Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis.

BACKGROUND: Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. METHODS: Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. RESULTS: Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. CONCLUSIONS: This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. IMPLICATIONS FOR CANCER SURVIVORS: Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.

Youth-centred participatory action approach towards co-created implementation of socially and physically activating environmental interventions in Africa and Europe: the YoPA project study protocol.

INTRODUCTION: The majority of adolescents do not meet guidelines for healthy behaviours, posing major risks for developing multiple non-communicable diseases. Unhealthy lifestyles seem more prevalent in urban than rural areas, with the neighbourhood environment as a mediating pathway. How to develop and implement sustainable and effective interventions focused on adolescent health and well-being in urban vulnerable life situations is a key challenge. This paper describes the protocol of a Youth-centred Participatory Action (YoPA) project aiming to tailor, implement, and evaluate social and physical environmental interventions. METHODS AND ANALYSIS: In diverse urban environments in Denmark, the Netherlands, Nigeria and South Africa, we will engage a dynamic group of 15-20 adolescents (12-19 years) growing up in vulnerable life situations and other key stakeholders (eg, policy makers, urban planners, community leaders) in local co-creation communities. Together with academic researchers and local stakeholders, adolescents will take a leading role in mapping the local system; tailoring; implementing and evaluating interventions during participatory meetings over the course of 3 years. YoPA applies a participatory mixed methods design guided by a novel Systems, User perspectives, Participatory co-creation process, Effects, Reach, Adoption, Implementation and Maintenance framework assessing: (i) the local systems, (ii) user perspectives, (iii) the participatory co-creation process, (iv) effects, (v) reach, (vi) adoption, (vii) implementation and (viii) maintenance of interventions. Through a realist evaluation, YoPA will explore why and how specific outcomes were reached (or not) in each setting (n=800-1000 adolescents in total). ETHICS AND DISSEMINATION: This study received approval from the ethics committees in Denmark, the Netherlands, Nigeria and South Africa and will be disseminated via various collaborative dissemination activities targeting multiple audiences. We will obtain informed consent from all participants. We envision that our YoPA co-creation approach will serve as a guide for participation of adolescents in vulnerable life situations in implementation of health promotion and urban planning in Europe, Africa and globally. TRIAL REGISTRATION NUMBER: NCT06181162.

Different sedentary behavior domains present distinct associations with eating-related indicators.

BACKGROUND: Unhealthful dietary patterns have been consistently associated with low levels of physical activity (PA), but studies dedicated to sedentary behavior (SB) are scarce, especially in adults. The few studies that investigated the association between SB and dietary patterns focused mostly on specific types of SB, such as TV-watching or screen time. SB can be accumulated in distinct domains (i.e., work, transport, and leisure-time), thus, it is key to investigate in depth the impact that different domains of SB can have on eating-related indicators. We aimed to investigate the associations between different SB domains and eating-related indicators, in a sample of adults. METHODS: Cross-sectional data from students, teachers, and staff from a Portuguese University was collected in November/2021 through an anonymous online survey. Data analyses were performed using the IBM SPSS software (version 28.0) and included descriptive statistics, partial correlations, and group comparisons using one-way ANOVA. Daily average SB at work/study, transport, and in leisure-time were self-reported and eating-related indicators were measured with several items from the Mediterranean Diet Score. Specific eating-related behaviors reflecting a protective eating pattern (e.g., eating breakfast regularly), and eating behavior traits (e.g., external eating) were also assessed. Body mass index (BMI) was calculated as weight (kg)/height(m)2. The International Physical Activity Questionnaire/Short-Form was used to assess PA. RESULTS: The sample included 301 adults (60.1% women), with a mean age of 34.5 years. Overall, leisure-time SB was inversely associated with adherence to the Mediterranean diet (r = -0.20; p < 0.001) and with a protective eating profile (r = -0.31; p < 0.001). Higher transport SB was also related to lower adherence to the Mediterranean diet (r = -0.20; p < 0.001) and to an unhealthier eating profile (r = -0.22; p < 0.001), but no associations were found for work-related SB (p > 0.05). These results persisted after the adjustment for BMI, sex, and self-reported PA. These results were impacted by the age tertile. CONCLUSIONS: Our findings suggest that adults with higher levels of SB in leisure-time and transport domains tend to report less healthy eating-related behaviors, irrespective of BMI, sex, and PA level. However, some differences in these associations were found according to the age tertile. This information may assist public health authorities in focusing their efforts in augmenting literacy on SB, namely on how SB can be accumulated via different settings. Furthermore, public health literacy efforts need to extend besides the more known deleterious effects of SB on health (e.g., diabetes, cardiovascular disease), to also include the interplay with eating indicators. Strategies to reduce SB and unhealthy eating should be particularly focused on promoting physically active forms of commuting and reducing SB in the leisure setting.

Validation of the Portuguese Version of the Perceived Physical Literacy Instrument.

BACKGROUND: The Perceived Physical Literacy Instrument (PPLI) has been the most adopted physical literacy instrument designed for adults to date, having been already translated to 5 languages. Still, despite its popularity, there is limited evidence of its psychometric properties. The aim of this study was to translate and adapt cross-culturally the PPLI to the Portuguese language and to analyze the psychometric properties of the Portuguese version in a sample of Portuguese-speaking adults. METHODS: The study sample was composed of 434 participants (70% females) with a median age of 25 (18-39) years. Confirmatory factor analysis was used to assess psychometric properties of the scale. In addition, instrument assumptions between sexes through invariance testing were examined. Finally, concurrent validity, test-retest reliability, and test-retest agreement analyses were performed to gather additional evidence. RESULTS: The results of the present study generally supported the measurement model. The 9-item, 3-factor model presented a good fit to the data and adequate construct validity (χ2 = 82.859 [24], P < .001, comparative-fit index = .948, Tucker-Lewis index = .922, standardized root mean square residual = .049, root mean square error of approximation = .075). In addition, the scale presented concurrent validity. Some issues arose with measurement invariance and overtime consistency. CONCLUSIONS: Considering the lack of validated instruments, we suggest a fair use of Portuguese version of PPLI to access physical literacy in adults. This study contributes to the validation of the PPLI by providing evidence of its psychometric properties in the Portuguese-speaking adult population and facilitates comparative analysis with previous and future studies utilizing the PPLI instrument.

Implementation determinants of physical activity interventions in primary health care settings using the TICD framework: a systematic review.

BACKGROUND: Translation into practice of effective physical activity interventions in primary care is difficult, due to a complex interaction of implementation determinants. We aimed to identify implementation barriers and facilitators of four primary care interventions: physical activity assessment, counselling, prescription, and referral. METHODS: A systematic review of qualitative, quantitative and mixed-methods studies published since 2016 was conducted. The "Tailored Implementation for Chronic Diseases" (TICD) framework was adapted to extract and synthesize barriers and facilitators. RESULTS: Sixty-two studies met the inclusion criteria. Barriers (n = 56) and facilitators (n = 55) were identified across seven domains, related to characteristics of the intervention, individual factors of the implementers and receivers, organizational factors, and political and social determinants. The five most frequently reported determinants were: professionals' knowledge and skills; intervention feasibility/compatibility with primary health care routine; interventions' cost and financial incentives; tools and materials; and professionals' cognitions and attitudes. "Social, political and legal factors" domain was the least reported. Physical activity counselling, prescription, and referral were influenced by determinants belonging to all the seven domains. CONCLUSION: The implementation of physical activity interventions in primary care is influenced by a broader range of determinants. Barriers and facilitators related with health professionals, intervention characteristics, and available resources were the most frequently reported. A deep understanding of the local context, with particularly emphasis on these determinants, should be considered when preparing an intervention implementation, in order to contribute for designing tailored implementation strategies and optimize the interventions' effectiveness.

Promoting physical activity through supervised vs motivational behavior change interventions in breast cancer survivors on aromatase inhibitors (PAC-WOMAN): protocol for a 3-arm pragmatic randomized controlled trial.

BACKGROUND: Aromatase inhibitors (AI) are frequently used to treat hormone-receptor-positive breast cancer, but they have multiple adverse effects (e.g., osteoporosis, arthralgia), resulting in premature therapy discontinuation/switch. Physical activity (PA) can attenuate these negative effects and improve quality of life (QoL). However, most cancer survivors fail to perform/sustain adequate PA levels, especially in the long-term. Theory-based interventions, using evidence-based behavior change techniques, aimed at promoting long-term behavior change in breast cancer survivors are effective, but remain scarce and fail to promote self-regulatory skills and better-quality motivations associated with sustained PA adoption. This paper describes the design of the PAC-WOMAN trial, which will test the long-term effectiveness and cost-effectiveness of two state of the art, group-based interventions encouraging sustained changes in PA, sedentary behavior, and QoL. Additional aims include examining the impact of both interventions on secondary outcomes (e.g., body composition, physical function), and key moderators/mediators of short and long-term changes in primary outcomes. METHODS: A 3-arm pragmatic randomized controlled trial, involving a 4-month intervention and a 12-month follow-up, will be implemented, in a real exercise setting, to compare: 1) brief PA counseling/motivational intervention; 2) structured exercise program vs. waiting-list control group. Study recruitment goal is 122 hormone-receptor-positive breast cancer survivors (stage I-III), on AI therapy (post-primary treatment completion) ≥ 1 month, ECOG 0-1. Outcome measures will be obtained at baseline, 4 months (i.e., post-intervention), 10 and 16 months. Process evaluation, analyzing implementation determinants, will also be conducted. DISCUSSION: PAC-WOMAN is expected to have a relevant impact on participants PA and QoL and provide insights for the improvement of interventions designed to promote sustained adherence to active lifestyle behaviors, facilitating its translation to community settings. TRIAL REGISTRATION: April 20, 2023 - NCT05860621. April 21, 2023 - https://doi.org/10.17605/OSF.IO/ZAQ9N April 27, 2023 - UMIN000050945.

Physical literacy assessment in adults: A systematic review.

Physical literacy is a multidimensional construct that has been defined and interpreted in various ways, one of the most common being "the motivation, confidence, physical competence, knowledge and understanding to maintain physical activity throughout the life course". Although its improvement can positively affect many behavioral, psychological, social, and physical variables, debate remains over an appropriate method of collecting empirical physical literacy data. This systematic review sought to identify and critically evaluate all primary studies (published and unpublished, regardless of design or language) that assessed physical literacy in adults or have proposed measurement criteria. Relevant studies were identified by searching four databases (Pubmed, SportDiscus, APA PsycINFO, Web of Science), scanning reference lists of included articles, and manual cross-referencing of bibliographies cited in prior reviews. The final search was concluded on July 15, 2022. Thirty-one studies, published from 2016 to 2022, were analyzed. We found seven instruments measuring physical literacy in adults, of which six were questionnaires. The Perceived Physical Literacy Instrument was the first developed for adults and the most adopted. The included studies approached physical literacy definition in two ways: by pre-defining domains and assessing them discretely (through pre-validated or self-constructed instruments) and by defining domains as sub-scales after factorial analyses. We found a fair use of objective and subjective measures to assess different domains. The wide use of instruments developed for other purposes in combined assessments suggests the need for further instrument development and the potential oversimplification of the holistic concept, which may not result in a better understanding of physical literacy. Quality and usability characteristics of measurements were generally insufficiently reported. This lack of data makes it impossible to compare and make robust conclusions. We could not identify if any of the existing physical literacy assessments for adults is appropriate for large-scale/epidemiological studies.

Providing office workers with height-adjustable workstation to reduce and interrupt workplace sitting time: protocol for the Stand Up for Healthy Aging (SUFHA) cluster randomized controlled trial.

BACKGROUND: Sedentary behavior (SB) has been linked to several negative health outcomes. Therefore, reducing SB or breaking up prolonged periods of SB improves functional fitness, food consumption, job satisfaction, and productivity. Reducing SB can be achieved by introducing a health-enhancing contextual modification promoted by a sit-stand desk in the workplace. The primary goal will be to test the effectiveness of this intervention in reducing and breaking up SB, while improving health outcomes in office-based workers during a 6-month intervention. METHODS: A two-arm (1:1), superiority parallel-group cluster RCT will be conducted to evaluate the effectiveness of this intervention in a sample of office-based workers from a university in Portugal. The intervention will consist of a psychoeducation session, motivational prompts, and contextual modification promoted by a sit-stand desk in the workplace for 6 months. The control group will work as usual in their workplace, with no contextual change or prompts during the 6-month intervention. Three assessment points will be conducted in both groups, pre-intervention (baseline), post-intervention, and a 3-month follow-up. The primary outcomes include sedentary and physical activity-related variables, which will be objectively assessed with 24 h monitoring using the ActivPAL for 7 days. The secondary outcomes include (a) biometric indices as body composition, body mass index, waist circumference, and postural inequalities; and (b) psychosocial variables such as overall and work-related fatigue, overall discomfort, life/work satisfaction, quality of life, and eating behavior. Both the primary and secondary outcomes will be assessed at each assessment point. DISCUSSION: This study will lean on the use of a sit-stand workstation for 6 months, prompted by an initial psychoeducational session and ongoing motivational prompts. We will aim to contribute to this topic by providing robust data on alternating sitting and standing postures in the workplace. TRIAL REGISTRATION: The trial was prospectively registered, and the details are at: https://doi.org/10.17605/OSF.IO/JHGPW ; Registered 15 November 2022. OSF Preregistration.

How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect: a mixed methods process evaluation embedded in a randomised controlled trial.

BACKGROUND: A randomised trial of European Fans in Training (EuroFIT), a 12-week healthy lifestyle program delivered in 15 professional football clubs in the Netherlands, Norway, Portugal, and the United Kingdom, successfully increased physical activity and improved diet but did not reduce sedentary time. To guide future implementation, this paper investigates how those effects were achieved. We ask: 1) how was EuroFIT implemented? 2) what were the processes through which outcomes were achieved? METHODS: We analysed qualitative data implementation notes, observations of 29 of 180 weekly EuroFIT deliveries, semi-structured interviews with 16 coaches and 15 club representatives, and 30 focus group discussions with participants (15 post-program and 15 after 12 months). We descriptively analysed quantitative data on recruitment, attendance at sessions and logs of use of the technologies and survey data on the views of participants at baseline, post program and after 12 months. We used a triangulation protocol to investigate agreement between data from difference sources, organised around meeting 15 objectives within the two research questions. RESULTS: We successfully recruited clubs, coaches and men to EuroFIT though the draw of the football club seemed stronger in the UK and Portugal. Advertising that emphasized getting fitter, club-based deliveries, and not 'standing out' worked and attendance and fidelity were good, so that coaches in all countries were able to deliver EuroFIT flexibly as intended. Coaches in all 15 clubs facilitated the use of behaviour change techniques and interaction between men, which together enhanced motivation. Participants found it harder to change sedentary time than physical activity and diet. Fitting changes into daily routines, planning for setbacks and recognising the personal benefit of behaviour change were important to maintain changes. Bespoke technologies were valued, but technological hitches frustrated participants. CONCLUSION: EuroFIT was delivered as planned by trained club coaches working flexibly in all countries. It worked as expected to attract men and support initiation and maintenance of changes in physical activity and diet but the use of bespoke, unstable, technologies was frustrating. Future deliveries should eliminate the focus on sedentary time and should use only proven technologies to support self-monitoring and social interaction. TRIAL REGISTRATION: ISRCTN81935608, registered 16/06/2015.

Can marine heatwaves affect the fatty acid composition and energy budget of the tropical fish Zebrasoma scopas?

Marine heatwaves (MHWs) are extreme weather events featuring abnormally high seawater temperature, and expected to increase in frequency, duration and severity over this century. The impacts of these phenomena on physiological performance of coral reef species require understanding. This study aimed to evaluate the effects of a simulated MHW (category IV; ΔT = +2 °C, 11 days) (after exposure and 10-day recovery period) on fatty acid (FA) composition (as a biochemical indicator) and energy budget (i.e., growth, G, excretion (faecal, F and nitrogenous losses, U), respiration, R and food consumption, C) of a juvenile tropical surgeonfish species (Zebrasoma scopas). Significant and different changes were found under MHW scenario for some of the most abundant FA and respective groups (i.e., an increase in the contents of 14:0, 18:1n-9, ΣMonounsaturated (ΣMUFA) and 18:2n-6; and a decrease in the levels of 16:0, ΣSaturated (ΣSFA), 18:1n-7, 22:5n-3 and ΣPolyunsaturated (ΣPUFA)). The contents of 16:0 and ΣSFA were also significantly lower after MHW exposure compared to control (CTRL). Additionally, lower feed efficiency (FE), relative growth rate (RGR) and specific growth rate in terms of wet weight (SGRw), as well as higher energy loss for respiration were observed under MHW exposure conditions in comparison with CTRL and MHW recovery period. The energy proportion channelled for faeces dominated the mode of energy allocation, followed by growth in both treatments (after exposure). After MHW recovery, this trend was reversed, and a higher percentage was spent for growth and a lower fraction for faeces than in the MHW exposure period. Overall, FA composition, growth rates and energy loss for respiration of Z. Scopas were the physiological parameters most influenced (mainly in a negative way) by an 11-day MHW event. The observed effects in this tropical species can be exacerbated with increasing intensity and frequency of these extreme events.

Factors influencing the implementation of the EuroFIT lifestyle change program in professional football clubs in Europe: a qualitative study in four European countries.

This paper investigated facilitators and barriers to implementing the European Football Fans in Training program (EuroFIT) in professional sports clubs in England, the Netherlands, Norway, and Portugal. We analyzed qualitative data collected at clubs that delivered EuroFIT, based on semi-structured interviews with coordinating staff (n = 15), coaches (n = 16), and focus group interviews with participants (n = 108), as well as data from clubs that considered delivering EuroFIT in the future, based on interviews with staff (n = 7) and stakeholders (n = 8). Facilitators for implementation related to the content and structure of the program, its evidence-base, and the context for delivery in the football stadia. Financial and human resources were both facilitators and barriers. Further barriers were mostly practical, relating to human resources and infrastructure. Major differences between countries related to experience and commitment to running community projects, and differences in infrastructure, financing, and human resources. Professional football clubs' ability to support health promotion efforts depended on their ethos and the financial and human resources available to them. Overall, the EuroFIT program was well received by clubs, coaches, participants, and stakeholders, which was reflected by the many facilitators supporting sustained implementation. For sustainable implementation, it is crucial that clubs and their stakeholders engage fully with the EuroFIT program and understand that for an adequate program delivery their views (ethos) and ways of working influence the implementation and thereby the effectiveness of EuroFIT. An important prerequisite for future roll out of EuroFIT would be a strong EuroFIT delivery partner organization to ensure financial and human resources while overseeing and guiding the quality of delivery in clubs.

The European Football Fans in Training program (EuroFIT) led to health improvements in male football fans delivered through professional sports clubs in England, the Netherlands, Norway, and Portugal. This study looked at what factors influenced the implementation of the program. Facilitators for implementation related to the content and structure of the program, its evidence-base, and the context for delivery in the football stadia. Financial and human resources were both facilitators and barriers. Further barriers were mostly practical, relating to human resources and infrastructure. Major differences between countries related to experience and commitment to running community projects, and differences in infrastructure, financing, and human resources. Professional football clubs' ability to support health promotion efforts depended on their ethos and financial and human resources available to them. Overall, the EuroFIT program was well received by clubs, coaches, participants, and stakeholders, which was reflected by the many facilitators supporting sustained implementation. Yet, an important prerequisite for the future roll out of EuroFIT would be a strong EuroFIT delivery partner organization to ensure financial and human resources, while overseeing and guiding the quality of delivery in clubs.

“RespirArFundo”: Um programa de promoção de exercício físico em professores e funcionários em contexto escolar -Estudo quantitativo e qualitativo / “RespirArFundo”: Un programa para promover el ejercicio físico en profesores y personal en un contexto escolar -Estudio cuantitativo y cualitativo / “RespirArFundo”: A program to promote physical exercise for teachers and employees in the school context -Quantitative and qualitative study

O projeto RespirArFundo, através de uma metodologia mista quantitativa e qualitativa teve como objetivo avaliar o efeito de um programa de intervenção (22 “sessões teórico-práticas”), com realização de diferentes tipos de atividades, para melhorar os níveis de aptidão física, bem-estar e qualidade de vida (QdV) em professores e funcionários de uma escola secundária da região centro de Portugal. Pretendeu-se ainda avaliar os níveis de satisfação dos participantes com o projeto e identificar as principais barreiras e facilitadores à sua participação. A fase de intervenção deste projeto decorreu entre janeiro e junho de 2021. A amostra foi constituída por 26 profissionais da escola (19 professores e 7 funcionários não docentes), sendo na sua maioria (92.3%) do sexo feminino (53.7 ± 5.0 anos). Para a avaliação da aptidão física foram utilizados os testes “levantar e sentar da cadeira”, “levantar, percorrer 2.44m e sentar” e o “teste de preensão manual”. Para a avaliação do bem-estar recorreu-se às escalas PANAS, SWLS e SVS enquanto o WHOQOL-Bref foi utilizado para a avaliação da QdV. Foi ainda realizado um grupo focal. Apóso programa, verificou-se que os participantes melhoraram no teste “levantar e sentar na cadeira” (η2=0.51), em relação ao momento inicial. Para além disso, os participantes revelaram níveis elevados de satisfação com o programa e percecionaram a existência de benefícios físicos e de bem-estar associados ao projeto, adotando hábitos saudáveis. A importância do projeto foi reconhecida pela Direção da escola, tendo sido atribuídas horas específicas para que o projeto continuassea funcionar nos seguintes anos letivos. (AU)

The project RespirArFundo, through a mixed method (quantitative and qualitative), aimed to assess the effect of an intervention program (22 theoretical-practical sessions). It carried out different types of activities to improve physical fitness levels, well-being,and quality of life (QoL) in teachers and employees of a higher school in the centre region of Portugal. It was also intended to assess the satisfaction levels of the participants that participated in the project as well as to identify the main barriers and facilitators to their participation. The intervention phase of this project took place between January and June 2021. The sample consisted of 26 school professionals (19 teachers and 7 employees). The majority was female (92.3%) with a mean age of 53.7 (± 5.0 years old). In order to assess physical fitness we used the following tests “chair stand”, “8-Ft Up-&-Go” and “hand grip”. For the assessment of well-being, the PANAS, SWLS and SVS scales were used, while the WHOQOL-Bref was used to assess QoL. A focusgroup was also performed. After the program, it was found that participants improved on the test “chair stand” (η2=0.51), in relation to the initial moment. Moreover, participants revealed high levels of satisfaction with the program and perceived the existence of physical and well-being benefits associated with the project, adopting healthy habits. The importance of the project was recognized by the school's management, and specific hours were assigned so that the project continues to function in the following academic years. (AU)

El proyecto RespirArFundo, a través de una metodología mixta cuantitativa y cualitativa, tuvo como objetivo evaluar el efecto de un programa de intervención (22 "sesiones teórico-prácticas"), con diferentes tipos de actividades, para mejorar los niveles de aptitud física, el bienestar y la calidad de vida (CdV) en profesores y empleados de una escuela secundaria en la región central de Portugal. También queríamos evaluar el grado de satisfacción de los participantes con el proyecto e identificar los principales obstáculos y facilitadores de su participación. La fase de intervención de este proyecto tuvo lugar entre enero y junio de 2021. La muestra estaba compuesta por 26 profesionales (19 profesores y 7 personal no docente), siendo la mayoría (92.3%) mujeres (53.7 ± 5.0 años). Para la evaluación de la aptitud física se utilizaron las pruebas "levantarse y sentarse de una silla", "levantarse, caminar 2.44 m y sentarse" y la " fuerza de prensiónmanual ". Se utilizaron las escalas PANAS, SWLS y SVS para evaluar el bienestar, mientras que el WHOQOL-Bref se utilizó para evaluar la CdV. También se realizó un grupo de discusión. Tras el programa, se comprobó que los participantes mejoraron en la prueba "levantarse y sentarse en una silla” (η2=0.51). Además, los participantes revelaron altos niveles de satisfacción con el programa y percibieron la existencia de beneficios físicos y de bienestar asociados al proyecto, adoptando hábitos saludables. La dirección de la escuela reconoció la importancia del proyecto y le asignó horas específicas para que continuara en los años siguientes.

Mapping the social representations of Psychology: a study in a Portuguese context / Mapeamento das representações sociais da Psicologia: um estudo em contexto português

Objective: The present study aimed to analyse the social representations of Psychology in a sample of Portuguese respondents, thus contributing to a better understanding of the social meaning of this scientific area. Method: A free association task was performed by a sample of 205 Portuguese individuals who were given the word "Psychology" as a stimulus. Data were analysed using content analysis, supported by the Max-Qda software. Results: The main results show a greater diversity of representations compared to previous studies. However, the dominant representation in terms of intervention is still the curative clinic and the medical paradigm. Conclusion: This research made it possible to highlight the need for Psychology professionals, and the entities that represent them, to reinforce the visibility and awareness of the community in general, of the application areas both in the scientific and professional context.

Objetivo: O presente estudo teve por objetivo analisar as representações sociais da Psicologia numa amostra de inquiridos portugueses, contribuindo, assim, para um maior entendimento do significado social dessa área científica. Método: Foi realizada uma tarefa de associação em uma amostra composta de 205 portugueses aos quais foi dado como estímulo a palavra "Psicologia". Os dados foram analisados através de análise de conteúdo, com apoio do software Max-Qda. Resultados: Os principais resultados evidenciam uma maior diversidade de representações face a estudos anteriores. No entanto, a representação dominante em termos interventivos continua a ser a clínica curativa e o paradigma médico. Conclusão: Esta pesquisa permitiu evidenciar a necessidade de que profissionais de Psicologia e entidades que os representam reforcem a visibilidade e a consciência da comunidade em geral sobre as áreas de aplicação da Psicologia, quer no contexto científico, quer no profissional.

The Pfister Test in Psychological Assessment for Firearm Handling / Teste de Pfister na Avaliação Psicológica para Manuseio de Arma de Fogo

Abstract As there are few Pfister Test studies in the context of assessment for handling a firearm, the objective was to describe the personality characteristics of security guards and candidates for handling firearms (n= 112) when compared with people from the general population (n= 288). The data collection instruments were a questionnaire to collect sociodemographic information and the Pfister Test. For data analysis, nonparametric tests and multiple linear regression analysis were used. Candidates for handling weapons showed characteristics of more rigidity, anxiety and immaturity with a predisposition to be more oppositional and ambivalent in relation to their feelings. There is also a need for further studies with more comprehensive and diversified samples.

Resumo Como há poucos estudos do Teste de Pfister no contexto de avaliação para o manuseio de arma, o objetivo foi descrever as características de personalidade de vigilantes e candidatos para manusear armas de fogo (n= 112) quando comparados com pessoas da população em geral (n= 288). Os instrumentos de coleta de dados foram um questionário para recolher informações sociodemográficas e o Teste de Pfister. Para a análise de dados utilizou-se testes não paramétricos e análise de regressão linear múltipla. Os candidatos ao manuseio de arma apresentaram características de mais rigidez, ansiedade e imaturidade com predisposição para serem mais oposicionistas e ambivalentes em relação aos seus sentimentos. Nota-se ainda a necessidade de mais estudos com amostras mais abrangentes e diversificadas.

Predictors of physical activity promotion in clinical practice: a cross-sectional study among medical doctors.

BACKGROUND: Physical activity is a major determinant of physical and mental health. International recommendations identify health professionals as pivotal agents to tackle physical inactivity. This study sought to characterize medical doctors' clinical practices concerning the promotion of patients' physical activity, while also exploring potential predictors of the frequency and content of these practices, including doctors' physical activity level and sedentary behaviours. METHODS: A cross-sectional study assessed physical activity promotion in clinical practice with a self-report questionnaire delivered through the national medical prescription software (naturalistic survey). Physical activity and sedentary behaviours were estimated using the International Physical Activity Questionnaire (short form). Indicators of medical doctors' attitudes, knowledge, confidence, barriers, and previous training concerning physical activity promotion targeting their patients were also assessed. Multiple regression analysis was performed to identify predictors of physical activity promotion frequency by medical doctors, including sociodemographic, attitudes and knowledge-related variables, and physical activity behaviours as independent variables. RESULTS: A total of 961 medical doctors working in the Portuguese National Health System participated (59% women, mean age 44 ± 13 years) in the study. The majority of the participants (84.6%) reported to frequently promote patients' physical activity. Five predictors of physical activity promotion frequency emerged from the multiple regression analysis, explaining 17.4% of the dependent variable (p < 0.001): working in primary healthcare settings (p = 0.037), having a medical specialty (p = 0.030), attributing a high degree of relevance to patients' physical activity promotion in healthcare settings (p < 0.001), being approached by patients to address physical activity (p < 0.001), and having higher levels of physical activity (p = 0.001). CONCLUSIONS: The sample of medical doctors approached reported a high level of engagement with physical activity promotion. Physical activity promotion frequency seems to be influenced by the clinical practice setting, medical career position and specialty, attitudes towards physical activity, and perception of patients´ interest on the topic, as well as medical doctors' own physical activity levels.

Questionnaires measuring movement behaviours in adults and older adults: Content description and measurement properties. A systematic review.

BACKGROUND: Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults. METHODS: The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese. FINDINGS AND CONCLUSIONS: Data extraction, results, studies' quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.

Changes in food reward and intuitive eating after weight loss and maintenance in former athletes with overweight or obesity.

OBJECTIVE: This study aimed to explore the following: 1) the impact of Champ4Life's intervention on intuitive eating and food reward; and 2) associations between changes in eating behavior and changes in body composition. METHODS: A total of 94 former athletes (mean [SD], BMI = 31.1 [4.3] kg/m2 , age = 43.0 [9.4] years, 34% female) assigned to intervention (n = 49) and control groups (n = 45) underwent 4 months of active weight loss (WL) followed by 8 months of WL maintenance. Intuitive eating and food reward were assessed by the Intuitive Eating Scale and the Leeds Food Preference Questionnaire, respectively. RESULTS: The WL was -4.8% (4.9%) and 0.3% (2.6%) for the intervention and control groups, respectively. Participants reported a decrease in fat bias for explicit/implicit wanting and explicit liking after 4 months and 1 year. For intuitive eating, the unconditional permission to eat decreased after 4 months, and the body-food choice congruence increased after 1 year. Changes in unconditional permission to eat and in body-food choice congruence were positively and negatively associated with both Δweight and with Δfat mass, respectively. Changes in explicit wanting for fat and taste bias were associated with Δweight. CONCLUSIONS: Food reward decreased after a moderate WL intervention. Participants successfully maintained their reduced weight, and most of the changes in eating behavior remained significant at the end of the follow-up period. Lifestyle interventions aiming at WL should also consider intuitive eating and food reward.

The Development of Smoked Mackerel with Reduced Sodium Content.

The World Health Organization recommends reducing salt (sodium chloride, NaCl) intake by 30% by 2025. Since smoked fish can deliver up to 4 g NaCl/100 g, the aim of this study was to develop safe, healthy and attractive smoked chub mackerel (Scomber japonicus) with a reduced NaCl content. Two brines (5% and 10%) were used with different ratios of NaCl and potassium chloride (KCl). In each brine, 0%, 25%, 50% and 75% of NaCl was replaced by KCl, resulting in 1.3, 1.1, 0.9 and 0.6 g NaCl (5% brine), and 2.6, 2.0, 1.2 and 0.8 g NaCl (10% brine) per 100 g, respectively. Similar yield, nutritional, safety, texture and colour properties were found in most formulations. The most desirable taste attributes (negligible bitterness and adequate saltiness) were obtained with a 5% brine prepared with 75% NaCl + 25% KCl. Such conditions seemed to allow for obtaining an attractive product for conscious consumers.

Carga de trabalho dos enfermeiros na consulta de enfermagem de saúde infantil e juvenil / Nurses 'workload in child and youth health nursing consultation

Em Portugal, para os Cuidados de Saúde Primários em geral e para as unidades de cuidados às famílias em particular, é imperativo a definição de dotação segura no sentido de contribuir para se atingir os índices de segurança e de qualidade dos cuidados de enfermagem correspondentes às reais necessidades dos seus clientes. O Enfermeiro Especialista em Enfermagem de Saúde Infantil e Pediátrica tem um conhecimento aprofundado do desenvolvimento da criança e adolescente, neste sentido é o profissional mais adequado para o cálculo da carga de trabalho do enfermeiro na consulta de saúde infantil e juvenil. Com o objetivo de identificar as intervenções que os enfermeiros realizam durante as consultas de saúde infantil e juvenil, determinar o tempo gasto com cada uma delas e analisar a relação entre a idade da criança ou adolescente e o tempo gasto nas intervenções desenvolvidas realizou-se um estudo quantitativo, descritivo-correlacional. A amostra compreendeu 170 crianças e adolescentes em idades correspondentes às consultas preconizadas no Programa Nacional de Saúde Infantil e Juvenil. Os dados foram colhidos através de um formulário eletrónico durante o período compreendido entre maio e julho de 2021. A consulta ao recém-nascido foi a que se realizou mais vezes (11,2%), seguida da consulta dos 15 meses (7,6%). Verificou-se que em média, foram necessários 34,27 minutos por consulta para os enfermeiros realizarem um conjunto de intervenções do âmbito da consulta de saúde infantil e juvenil. As intervenções em que os enfermeiros despendem mais tempo são dos domínios do "Desenvolvimento humano" com uma média de 12,35 minutos e "Atividades não assistenciais" com uma média de 10,13 minutos por consulta. Constatou-se ainda que à medida que aumenta a idade das crianças o tempo gasto pelos enfermeiros nas intervenções dos domínios "Adesão à vacinação", "Papel parental", "Papel segurança" e "Vinculação" diminui e nas intervenções que integram o domínio "Autocontrolo" aumenta. O tema das dotações seguras dos enfermeiros em Cuidados de Saúde Primários tem sido pouco estudado e os resultados deste estudo evidenciam a necessidade de dar continuidade à investigação sobre a temática, no sentido de contribuir para a organização das Unidades de Saúde Familiar e Unidade de Cuidados de Saúde Personalizados e uma prática clínica adequada às reais necessidades das crianças, adolescentes e famílias.

In Portugal, for Primary Health Care in general and for family care units, it is imperative to define a safe endowment to contribute to achieving the safety and quality of nursing care rates corresponding to the real needs of its clients. The Nurse Specialist in Child and Pediatric Health Nursing has an in-depth knowledge of the development of children and adolescents, in this sense it is the most appropriate professional for calculating the workload of nurses in the consultation of child and youth health. To identify the interventions that nurses perform during child and juvenile health consultations, to determine the time spent with each of them and to analyze the relationship between the age of the child or adolescent and the time spent in the interventions developed, a quantitative, descriptive-correlational study. The sample comprised 170 children and adolescents at ages corresponding to the consultations recommended in the National Program for Child and Youth Health. Data were collected using an electronic form during the period from May to July 2021. The consultation with the newborn was the one that was the one that was the most often (11.2%), followed by the 15-month consultation (7.6%). It was found, on average, it took 34.27 minutes per consultation for nurses to perform a set of interventions within the scope of the child and juvenile health consultation. The interventions in which nurses consume the most time are from the domains of "Human Development" with an average of 12.35 minutes and "non-care activities" with an average of 10.13 minutes per consultation. It was also found that as the age of children increases, the time spent by nurses in the interventions of the domains "Vaccination adhering", "Parental role", "Safety paper" and "Linking" decreases and in the interventions that integrate the domain "Self-control" increases. The theme of the safe appropriations of nurses in Primary Health Care has been little studied and these results show the need to continue this study, to contribute to the organization of Family Health Units and Personalized Health Care Unit and a clinical practice appropriate to the real needs of children, adolescents and families.

Users' Experiences With the NoHoW Web-Based Toolkit With Weight and Activity Tracking in Weight Loss Maintenance: Long-term Randomized Controlled Trial.

BACKGROUND: Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness. OBJECTIVE: The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)-a DBCI that targets weight loss maintenance-over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience. METHODS: An 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion. RESULTS: The usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements. CONCLUSIONS: The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content. TRIAL REGISTRATION: ISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2019-029425.