Relationship Between the Physical Environment and Physical Activity Levels in Preschool Children: A Systematic Review.

PURPOSE OF REVIEW: The aim of this study was to understand the influence of the physical environment on the physical activity (PA) behavior of preschool children (aged 2 to 6 years), in order to provide an overview of these influences from the perspective of the ecological model. RECENT FINDINGS: PA is of great importance for the prevention of obesity and cardiovascular diseases since childhood. The physical environment has a direct relationship with the different domains, where people can spend their time being physically active. Nonetheless, despite the importance of the physical environment to engagement in PA, very few reviews have focused on this relationship in the context of the growing problem of physical inactivity among preschool children. Studies that had analyzed the school domain had found that greater availability of a wider variety of portable play equipment, presence of certain fixed playground equipment, and presence of open spaces had favored PA levels. Furthermore, different studies had shown that the natural environment and the presence of hills were important for children's PA. Thus, despite the associations with PA we were able to identify in this review, new studies will still be needed to link the physical environment with PA levels, especially regarding transportation and leisure time. In conclusion, promoting studies on this subject from an early age will allow us to obtain information that could allow the adaptation, design, and construction of healthier homes, neighborhoods, and schools that promote children's health.

Reliability of streetscape audits comparing on-street and online observations: MAPS-Global in 5 countries.

BACKGROUND: Microscale environmental features are usually evaluated using direct on-street observations. This study assessed inter-rater reliability of the Microscale Audit of Pedestrian Streetscapes, Global version (MAPS-Global), in an international context, comparing on-street with more efficient online observation methods in five countries with varying levels of walkability. METHODS: Data were collected along likely walking routes of study participants, from residential starting points toward commercial clusters in Melbourne (Australia), Ghent (Belgium), Curitiba (Brazil), Hong Kong (China), and Valencia (Spain). In-person on the street and online using Google Street View audits were carried out by two independent trained raters in each city. The final sample included 349 routes, 1228 street segments, 799 crossings, and 16 cul-de-sacs. Inter-rater reliability analyses were performed using Kappa statistics or Intraclass Correlation Coefficients (ICC). RESULTS: Overall mean assessment times were the same for on-street and online evaluations (22 ± 12 min). Only a few subscales had Kappa or ICC values < 0.70, with aesthetic and social environment variables having the lowest overall reliability values, though still in the "good to excellent" category. Overall scores for each section (route, segment, crossing) showed good to excellent reliability (ICCs: 0.813, 0.929 and 0.885, respectively), and the MAPS-Global grand score had excellent reliability (ICC: 0.861) between the two methods. CONCLUSIONS: MAPS-Global is a feasible and reliable instrument that can be used both on-street and online to analyze microscale environmental characteristics in diverse international urban settings.

Experiencias y necesidades de los hermanos de niños en situación paliativa: estudio cualitativo desde la perspectiva de los profesionales / Experiences and needs of siblings of children in a palliative situation: a qualitative study from the perspective of professionals

INTRODUCCIÓN: Los cuidados paliativos pediátricos consisten en los cuidados activos e integrales que se realizan al cuerpo, mente y espíritu del niño y su familia, desde que es diagnosticado de una enfermedad amenazante para la vida. Las investigaciones se centran sobre los efectos que esto causa en los padres y los niños, sin centrarse en las repercusiones que esto tiene en los hermanos. OBJETIVO: Conocer y analizar las experiencias y necesidades de los hermanos de niños en situación paliativa desde la perspectiva de los profesionales más cercanos a ellos. MATERIALES Y MÉTODO: Estudio cualitativo exploratorio, que se centró en la provincia de Valencia. Participaron cinco profesionales que trabajan en la Asociación de Padres de Niños con Cáncer de la Comunidad Valenciana (ASPANION), y la obtención de datos se realizó mediante entrevistas individuales semiestructuradas. RESULTADOS: Aspectos referidos a la adaptación de la familia, los cambios de comportamiento de los hermanos durante el proceso, la comunicación entre ambos, la importancia de la información y la participación del hermano durante la enfermedad, así como las dificultades que encuentran los profesionales para tratar con estos hermanos, son algunos de los resultados obtenidos. CONCLUSIONES: Los hermanos viven los procesos paliativos con gran capacidad de adaptación, aunque, en momentos de estrés o cuando aparecen sentimientos de abandono o culpa, los hermanos lo expresan a través de cambios en el comportamiento. Es importante que los padres expresen sus miedos y mantengan el vínculo con el hermano, haciéndoles partícipes de la situación e informándoles de todo, teniendo muy en cuenta el factor de la edad. La gran demanda de los profesionales es la de poder trabajar con los hermanos directamente, de manera que puedan tener una atención más cercana

INTRODUCTION: Research on children in a palliative situation and the effects this exerts on parents is increasingly abundant. Despite this, there is still a gap in understanding the way in which siblings live through the stages of terminal illness and death. OBJECTIVE: To know and analyze the experiences and needs of the siblings of children in a palliative situation from the perspective of the professionals closest to them. MATERIAL AND METHOD: A qualitative exploratory study focused on the province of Valencia. Five professionals working for the Asociación de Padres de Niños con Cáncer de la Comundad Valenciana (ASPANION) participated, and the data collection was carried out using semi-structured individual interviews. RESULTS: Aspects related to family adaptation, behavior changes in siblings during the process, communication between family members, the importance of sibling information and participation during the illness period, and the difficulties professionals find in dealing with siblings are some of the results obtained. CONCLUSIONS: Siblings live palliative processes with great adaptability, although in times of stress, or when feelings of abandonment or guilt appear, they express their discomfort through changes in behavior. It is important that parents express their fears and maintain their bond with siblings, making them participants in the situation and informing them of everything, taking into account the age factor. The great demand by professionals is that they may work with siblings directly, so these may receive closer attention