Worldwide use of the first set of physical activity Country Cards: The Global Observatory for Physical Activity - GoPA!

BACKGROUND: The work of The Global Observatory for Physical Activity-GoPA! is the first global effort to compile standardized country-level surveillance, policy and research data for physical activity in order to better understand how countries and regions address promoting physical activity. GoPA! developed standardized country-specific physical activity profiles ("Country Cards") to summarize country-level data through 2013. The aim of this study was to assess use of the Country Cards, identify the factors associated with their use, and develop recommendations for supporting country-level physical activity promotion. METHODS: Cross sectional internet-based survey conducted between August-October 2016. Target study participants were national physical activity leaders and advocates in academia, government and practice from the GoPA! countries, and members of the International Society of Physical Activity and Health. A Country Card use composite score was created based on the diversity and frequency of use. Statistical analyses on the associations between the composite score and respondent characteristics, country characteristics, barriers and opinions were conducted (including descriptive analyses and a logistic regression with robust standard errors). RESULTS: One hundred forty three participants from 68 countries completed the survey. Use of the Country Cards was associated with being part of the GoPA! network, knowing about the Country Cards, and on the stage of country capacity for physical activity promotion. Country Card knowledge varied by country income group, region and the country specific context. More diverse and frequent use of the cards (highest tertile of the composite score for use) was associated with: 1. Being a country contact vs general participant (OR 18.32-95% CI 5.63-59.55, p = 0.002), and 2. Collaborating with a government representative working in NCDs on a monthly or more frequent contact vs less frequent contact (OR 3.39-95% CI 1.00-11.54, P < 0.05). CONCLUSIONS: For the Country Cards to have a broader impact, GoPA! will need to widen its reach beyond the academic sector. With further refinement of the cards, and training in their implementation, they could be an important tool for advancing country capacity for contextually-relevant strategies, actions and timelines for PA promotion.

Pilates for breast cancer: A systematic review and meta-analysis / Pilates para mulheres com câncer de mama: revisão sistemática e metanálise

Summary Introduction: Breast cancer is the leading type of cancer causing death in women worldwide. The incidence of the disease is expected to grow worldwide due to the aging of the population and risk factors related to lifestyle behaviors. Considering the lifestyle of women with breast cancer before or after surgery, pilates exercise may be a complementary intervention additionally to standard treatment. Objective: To analyze the efficacy of pilates compared to other exercises and to no exercise for women with breast cancer diagnosis. Method: We searched Medline via Pubmed, Embase via Ovid, Amed via EBSCO, Biosis via Ovid, Lilacs and the Cochrane Library for relevant publications until March 2017. The keywords used were pilates and "breast cancer," and only randomized controlled trials were included. Critical appraisal was done using Risk of Bias Tool and GRADE score for assessing the quality of evidence. Results: A total of five studies were included in our review. Our results demonstrate that pilates or home-based exercises are better than no exercise in each individual study. We observed significant improvements in the pilates groups compared to home-based exercises. Additionally, in the individual studies, we observed improvements in range of motion, pain and fatigue. Conclusion: The evidence shows that pilates or home-based exercise should be encouraged to women with breast cancer.

Resumo Introdução: O câncer de mama é o principal tipo de câncer que causa morte em mulheres em todo o mundo. Estima-se que a doença cresça em razão do envelhecimento da população e dos fatores de risco relacionados ao comportamento e estilo de vida. Considerando o estilo de vida das mulheres com câncer de mama antes ou após a cirurgia, o exercício de pilates pode ser uma intervenção complementar, além do tratamento padrão. Objetivo: Analisar a eficácia do pilates em relação a outros exercícios e a nenhum exercício para mulheres com diagnóstico de câncer de mama. Método: Buscamos em Medline via Pubmed, Embase via Ovid, Amed via EBSCO, Biosis via Ovid, Lilacs e Cochrane Library publicações relevantes até março de 2017. As palavras-chave utilizadas foram pilates e "câncer de mama"; apenas ensaios clínicos randomizados foram incluídos. A avaliação crítica foi feita com a ferramenta Risk of Bias e escore GRADE para avaliar a qualidade da evidência. Resultados: Um total de cinco estudos foi incluído nesta revisão. Nossos resultados demonstram que pilates ou exercícios feitos em casa são melhores do que a ausência de exercícios em cada estudo individual. Observamos melhorias significativas no grupo de pilates em comparação com exercícios em casa. Adicionalmente, nos estudos individuais observamos melhorias na amplitude de movimento, dor e fadiga. Conclusão: A evidência mostra que pilates ou exercícios em casa devem ser encorajados a mulheres com câncer de mama.

Pilates for breast cancer: A systematic review and meta-analysis.

INTRODUCTION: Breast cancer is the leading type of cancer causing death in women worldwide. The incidence of the disease is expected to grow worldwide due to the aging of the population and risk factors related to lifestyle behaviors. Considering the lifestyle of women with breast cancer before or after surgery, pilates exercise may be a complementary intervention additionally to standard treatment. OBJECTIVE: To analyze the efficacy of pilates compared to other exercises and to no exercise for women with breast cancer diagnosis. METHOD: We searched Medline via Pubmed, Embase via Ovid, Amed via EBSCO, Biosis via Ovid, Lilacs and the Cochrane Library for relevant publications until March 2017. The keywords used were pilates and "breast cancer," and only randomized controlled trials were included. Critical appraisal was done using Risk of Bias Tool and GRADE score for assessing the quality of evidence. RESULTS: A total of five studies were included in our review. Our results demonstrate that pilates or home-based exercises are better than no exercise in each individual study. We observed significant improvements in the pilates groups compared to home-based exercises. Additionally, in the individual studies, we observed improvements in range of motion, pain and fatigue. CONCLUSION: The evidence shows that pilates or home-based exercise should be encouraged to women with breast cancer.

Effects of whey protein supplement in the elderly submitted to resistance training: systematic review and meta-analysis.

AIM: We performed a systematic review to map the evidence and analyze the effect of whey protein supplementation in the elderly submitted to resistance training. METHODS: A comprehensive search on Medline, LILACS, EMBASE, and the Cochrane Library for relevant publications was conducted until August 2015. The terms used in the search were: "Resistance training"; "Whey protein"; "Elderly". RESULTS: A total of 632 studies were screened. Five studies were included composing a sample of 391 patients. The supplement whey protein was associated with higher total protein ingestion 9.40 (95% CI: 4.03-14.78), and with an average change in plasma leucine concentration. The supplementation was also associated with increased mixed muscle protein synthesis 1.26 (95% CI: 0.46-2.07) compared to the control group. CONCLUSION: We observed an increase in total protein intake, resulting in increased concentration of leucine and mixed muscle protein fractional synthesis rate.

Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy.

BACKGROUND: Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of a rapid point of care test, the clinical diagnosis of dengue is complex. The World Health Organisation has outlined diagnostic criteria for making the diagnosis of dengue infection, which includes the use of the tourniquet test (TT). PURPOSE: To assess the quality of the evidence supporting the use of the TT and perform a diagnostic accuracy meta-analysis comparing the TT to antibody response measured by ELISA. DATA SOURCES: A comprehensive literature search was conducted in the following databases to April, 2016: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, BIOSIS, Web of Science, SCOPUS. STUDY SELECTION: Studies comparing the diagnostic accuracy of the tourniquet test with ELISA for the diagnosis of dengue were included. DATA EXTRACTION: Two independent authors extracted data using a standardized form. DATA SYNTHESIS: A total of 16 studies with 28,739 participants were included in the meta-analysis. Pooled sensitivity for dengue diagnosis by TT was 58% (95% Confidence Interval (CI), 43%-71%) and the specificity was 71% (95% CI, 60%-80%). In the subgroup analysis sensitivity for non-severe dengue diagnosis was 55% (95% CI, 52%-59%) and the specificity was 63% (95% CI, 60%-66%), whilst sensitivity for dengue hemorrhagic fever diagnosis was 62% (95% CI, 53%-71%) and the specificity was 60% (95% CI, 48%-70%). Receiver-operator characteristics demonstrated a test accuracy (AUC) of 0.70 (95% CI, 0.66-0.74). CONCLUSION: The tourniquet test is widely used in resource poor settings despite currently available evidence demonstrating only a marginal benefit in making a diagnosis of dengue infection alone. REGISTRATION: The protocol for this systematic review was registered at PROSPERO: CRD42015020323.