Physical Activity Policies at National and Subnational Levels: A Study in Colombia, Costa Rica, Ecuador, and Mexico.

BACKGROUND: National physical activity (PA) policy processes are only beginning to be studied in Latin America, and little attention has focused at the subnational level. This study examined national-subnational relations in the policy process (agenda setting, policy formulation, adoption, implementation, and evaluation) in selected Latin American countries. METHODS: The Global Observatory for Physical Activity's (GoPA!) INTEGRATE-PA-Pol tool was applied in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital plus one noncapital city among national and subnational policymakers (n = 27), previously identified by the GoPA! Country Contacts. PA policy development and implementation were assessed using descriptive statistics. RESULTS: Twenty-three (response rate = 85.2%) informants provided data, mainly from the health sector (52.2%), followed by the sport (26.1%), transport (13.0%), and education (8.7%) sectors. Most informants reported that their countries had a current PA policy embedded within noncommunicable diseases prevention plans (46.2%), other plans (46.2%), or obesity prevention/management/control plans (7.7%). Respondents at the subnational level rated PA promotion as central (64.3%), while the national-level role was important but not central (75.0%). National and subnational policymakers indicated low-to-little involvement in the other level's PA policy processes across the 5 policy stages. CONCLUSIONS: This study demonstrated that collecting national and subnational PA policy data across countries with the active collaboration of the GoPA! network was feasible. We also successfully identified governmental interactions throughout the PA policy process, suggesting suboptimal engagement between national and subnational levels.

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity-GoPA! 2015 and 2020 Surveys.

BACKGROUND: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. METHODS: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. RESULTS: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world's population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world's population live in countries where PA promotion capacity should be significantly improved. CONCLUSION: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.

Physical activity during recess in elementary schoolchildren in Belgium and Ecuador: The role of the physical environment at school.

To increase physical activity levels in children, knowledge on how school playgrounds can be optimally designed is important. Until now, the contribution of playground variety and greening to children's physical activity level during recess remains unclear. This study examined the associations of school playground variety and greening with energy expenditure (EE) in elementary school children in Ecuador and Belgium. Additionally, moderating effects of study site and gender were studied. Observational data were collected using SOPLAY in ten schools in East Flanders (Belgium) and Cuenca (Ecuador). Data were analysed with linear mixed-effects model analyses. Results showed that independent of study site, EE was higher in playground areas with less green elements, and a higher level of total variety. Primary surface was only associated with EE in boys, they were more active when an artificial surface was present. Implementation of loose equipment was somewhat more strongly positively associated with EE in Ecuadorian than in Belgian children. Because of the well-known restorative effects of green elements, we do not wish to suggest that less greening should be implemented at schools. However, ideally green spaces should be designed in a way that active play is stimulated by combining green elements with other improvements.

Síndrome de Intestino Irritable en personal de enfermería de un Hospital de Cuenca-Ecuador / Irritable Bowel Syndrome in nursing staff at a hospital in Cuenca-Ecuador

INTRODUCCIÓN: El síndrome de intestino irritable (SII) es un trastorno funcional digestivo frecuente en personal de salud, con importantes repercusiones en la calidad de vida, en el trabajo, en el sistema de salud y la sociedad. El objetivo del presente estudio fue determinar la frecuencia de reporte del SII y sus subtipos en los historiales médicos del personal de enfermería de un hospital en Cuenca - Ecuador. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, en una muestra aleatoria de trabajadores del área de enfermería del José Carrasco Arteaga de Cuenca-Ecuador, entre junio 2017-abril 2018. De acuerdo con los criterios de Roma III, se valoraron los historiales médicos de los trabajadores para determinar la frecuencia de SII y sus subtipos. Finalmente, se describieron los factores sociodemográficos, laborales y psicológicos del personal de enfermería. RESULTADOS: Fueron evaluados los historiales médicos de 214 miembros del personal de enfermería (media de edad: 38.7±10.4 años, sexo: 95.3% de mujeres). Se encontró diagnóstico de SII en el 7.0% (15/214) del personal evaluado, siendo los subtipos indeterminado (7/15) y mixto (4/15) los más frecuentes. El 20% del personal del área de enfermería con SII tenía trastornos mentales (ansiedad, depresión y/o distimia) y el mismo porcentaje trabajaban por turnos CONCLUSIÓN: Los resultados obtenidos permiten evidenciar que el SII reportado en historiales médicos de personal de enfermería, en la ciudad de Cuenca-Ecuador, es menor a lo esperado (7%). Los subtipos de SII más frecuentes fueron el subtipo indeterminado, seguido del subtipo mixto.

BACKGROUND: Irritable bowel syndrome (IBS) is a common functional-digestive disorder in health personnel, with significant repercussions on life quality, work, healthcare system and society. The aim of this study was to determine the frequency of reported IBS and its subtypes in the nursing staffs' medical records of a public hospital, in Cuenca - Ecuador. METHODOLOGY: A cross-sectional, descriptive study, with a randomized sample of nursing workers of Hospital Jose Carrasco Arteaga, Cuenca- Ecuador; between June 2017 and April 2018. According to Rome III criteria, medical records were assessed looking for IBS diagnosis and the subtype. Finally, sociodemographic, occupational and psychological factors among the nursing staff was also described. RESULTS: Two-hundred and fourteen medical records were evaluated (average age: 38.7 ± 10.4 years, 95.3% women). A diagnosis of IBS was found in 7.0% (15/214) of the personnel evaluated. The most frequent IBS subtypes were undetermined (46.7%, 7/15) and mixed (26.7%, 4/15). Twenty percent of the nursing staff with IBS, had mental disorders diagnosis (anxiety, depression and/or dysthymia), the same percent worked shifts. CONCLUSION: The diagnosis of IBS reported in the nursing staff medical records, in Cuenca- Ecuador was lower than expected (7%). The most frequent IBS subtypes were undetermined subtype, followed by mixed subtype.

Estudio Transversal: Factores de Riesgo para Alergia Alimentaria en Adolescentes de Cuenca y Santa Isabel, Ecuador / Cross-Sectional Study: Risk Factors for Food Allergy in Adolescents from Cuenca and Santa Isabel, Ecuador

INTRODUCCIÓN: La alergia alimentaria en adolescentes ha sido asociada ampliamente con ciertos factores de riesgo. El objetivo de esta investigación fué determinar y comparar, entre adolescentes de Cuenca y Santa Isabel, la prevalencia de alergia alimentaria y la asociación con factores de riesgo demográficos, genéticos, medioambientales y clínicos determinados por autoreporte y test cutáneo. MÉTODO: Se realizó un estudio transversal en 1508 adolescentes de Cuenca (n=1008) y Santa Isabel (n=500) entre julio de 2013 y julio de 2014. Para determinar alergia alimentaria y sus factores de riesgo se aplicaron cuestionarios de autoreporte y de necesidades básicas insatisfechas, excepto para sensibilización a aeroalérgenos. Este factor de riesgo fue establecido por test cutáneo. Se emplearon modelos de regresión lineal para determinar las asociaciones entre alergia alimentaria y factores de riesgo. RESULTADOS: La prevalencia de alergia alimentaria (síntomas de alergia alimentaria autoreportada más test cutáneo positivo al menos a un alimento), para 1411 participantes con información completa, fue de 2.34 %; no se observó diferencias estadísticamente significativas entre las áreas de estudio (Cuenca: 2.31 % vs. Santa Isabel: 2.39 %; p: > 0.05). La rinoconjuntivitis fue el único factor de riesgo asociado con la alergia alimentaria. Los adolescentes que reportaron síntomas de rinoconjuntivitis fueron 5.4 % más propensos a presentar alergia alimentaria que reportaron (p: < 0.001). Ninguna otra interacción persistió estadísticamente significativa en el modelo de regresión lineal completo por lo que ningún resultado fue estratificado por cantón. CONCLUSIONES: La alergia alimentaria determinada por auto reporte y test cutáneo fue prevalente en los adolescentes de Cuenca y Santa Isabel. Para este grupo la rinoconjuntivitis fue el único factor de riesgo relacionado con alergia alimentaria, denotando una predisposición genética a presentar enfermedades alérgicas. La rinoconjuntivitis incrementó un 5.4 % la probabilidad de padecer alergia alimentaria para los adolescentes de las regiones estudiadas.

BACKGROUND: Food allergy in adolescents has been widely associated with risk factors. The aimofthis investigation was determined, among adolescents of Cuenca and Santa Isabel, the prevalence of food allergy and its association with reported risk factors determined by self-report and skin prick test. METHODS: A cross-sectional study was developed in 1508 adolescents (n = 1008) of Cuenca and Santa Isabel (n = 500), between July 2013 and July 2014. To define food allergy and risk factors of food allergy self-reported and unsatisfied basic needs questionnaires were applied. Aeroallergen sensitization was determined by skin prick test with aeroallergens. Linear regression models were applied to determine the associations between food allergy and factors risks. RESULTS: The prevalence of food allergy (self-reported allergy symptoms and positive skin prick test to at least one food), for 1411 participants with complete information was 2.34 %. Do not was observed statistically significant differences between the study areas (2.31%Cuenca vs. 2.39%in Santa Isabel; p > 0.05). Rhino-conjunctivitis was the only risk factors associated. Adolescents who self-reported rhino-conjunctivitis were 5.4 % more likely to have food allergy than adolescents who not reported it (p: < 0.001). No other statistically significant interaction persisted in the full linearregression model so result no was stratified by canton. CONCLUSIONS: Food allergy determined by skin testwas prevalentin adolescents ofCuenca and Santa Isabel. Rhinoconjunctivitis forthis group was the only risk factor associated with food allergy, denoting a genetic predisposition to develop allergic diseases. Rhinoconjunctivitis increased 5.4 % chance of developing the food allergy for adolescents in the regions studied.

Evaluación del Consumo de Macronutrientes, Sodio, Calcio y Azúcares Añadidos de Acuerdo A las Recomendaciones de la Oms en Adolescentes de 9 A 18 Años de Cuenca y Nabón / Evaluation of Macronutrient Intake, Sodium, Calcium and Added Sugars According to WHO Recommendations in Adolescents 9 to 18 Years of Cuenca and Nabon

Antecedentes: La adolescencia es un periodo de crecimiento acelerado en donde se producen una serie de cambios físicos, lo que origina una mayor demanda de necesidades nutricionales, tanto de energía como de carbohidratos, proteínas, grasas, vitaminas y minerales. Estas características condicionan la posibilidad de producirse deficiencias nutricionales en esta edad si la ingesta no es la adecuada.Objetivo: El objetivo de este estudio es evaluar el con-sumo de macronutrientes, sodio, calcio y azúcar añadido en adolescentes de Cuenca y Nabón de acuerdo a las recomendaciones establecidas por la OMS. Materiales y Método: Un estudio descriptivo transversal fue realizado desde enero 2008 hasta abril 2009 en 765 adolescentes de 8vo, 9no y 10mo de educación básica de Cuenca y Nabón (Ecuador). La recolección de la ingesta dietaria fue mediante recordatorio de 24 horas aplicado en 2 días no consecutivos. Se utilizó el Software Lucille 0.1 para el ingreso y el cálculo de la ingesta de alimentos. El análisis de los datos fue realiza-do mediante el programa estadístico STATA 12, donde se determinó el consumo diario de nutrientes ajustado para la energía total y se calculó el porcentaje de adolescentes que cumple con las recomendaciones de la OMS. resultados: La ingesta de carbohidratos (80%), grasas (76%) y proteínas (67%), en la mayoría de los adolescentes se encuentran dentro del rango recomendado por la OMS; sin embargo, en el caso del consumo de sodio y azúcar añadido, los valores de más de la mitad de los adolescentes están por encima de las recomendaciones. Así también, solo alrededor del 1% de la población estudiada cumple con los requerimientos diarios de consumo de calcio. Conclusión: Esta población de adolescentes presenta un desequilibrio en la ingesta dietética, especialmente de micronutrientes y azúcar añadido. Por lo que se ven necesarios programas de intervención en alimentación saludable y prevención de la obesidad e hipertensión sobre todo en las instituciones educativas.

Objective: The objective of this study is to evaluate the intake of macronutrients, sodium, calcium and added sugar in adolescents of Cuenca and Nabón according to the recommendations established by the WHO. Materials and Method: A cross-sectional descriptive study was conducted from January 2008 to April 2009 in 765 adolescents from 8th, 9th and 10th grade basic education in Cuenca and Nabón (Ecuador). The collec-tion of dietary intake was through a reminder of 24-hours that was applied in 2 non-consecutive days. The Softwa-re Lucille 0.1 was used for the intake and calculation of ingested food. Data analysis was performed using the statistical program STATA 12, which determined the daily intake of nutrients that were adjusted for the total energy and calculated according to the percentage of adolescents that follows the WHO recommendations.rEsults: The intake of carbohydrates (80%), fats (76%) and proteins (67%) in most adolescents are within the range recommended by the WHO; however, in the case of consumption of sodium and added sugar, the values of more than half of adolescents are above re-commendations. Thus, only about 1% of the population studied meets the daily requirements of calcium con-sumption. Conclusion: This population of adolescents presents an imbalance in dietary intake, especially of micronu-trients and added sugar. Therefore, intervention pro-grams in healthy eating and prevention of obesity and hypertension are necessary especially in educational institutions.