Refining index to measure physical activity inequality: which group of the population is the most vulnerable?

BACKGROUND: The existing body of research mostly discusses inequality in physical activity (PA) based on the difference in the level of moderate-to-vigorous physical activity (MVPA). Evidence is lacking on the quantified inequality measures (e.g., how big the inequality is, and the distribution) in order to identify the most vulnerable groups of a population. This study measured PA inequality among Thai adults by using three parameters to construct an inequality index: (1) Proportion of the population with sufficient MVPA; (2) Cumulative minutes of MVPA; and (3) The Gini coefficient. METHODS: This study employed three rounds of data from Thailand's Surveillance on Physical Activity (SPA) 2019-2021. In each round, over 6,000 individuals age 18-64 years were selected as nationally-representative samples, and were included in the analysis. PA inequality was constructed by using three parameters, with a combination of the three as the final measure, to identify the sub-groups of the Thai adults who are most vulnerable: groups with the least MVPA, highest insufficiency, and highest inequality index (Gini). RESULTS: Covid-19 containment measures have widened the gap in PA inequality, as shown by a declining proportion of the population meeting the recommended guidelines, from 74.3% in 2019 to 56.7% in 2020 and 65.5% in 2021. PA inequality existed in all sub-populations. However, by combining three parameters, the most vulnerable groups during the Covid-19 epidemic were identified as follows: (1) Those with no income; (2) The unemployed; (3) Those who have no access to PA facilities; (4) Older adults aged 60 + years; and (5) Those earning < 3,500 baht per month. Further, residents of Bangkok, young adults aged 18-24, individuals who attained primary level education or less, those who had no exposure to a PA awareness campaign and those who have a debilitating chronic disease also had elevated risk of PA insufficiency. CONCLUSION: A concerning level of PA inequality existed in all sub-populations. The use of combined indicators in measuring PA inequality should aid in determining the most vulnerable groups of the population with a refined procedure. This method can be applied in many settings since the baseline data used to measure inequality (i.e., percent sufficient and cumulative minutes of MVPA) are widely available.

Recovery shape of physical activity after COVID-19 pandemic.

BACKGROUND: Since the shutdowns associated with the coronavirus disease 2019 pandemic, there has been limited discourse on physical activity (PA) recovery (i.e., the ability of individuals to resume PA at pre-pandemic levels), including recovery rate, speed of recovery, which individuals are able to return quickly, who is left behind, and what are the causes of those differences. This study aimed to estimate the level and shape of PA recovery rate in Thailand. METHODS: This study employed 2 rounds (2020 and 2021) of Thailand's Surveillance on Physical Activity dataset for the analysis. Each round included over 6600 samples from individuals aged 18 years or older. PA was assessed subjectively. Recovery rate was calculated from the relative difference in the cumulative minutes of moderate-to-vigorous PA (MVPA) from 2 different periods. RESULTS: The Thai population experienced a medium level of recession of PA (-26.1%) and a moderate level of recovery of PA (37.44%). PA recovery in the Thai population resembled an imperfect V shape, reflecting a sharp decline followed by an immediate upturn; still, recovered PA remained lower than pre-pandemic levels. The quickest recovery was found among older adults, whereas students, young adults, residents of Bangkok, the unemployed, and those who had a negative attitude toward PA experienced the highest recession of PA and were among the slowest to recover. CONCLUSION: The level of recovery of PA among Thai adults is largely determined by the preventive behaviors demonstrated by groups within the population who have a higher awareness of their health. The effect of the mandatory coronavirus disease 2019 containment measures on PA was temporary. However, the slower recovery rate of PA among some individuals was caused by a combination of restrictive measures and socioeconomic inequality, which required more time and effort to overcome.

Distribution and Molecular Characterization of Escherichia coli Harboring mcr Genes Isolated from Slaughtered Pigs in Thailand.

The resistance of Enterobacteriaceae to colistin mediated by plasmid-borne mobile mcr genes is an emerging public health concern. This study aimed to explore the distribution and characteristics of Escherichia coli isolates harboring mcr genes from slaughtered pigs in Thailand from 2014 to 2015. A total of 779 E. coli isolates were assessed, of which 61 (7.8%) were found to carry mcr genes, including mcr-1, mcr-3, mcr-6, mcr-7, mcr-8, and mcr-9, together with co-occurrences of mcr-1+mcr-3, mcr-1+mcr-9, and mcr-3+mcr-6+mcr-7. In these mcr-harboring E. coli isolates, mcr-1 (40.9%) and mcr-9 (32.8%) were predominant. Colistin resistance was mainly mediated by the mcr-1 gene, whereas intermediate resistance was noted in isolates that harbored mcr-9, mcr-6, mcr-7, and mcr-8 genes. Most E. coli isolates harboring mcr genes were susceptible to third-generation cephalosporins and all of these isolates were susceptible to carbapenems. Clermont phylotyping demonstrated that mcr-harboring isolates mainly belonged to phylogroup A (44.3%), followed by phylogroups B1 (34.4%), D (14.8%), and B2 (6.6%). Multilocus sequence typing revealed that 25 sequence types (STs) were assigned to 45 mcr-harboring E. coli isolates, whereas the remaining 16 isolates were novel STs. The mcr-1 and mcr-9 genes were mostly predominant in ST101 and ST8900, respectively. This study provides a comprehensive insight into the prevalence and diversity of mcr-harboring E. coli isolates obtained from slaughtered pigs across Thailand. Strengthening of surveillance systems by the government for controlling and preventing mcr dissemination from animals to humans or vice versa is urgently needed. No clinical trial registration number.