C; 1.93 (0.99-3.83), P-trend: 0.06, for vitamin E and 2.34 (1.21-4.52), P-trend: 0.01, for folates. Nonadherence to the RDAs of vitamins was related to frailty for thiamine odds ratio (OR): 2.09 (1.03-4.23); niacin OR: 2.80 (1.46-5.38) and vitamin B6; 2.23 (1.30-3.83). When considering tertiles of RDAs for the 10 vitamins those who met <5 RDAs had a higher risk of frailty, OR: 2.84 (1.34-6.03); P-trend: <0.001, compared to those who met >7. Conclusion: a lower intake of vitamins B6, C, E and folates was associated with a higher risk of frailty. Not meeting RDAs for vitamins was also strongly associated.

The association of major patterns of physical activity, sedentary behavior and sleep with health-related quality of life: a cohort study.

OBJECTIVE: To examine the prospective association of patterns of physical activity, sedentary behavior and sleep with health-related quality of life (HRQL) in the general population of Spain. METHODS: A cohort study with 4271 individuals aged ≥ 18 years was recruited in 2008-2010 and followed-up prospectively through 2012. Activity patterns were derived from factor analysis. HRQL was assessed with the SF-12 questionnaire, and suboptimal HRQL was defined as a score below the sex-specific sample median. RESULTS: Three main activity patterns were identified. A higher adherence to the pattern named "vigorous activity-seated at the computer" was inversely associated with a suboptimal score in the physical-composite summary (PCS) of the SF-12 (multivariate adjusted odds ratio [aOR] for the highest vs. the lowest quartile 0.71; 95% confidence interval [IC] 0.55-0.90; p-trend=0.003). The "light activity-seated for reading" pattern was inversely associated with a suboptimal score in the mental-composite summary (aOR=0.73; 95% CI=0.61-0.89; p-trend=0.002). However, a higher adherence to the "seated for watching TV-daytime sleeping" pattern was directly associated with suboptimal PCS (aOR=1.35; 95% CI=1.10-1.66; p-trend=0.008). CONCLUSION: Patterns including any physical activity were associated with better physical or mental HRQL. However, a pattern defined by sedentary behavior with diurnal sleep showed worse HRQL and should be a priority target of preventive interventions.

Effectiveness of assisted standing on bone mineral density in children with cerebral palsy. A systematic review. / Efectividad de la bipedestación asistida en la densidad mineral ósea, en niños con parálisis cerebral. Una revisión sistemática.

Cerebral palsy is associated with complications such as low bone mineral density, which is more severe in patients with greater motor involvement. Assisted standing helps to prevent or delay this complication; however, its effect is controversial because the type of stander, the type of standing (dynamic or static), and its dosage are not clear. The objective of this study was to determine the effectiveness of assisted standing on bone mineral density in children with cerebral palsy. A systematic review was carried out in compliance with the PRISMA guidelines, using 5 databases. The results were presented using tables, a risk of bias analysis, and a narrative synthesis. Four studies met the inclusion criteria. Assisted standing generates positive changes in bone mineral density, but further research is required, with studies that have greater methodological rigor, longer follow-up periods, and a larger number of patients.

La parálisis cerebral tiene complicaciones asociadas como una baja densidad mineral ósea; esta es más acentuada a mayor compromiso motor. La bipedestación asistida ayuda a prevenir y/o a retrasar esta complicación, aunque su efecto es controversial, porque no está claro el tipo de bipedestador, el tipo de bipedestación (dinámica o estática) ni su dosificación. El objetivo de este estudio es determinar la efectividad de la bipedestación asistida en la densidad mineral ósea, en niños con parálisis cerebral. Se realizó una revisión sistemática bajo los lineamientos PRISMA, se utilizaron cinco bases de datos. Los resultados se presentaron a través de tablas, análisis de riesgo de sesgo y síntesis narrativa. Cuatro estudios cumplieron los criterios de inclusión. La bipedestación asistida genera cambios positivos en la densidad mineral ósea, pero se necesita más investigación, con estudios que tengan un mayor rigor metodológico, períodos de seguimiento más largos y que incluyan una mayor cantidad de pacientes.

Association of screen time and physical activity with health-related quality of life in college students.

OBJECTIVE: To determine the association between screen time and physical activity with quality of life among Chilean university students. METHODS: Cross-sectional and analytical study conducted on 726 first-year university students who replied three questionnaires: Youth Risk Behavior Survey, WHO Quality of Life-BREF scale, and the International Physical Activity Questionnaire. RESULTS: There were differences in overall quality of life (p < .001) and level of satisfaction in health (p < .01) according to screen exposure time. These results follow a linear trend for all the quality of life domains (p < .01), and they indicate that there is an inverse association between screen time and quality of life. CONCLUSION: There is an inverse association between screen time and quality of life in university students. Students with a longer screen exposure time showed a lower quality of life, specifically in the domains of social relationships and psychological health, regardless of sex, physical activity, or socioeconomic level.

Validity and reliability of the international physical activity questionnaire short form in Chilean adults.

PURPOSE: This study aimed to determine the test-retest reliability and concurrent validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) in Chilean adults. METHODS: A cross-sectional validation study was carried out on 161 adults aged between 35 and 65, selected from a population-based study in Temuco, Chile. IPAQ-SF was completed twice, seven days apart, to analyze the test-retest reliability with the intraclass correlation coefficient (ICC). Objective PA was assessed by accelerometry (ActiGraph GT3X+) for seven consecutive days. Intraclass correlation coefficients were used to determine the reliability. Spearman correlation coefficients (rho) and Bland-Altman plots were calculated to assess validity. RESULTS: 144 subjects (52.5 ± 8.8 years, 53.9% men) answered the IPAQ-SF on both occasions and had valid accelerometry data. The IPAQ-SF showed moderate reliability for sitting time (ICC = 0.62), while it was poor for walking (ICC = 0.40), moderate PA (ICC = 0.41), vigorous PA (ICC = 0.48), and total PA (ICC = 0.33). There were weak correlations between IPAQ-SF and accelerometry for sedentary behavior (rho = 0.28, p = 0.0005), walking (rho = 0.11, p = 0.17), moderate PA (rho = 0.13, p = 0.128), vigorous PA (rho = 0.18, p = 0.03), and total PA (rho = 0.26, p = 0.002). CONCLUSIONS: The results suggest that the IPAQ-SF test and retest would provide an acceptable measure of total SB and MVPA, and a weak correlation between IPAQ-SF and accelerometer.

Adherence to the Mediterranean diet and depression, anxiety, and stress symptoms in Chilean university students: a cross-sectional study.

This study aims to determine the association of adherence to the Mediterranean diet and its food groups with depressive symptoms in Chilean university students. The study design was cross-sectional. A total of 934 first-year students at a Chilean public university completed a self-report questionnaire. To assess adherence to Mediterranean diet, an index validated in Chile (Chilean-MDI) was used, and depression, anxiety, and stress symptoms were assessed using the Depression Anxiety and Stress Scale (DASS-21). Logistic regression models were used to analyze the association of adherence to Mediterranean diet and its food groups with depression, anxiety, and stress symptoms adjusted for the main confounders. Students with moderate and high adherence to Mediterranean diet showed lower odds of depression [DASS-21 > 5, odds ratio (OR) = 0.64; 95% confidence interval (95%CI): 0.47-0.88] than those with low adherence to Mediterranean diet. The consumption of 1-2 servings/day of vegetables (OR = 0.63; 95%CI: 0.43-0.92), > 2 servings/week of nuts (OR = 0.41; 95%CI: 0.21-0.80), 1-2 servings/day of fruits (OR = 0.60; 95%CI: 0.42-0.85), 1-2 servings/week of fish and seafood (OR = 0.67; 95%CI: 0.48-0.94), and 1/2-3 units/week of avocado (OR = 0.67; 95%CI: 0.48-0.93) showed low odds of depressive symptoms. The consumption of whole grains and cereals (> 2 servings/day) (OR = 1.63; 95%CI: 1.02-2.61) showed the opposite association. Adherence to Mediterranean diet and consumption of fruits, vegetables, nuts, avocado, fish, and seafood are associated with a lower likelihood of depression in Chilean university students. New policies and educational strategies are recommended to improve diet quality and the mental health of the entire university community.

Association between eating habits and quality of life among Chilean university students.

Objective To estimate the association between eating habits and quality of life (QOL) in Chilean university students. Participants: 1,212 students from the Universidad de La Frontera, Chile (mean age 18.7 ± 2.15) were surveyed in January-March 2018. Methods: Participants completed a cross-sectional self-report survey to evaluate QOL using the WHOQOL-BREF scale and eating habits with a food habits survey. Results: Students reporting a better healthy eating habits score also presented a higher QOL. Eating breakfast and eating home-cooked meals is a protective factor for QOL in each domain. The consumption of sweet snacks was shown to be a risk factor for the physical health and environment domains. The consumption of fast food is shown as the greatest risk factor in the physical domain. Conclusion: Healthy and unhealthy eating habits are associated with different dimensions of QOL. University authorities should develop new policies to improve the QOL of the entire university community.

Redrawing Cities with Children and Adolescents: Development of a Framework and Opportunity Index for Wellbeing-The REDibuja Study Protocol.

Global changes require urgent integration of health and wellbeing into all urban policies. Complex social and environmental factors define wellbeing outcomes and inequities present in cities. Additionally, political decisions are seldom thought and developed considering the needs and participation of children and adolescents. The REDibuja study aims to develop a multidimensional framework of wellbeing for children and adolescents and to validate an index of opportunities for better wellbeing for children and adolescents in the urban context of Temuco, Chile. This child-centered and cross-sectional study will involve mixed methodologies throughout the implementation of five work packages for two years (2022-2023): (1) development of a conceptual framework for child and adolescent wellbeing, (2) integration of available and public data, (3) studies in the local context, (4) data integration using geographic information systems, and (5) validation of the wellbeing opportunity index for children and adolescents. REDibuja will implement methodologies that until now are little used to facilitate political decisions in our regional context. This process and results could be transferred for assessment and decision-making in Latin America and low- and middle-income countries in other regions.

The Association Between Alcohol-Related Problems and Sleep Quality and Duration Among College Students: a Multicountry Pooled Analysis.

Alcohol consumption and sleep disorders are both prevalent and relevant problems among college students, but the relationship between these conditions is unclear. This study aimed to analyze the association between alcohol-related problems and sleep in first-year college students from Brazil, Chile, and Spain. Cross-sectional analyses were performed with data from three independent studies with first-year college students from each country. The risk of alcohol-related problems (RARP) and sleep quality and duration were self-reported using mixed methods. Pooled odds ratios (p-OR) and 95% confidence intervals (95% CI) of suboptimal sleep quality and of short (< 7 h) and long (> 8 h) sleep duration were estimated according to RARP adjusting for the main confounders. Of the 1830 students included (31.2% Brazilian, 42.2% Chilean, and 26.6% Spanish), 61.6% were female, and the mean age was 20.0 ± 3.6 years. Overall, 25.0% and 9.9% of the students were classified as intermediate and high RARP, respectively. In the combined results for the three countries, intermediate-to-high RARP was associated with a higher likelihood of suboptimal sleep quality (p-OR: 1.24; 95% CI: 1.00 to 1.52; I2 heterogeneity statistics: 43.0%), regardless of sociodemographic and lifestyle covariates and of self-rated health. The frequency of alcohol consumption was not associated with sleep quality or sleep duration. In this multicountry pooled analysis, first-year college students at risk of alcohol-related problems were more likely to report worse sleep quality. The coexistence of alcohol-related problems and sleep disorders could potentiate its adverse health effects among these young adults. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-022-00763-8.

Longitudinal association of physical activity and sedentary behavior during leisure time with health-related quality of life in community-dwelling older adults.

BACKGROUND: Evidence on the relation between leisure-time physical activity (LTPA) and health-related quality of life (HRQoL) in older adults is based primarily on clinical trials of physical exercise programs in institutionalized persons and on cross-sectional studies of community-dwelling persons. Moreover, there is no evidence on whether leisure-time sedentary behavior (LTSB) is associated with HRQoL independently of LTPA. This study examined the longitudinal association between LTPA, LTSB, and HRQoL in older community-dwelling adults in Spain. METHODS: Prospective cohort study of 1,097 persons aged 62 and over. In 2003 LTPA in MET-hr/week was measured with a validated questionnaire, and LTSB was estimated by the number of sitting hours per week. In 2009 HRQoL was measured with the SF-36 questionnaire. Analyses were done with linear regression and adjusted for the main confounders. RESULTS: Compared with those who did no LTPA, subjects in the upper quartile of LTPA had better scores on the SF-36 scales of physical functioning (ß 5.65; 95% confidence interval [CI] 1.32-9.98; p linear trend < 0.001), physical role (ß 7.38; 95% CI 0.16-14.93; p linear trend < 0.001), bodily pain (ß 6.92; 95% CI 1.86-11.98; p linear trend < 0.01), vitality (ß 5.09; 95% CI 0.76-9.41; p linear trend < 0.004) social functioning (ß 7.83; 95% CI 2.89-12.75; p linear trend < 0.001), emotional role (ß 8.59; 95% CI 1.97-15.21; p linear trend < 0.02) and mental health (ß 4.20; 95% CI 0.26-8.13; p linear trend < 0.06). As suggested by previous work in this field, these associations were clinically relevant because the ß regression coefficients were higher than 3 points. Finally, the number of sitting hours showed a gradual and inverse relation with the scores on most of the SF-36 scales, which was also clinically relevant. CONCLUSIONS: Greater LTPA and less LTSB were independently associated with better long-term HRQoL in older adults.

Pre-existing conditions in Latin America and factors associated with adverse outcomes of COVID-19: A review.

The coronavirus disease 2019 (COVID-19) pandemic, produced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly throughout the world. Latin American and the Caribbean countries have been harshly affected by the pandemic mainly due to less prepared healthcare systems and fragmented social safety nets. In the region, health status population-based indicators are worse than compared to the Organization for Economic Cooperation and Development. Recent evidence suggests that the progression and severity of COVID-19 are associated with the prior health status of individuals, and studies have shown that the case fatality rate is highly stratified among different populations. This narrative review aims to describe factors associated with adverse outcomes of COVID-19 in the context of social determinants of health in Latin American and Caribbean countries. In this review, we state that genetic and biological factors interact in a sophisticated way with social determinants of health, impacting the rapid spread of COVID-19 in Latin American and Caribbean countries. Behavioral factors, such as physical inactivity, smoking, and unhealthy diets, are related to chronic systemic inflammation. Also, air pollution can prolong inflammation and the hyper-activation of the immune system. Air pollutants could facilitate the spread of the virus. Finally, frailty and comorbidities can be associated with COVID-19 severity through increasing vulnerability to stressors and leading to more severe symptoms of COVID-19 disease, including a higher mortality risk. All these factors contribute to increasing the impact of COVID-19 in Latin American and Caribbean countries. We highlight the relevance of considering social determinants of health in Latin American and the Caribbean countries, not only in controlling the likelihood of getting the disease but also its progression and severity. All these social determinants can guide the design and implementation of tailored interventions promoting healthy lifestyle behaviors, which should lower the spread of the disease, its severity, and lethality.

La pandemia de la enfermedad por coronavirus 2019 (COVID-19), producida por el virus SARS-CoV-2, se ha diseminado rápidamente a través del mundo. Los países de Latinoamérica y el Caribe han sido afectados duramente por la pandemia principalmente debido a falta de preparación de sus sistemas de salud y debido al fragmentado sistema de seguridad social. Además, en la región, el estado de salud de la población muestra peores indicadores de salud comparado con los países de la Organización para la Cooperación y el Desarrollo Económico. Evidencia reciente sugiere que la progresión y severidad de la COVID-19 están asociadas con el estado de salud basal del individuo, y algunos estudios han mostrado que la letalidad está altamente estratificada entre diferentes poblaciones. El objetivo de esta revisión narrativa es describir los factores asociados con peor evolución de la COVID-19 en el contexto de los determinantes sociales de la salud en los países de Latinoamérica y el Caribe. En esta revisión, se indica que los factores biológicos y genéticos interactúan de una manera sofisticada con los determinantes sociales de la salud, impactando la rápida diseminación de la COVID-19 en los países de Latinoamérica y el Caribe. Factores del comportamiento, como la inactividad física, fumar, y una dieta poco saludable, están relacionadas con una inflamación sistémica crónica. Además, la contaminación ambiental puede prolonger la inflamación y la hiperactivación del sistema inmune. Las partículas contaminantes del aire pueden facilitar la dispersión del virus. Finalmente, el síndrome de fragilidad y las comorbilidades están asociadas con severidad de la COVID-19, aumentando la vulnerabilidad ante factores estresantes y provocando síntomas más graves de la enfermedad COVID-19, aumentando el riesgo de mortalidad. Todos los factores mencionados, contribuyen a aumentar el impacto de la pandemia por COVID-19 en los países de Latinoamérica y el Caribe. Destacamos la relevancia de considerar los determinantes sociales de la salud en los países de Latinoamérica y el Caribe, no sólo para controlar el riesgo de contagio, sino también la progresión y severidad de la enfermedad. Los determinantes sociales pueden guiar el diseño y la implementación de intervenciones para promover los estilos de vida saludable, que puede contribuir a reducir la diseminación de la enfermedad, su severidad y letalidad.

Change in health-related quality of life as a predictor of mortality in the older adults.

PURPOSE: We examined whether changes in health-related quality of life (HRQL) predict subsequent mortality among the Spanish elderly. METHODS: Prospective cohort study of 2,373 persons, representative of the Spanish population aged 60 and older. HRQL was measured in 2001 and 2003 using the SF-36 health questionnaire. Cox regression models were used to examine the association of changes in the physical and mental component summary (PCS and MCS) scores of HRQL from 2001 to 2003 with all-cause mortality through 2007. RESULTS: Two hundred twelve deaths were ascertained from 2003 to 2007. The hazard ratios for mortality across categories of PCS change were as follows: 2.12 (95% confidence interval [CI] 1.39-3.24) for a > 10-point decline; 1.51 (1.01-2.28) for a 6- to 10-point decline; 1 for the reference category, a change of -5 to +5 points; 0.83 (0.51-1.34) for a 6- to 9-point improvement and 0.68 (0.42-1.09) for a > 10-point improvement; P for linear trend <0.001. The associations between changes in the MCS and mortality showed the same direction, but were of a lower magnitude and attained statistical significance (P < 0.05) only for a > 10-point decline in MCS. CONCLUSIONS: Changes in HRQL predict mortality in the older adults. A decline in HRQL should alert to a worse vital prognosis and stimulate the search for the possible determinants of such decline.

2018 Chilean Physical Activity Report Card for Children and Adolescents: Full Report and International Comparisons.

BACKGROUND: The study summarizes the findings of the 2018 Chilean Report Card (RC) on Physical Activity (PA) for Children and Adolescents and compares the results with the first Chilean RC and with other countries from the Global Matrix 3.0. METHODS: A Research Work Group using a standardized methodology from the Global Matrix 3.0 awarded grades for 13 PA-related indicators based on the percentage of compliance for defined benchmarks. Different public data sets, government reports, and papers informed the indicators. RESULTS: The grades assigned were for (1) "behaviors that contribute to overall PA levels": overall PA, D-; organized sport participation, D-; active play, INC; and active transportation, F; (2) "factors associated with cardiometabolic risk": sedentary behavior, C-; overweight and obesity, F; fitness, D; sleep, INC; and (3) "factors that influence PA": family and peers, F; school, D; inclusion, INC; community and built environment, B; government strategies and investments, B-. CONCLUSIONS: Chile's grades remained low compared with the first RC. On the positive side, Chile is advancing in environmental and policy aspects. Our findings indicate that the implementation of new strategies should be developed through collaboration between different sectors to maximize effective investments for increasing PA and decreasing sedentary time among children and adolescents in Chile.

Sleep duration and health-related quality of life among older adults: a population-based cohort in Spain.

STUDY OBJECTIVES: The few studies that have addressed the association between sleep duration and health-related quality of life (HRQL) were cross-sectional and small-sized, targeted young and middle-aged persons, and did not adjust for the main confounders. This study sought to examine the cross-sectional and longitudinal relationship between habitual sleep duration and HRQL in older adults. DESIGN: Prospective study conducted from 2001 through 2003. Sleep duration was self-reported in 2001, and HRQL was measured using the SF-36 questionnaire in 2001 and 2003. Analyses were adjusted for the main confounders. SETTING: Community-based study. PARTICIPANTS: A cohort of 3834 persons representative of the non-institutionalized Spanish population aged 60 years and over. INTERVENTION: None. MEASUREMENT AND RESULTS: In comparison with women who slept 7 hours, those with extreme sleep durations (< or = 5 or > or = 10 h) reported worse scores on the SF-36 physical and mental scales in 2001. Among men, sleeping < or = 5 h was associated with a worse score in the role-physical scale in 2001. The magnitude of most of these associations was comparable with the reduction in HRQL associated with aging 10 years. Sleep duration in 2001 failed to predict changes in HRQL between 2001 and 2003. CONCLUSION: Extreme sleep durations are a marker of worse HRQL in the elderly.

Trends in mortality from cardiovascular diseases in Chile, 2000-2020 / Tendencias de la mortalidad por enfermedades cardiovasculares en Chile, 2000-2020 / Tendências de mortalidade por doenças cardiovasculares no Chile, 2000-2020

ABSTRACT Objective. To analyze trends in mortality caused by cardiovascular diseases (CVD) in Chile during the period 2000-2020. Methods. Data on age-adjusted mortality rates (AAMR) from CVD per 100 000 population in Chile for 2000-2020 were extracted from the World Health Organization Mortality Database. Joinpoint regression was used to analyze the trends and compute the average annual percent change (AAPC) in Chile. In addition, analyses were conducted by sex and type of CVD. Results. Between 2000 and 2020, the AAMR from CVD decreased in Chile from 159.5 to 94.6 per 100 000 population, with a statistically significant decrease in the AAPC of 2.6% (95% CI [-2.8, -2.4]). No joinpoints were identified. The AAMR from CVD decreased annually by 2.6% (95% CI [-2.8, -2.4]) and 2.8% (95% CI [-3.5, -2.6]) in men and women, respectively. The AAMR from ischemic heart disease reduced annually by 3.6% (95% CI [-4.6, -2.7]) with two joinpoints in 2011 and 2015. In the case of stroke, the mortality rate decreased annually by 3.7% (95% CI [-4.5, -3.0]), with two joinpoints in 2008 and 2011. Conclusions. Cardiovascular disease mortality rates have decreased significantly in Chile, in both sexes, especially in women. This decrease could be explained mainly by a significant reduction in the case fatality in recent decades. These results could be a reference for developing primary prevention and acute management of CVD policies focused on populations with higher mortality.

RESUMEN Objetivo. Analizar las tendencias de la mortalidad por enfermedades cardiovasculares (ECV) en Chile durante el período 2000-2020. Métodos. Los datos sobre la tasa de mortalidad ajustada por la edad (TMAE) por ECV por 100 000 habitantes en Chile durante el período 2000-2020 se extrajeron de la base de datos de mortalidad de la Organización Mundial de la Salud. Se utilizó la regresión de tipo joinpoint (punto de cambio) para analizar las tendencias y calcular el cambio porcentual anual promedio (CPAP) en Chile. Además, se realizaron análisis por sexo y por tipo de ECV. Resultados. Entre el 2000 y el 2020, la TMAE por ECV disminuyó en Chile de 159,5 a 94,6 por 100 000 habitantes, con una disminución del CPAP estadísticamente significativa del 2,6% (IC del 95% [-2,8 a -2,4]). No se detectó ningún punto de cambio (joinpoint). La TMAE por ECV disminuyó anualmente un 2,6% (IC del 95% [-2,8 a -2,4]) en los hombres y un 2,8% (IC del 95% [-3,5 a -2,6]) en las mujeres. La TMAE por cardiopatía isquémica se redujo anualmente en un 3,6 % (IC del 95 % [-4,6 a -2,7]), encontrándose dos puntos de cambio en el 2011 y el 2015. En el caso de los ataques cerebrovasculares, la tasa de mortalidad disminuyó anualmente un 3,7% (IC del 95% [-4,5 a -3,0]), encontrándose dos puntos de cambio en el 2008 y el 2011. Conclusiones. La tasa de mortalidad por ECV ha disminuido significativamente en Chile en ambos sexos, pero en especial en las mujeres. Este descenso podría explicarse principalmente por la reducción significativa de la letalidad observada en las últimas décadas. Estos resultados podrían constituir una referencia para la elaboración de políticas de prevención primaria y manejo de casos agudos de ECV que estén centradas en aquellos grupos poblacionales donde la mortalidad es más alta.

RESUMO Objetivo. Analisar as tendências de mortalidade causada por doenças cardiovasculares (DCV) no Chile no período de 2000 a 2020. Métodos. Taxas de mortalidade por DCV ajustadas por idade no Chile referentes ao período de 2000 a 2020 foram extraídas do Banco de Dados de Mortalidade da Organização Mundial da Saúde. Foi usado um modelo de regressão linear segmentada (joinpoint) para analisar tendências e calcular a variação percentual média anual no Chile. Além disso, foram realizadas análises por sexo e tipo de DCV. Resultados. No Chile, entre 2000 e 2020, a taxa de mortalidade por DCV ajustada por idade caiu de 159,5 para 94,6 por 100 mil habitantes, com uma redução estatisticamente significante da variação percentual média anual de 2,6% (IC de 95% [-2,8; -2,4]). Não foram identificados pontos de inflexão. Anualmente, a taxa de mortalidade por DCV ajustada por idade caiu 2,6% (IC 95% [-2,8; -2,4]) e 2,8% (IC 95% [-3,5; -2,6]) entre homens e mulheres, respectivamente. A taxa de mortalidade por doença cardíaca isquêmica ajustada por idade caiu 3,6% (95% CI [-4,6; -2,7]) por ano, com dois pontos de inflexão (em 2011 e 2015). No caso do acidente vascular cerebral, a taxa de mortalidade diminuiu 3,7% (IC de 95% [-4,5; -3,0]) por ano, com dois pontos de inflexão (em 2008 e 2011). Conclusões. As taxas de mortalidade por doenças cardiovasculares diminuíram significativamente no Chile em ambos os sexos, especialmente nas mulheres. Essa queda pode ser explicada principalmente por uma redução significativa na letalidade observada nas últimas décadas. Esses resultados podem ser uma referência para o desenvolvimento de políticas de prevenção primária e manejo de casos agudos de DCV voltadas para populações com maiores taxas de mortalidade.