The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis.

PURPOSE: Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. METHOD: Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. RESULTS: BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (-0.036; 95% confidence interval, -0.070 to -0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. CONCLUSIONS: BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI.

The stability of cardiometabolic risk factors clustering in children and adolescents: a 2-year longitudinal study.

Objective: The present study aims to verify the odds of remaining with the clustering of 3 or more, 4 or more, and 5 or more risk factors across a 2-year time span. Methods: Observational longitudinal study that included 358 children and adolescents (10.96 ± 2.28 years of age at baseline). Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Odds ratios of presenting n risk factors clustered at follow-up according to the number of risk factors observed at baseline were calculated. Results: More participants than expected were found presenting clustering of 4 or more and 5 or more risk factors at both baseline (11.7% and 5.6%, respectively) and follow-up (9.5% and 5.6%, respectively). The odds ratios calculated demonstrated that the odds of presenting the same number of risk factors clustered or more at follow-up increased according to the number of risk factors clustered at baseline. Conclusion: The higher the number of risk factors a child had at baseline, the higher the odds of presenting the same number of risk factors or more after two years of follow-up. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01174-1.

Cross-Lagged Associations between Physical Activity, Motor Performance, and Academic Skills in Primary School Children.

PURPOSE: Few longitudinal studies have investigated the interwoven longitudinal dynamics between physical activity (PA), motor performance, and academic skills in middle childhood. Therefore, we investigated the cross-lagged associations between PA, motor performance, and academic skills from grade 1 to grade 3 in Finnish primary school children. METHODS: A total of 189 children 6-9 yr old at baseline comprised the study sample. Total PA was assessed using a questionnaire filled out by parents, moderate-to-vigorous PA by combined heart rate and body movement monitor, motor performance by 10 × 5-m shuttle run test, and academic skills by arithmetic fluency and reading comprehension tests in grade 1 and grade 3. Data were analyzed using structural equation modeling adjusted for gender, parental education, and household income. RESULTS: The final model fitted the data very well ( χ237 = 68.516, P = 0.0012, root-mean-square error of approximation = 0.067, comparative fit index = 0.95, Tucker-Lewis Index = 0.89) and explained 91% of variance in the latent academic skills variable, 41% of the variance in the latent PA variable, and 32% of variance in motor performance in grade 3. Better motor performance in grade 1 was associated with higher academic skills in grade 3, but it did not predict PA. PA was not directly or indirectly associated with academic skills. However, higher levels of PA in grade 1 predicted better motor performance in grade 3. Academic skills did not predict PA or motor performance. CONCLUSIONS: These results suggest that better motor performance, but not PA, predicts later academic skills. Academic skills in grade 1 do not contribute to PA or motor performance in the early school years.

Study protocol of EMPOWER: A cluster randomized trial of a multimodal eHealth intervention for promoting mental health in the workplace following a stepped wedge trial design.

Objective: This article describes the EMPOWER study, a controlled trial aiming to determine the effectiveness and cost-effectiveness of an eHealth intervention to prevent common health problems and reduce presenteeism and absenteeism in the workplace. Intervention: The EMPOWER intervention spans universal, secondary and tertiary prevention and consists of an eHealth platform delivered via a website and a smartphone app designed to guide employees throughout different modules according to their specific profiles. Design: A stepped-wedge cluster randomized trial will be implemented in four countries (Finland, Poland, Spain and UK) with employees from small and medium enterprises (SMEs) and public agencies. Companies will be randomly allocated in one of three groups with different times at which the intervention is implemented. The intervention will last 7 weeks. Employees will answer several questionnaires at baseline, pre- and post-intervention and follow-up. Outcome measures: The main outcome is presenteeism. Secondary outcomes include depression, anxiety, insomnia, stress levels, wellbeing and absenteeism. Analyses will be conducted at the individual level using the intention-to-treat approach and mixed models. Additional analyses will evaluate the intervention effects according to gender, country or type of company. Cost-effectiveness and cost-utility analyses [based on the use of quality-adjusted life-years (QALYS)] will consider a societal, employers' and employees' perspective.

Determinants of Cognitive Performance in Children and Adolescents: A Populational Longitudinal Study.

We evaluated the determinants of cognitive performance in children and adolescents. This is a longitudinal study, secondary analysis of the Physical Activity and Nutrition in Children (PANIC) study. We assessed 502 children (51.6% girls) at middle childhood (range: 6.6 to 9.0 years), at late childhood, 437 children (51.0% girls, range: 8.8 to 11.2 years), and in 277 adolescents (54.5% girls, range: 15.0 to 17.4 years). Raven's progressive matrices tests estimated the participants' cognitive performance (outcome variable) at all time points. In total, we evaluated 29 factors from various dimensions (prenatal, neonatal, child fitness, lifestyle and anthropometrics). None of the neonatal and anthropometric parameters were associated with cognitive performance. Preeclampsia (prenatal) and listening to music, writing, arts and craft and watching TV (lifestyle) were negatively associated with cognitive performance. Shuttle run and box and block tests (fitness), and playing music, reading and time at the computer (lifestyle) were positive determinants of cognitive performance in children and adolescents. Fitness and lifestyle factors during childhood and adolescence diminished the importance of prenatal factors on cognitive performance and lifestyle factors were especially relevant in regard to cognitive performance. Reading was positively associated with cognitive performance, regardless of age and time dedicated, and should be promoted.

Universal school-based intervention targeting depressive symptoms in adolescents: A cluster randomized trial.

We investigated the effects of three different interventions on depressive symptoms in adolescents. As a secondary aim, we explored the mediating role of social isolation, anxiety, sleep quality, and cognitive function of the intervention effect on depressive symptoms. We conducted a cluster randomized controlled trial, in which schools were randomly assigned to 1. Doubling physical education (PE) classes (3:20 h of PE/week); 2. Workshop with the PE teachers; 3. Workshop with the PE teachers + Doubling PE classes; and 4. Control group (1:40 h of PE/week). In total, 1279 adolescents were included, 56.4% females. Doubling PE classes and the workshop with the PE teachers + Doubling PE classes groups did not affect depressive symptoms (-0.947, 95% CI -3.176 to 1.281; and, 0.726, 95% CI -1.558 to 3.009, respectively). The workshop with the PE teachers decreased adolescents' depressive symptoms (-2.495, 95% CI -4.668 to -0.323), social isolation (-4.759, 95% CI -9.025 to -0.493), and poor sleep quality (-0.560, 95% CI -1.108 to -0.012) compared with the control group. Social isolation mediated 32% of the workshop effect on depressive symptoms. The workshop with the PE teachers and the workshop with the PE teachers + Doubling PE classes groups lowered in 93% and in 54% the risk of the adolescents in developing high depressive symptomatology compared with the control group, respectively. A workshop updating PE teachers on pedagogical and health-related topics decreased depressive symptoms in adolescents. Moreover, improvements in the adolescents' social isolation mediated the effect of PE teachers' workshop intervention on the depressive symptoms in adolescents.

Mediators of lifestyle intervention effects on neonatal adiposity: are we missing a piece of the puzzle?

We evaluated possible mediators underlying lifestyle intervention effects on neonatal adiposity, assessed with sum of skinfolds and cord blood leptin. This is a secondary analysis of the DALI study, a randomised controlled trial in nine European countries. Pregnant women with a pre-pregnancy body mass index of ≥29 kg/m2 were randomly assigned to counselling for healthy eating (HE), physical activity (PA), HE&PA combined, or to usual care. We considered five maternal metabolic factors at 24-28 and 35-37 weeks of gestation, and four cord blood factors as possible mediators of the effect of combined HE&PA counselling on neonatal adiposity. From all potential mediators, the intervention only affected cord blood non-esterified fatty acids (NEFA), which was higher in the HE&PA group compared to UC (0.068 (mmol/L), 95% CI: 0.004 to 0.133). Cord blood NEFA did not mediate the HE&PA intervention effects on neonatal sum of skinfolds or cord blood leptin, based on an indirect effect on skinfolds of 0.018 (mm), 95% CI: -0.217 to 0.253 and an indirect effect on leptin of -0.143 (µg/l), 95% CI: -0.560 to 0.273. The Dali study observed reductions in neonatal adiposity in pregnant women with obesity, but we were not able to identify the underlying metabolic pathway.

The Role of Adiposity in the Association Between Physical Activity and Blood Pressure in Children.

Purpose: To analyze whether body adiposity mediates and/or moderates the association between time in moderate-to-vigorous physical activities (MVPA) and blood pressure in children. Methods: This was a cross-sectional study of 577 children aged 5 to 7 years old. MVPA was measured by accelerometry. Body mass index (BMI), waist circumference (WC), and the sum of tricipital and subscapular skinfolds (skinfolds) assessed children's body adiposity. Systolic (SBP) and diastolic blood pressure (DBP) were used as the dependent variables. Results: In the primary analysis adjusting for BMI or skinfolds measures, additional time in MVPA was associated with higher SBP. On the other hand, further analyses showed that children in the largest BMI tertile (ßSBP:0.18; 95%CI: 0.12-0.24; ßDBP:0.11; 95%CI: 0.05-0.17), waist circumference (ßSBP:0.16; CI: 0.09-0.22; ßDBP:0.08; CI:0.02-0.14), or sum of skinfolds (ßSBP:0.18; CI: 0.11-0.24; ßDBP:0.09; CI: 0.03-0.16) presented a positive relationship between MVPA and blood pressure whereas no positive association was observed for children in the first and second adiposity tertiles. Adiposity also mediated the association between MVPA and blood pressure. A decrease of 0.03 mmHg in the systolic blood pressure was observed by decreasing the sum of skinfolds for each additional minute per day in MVPA. A decrease in diastolic blood pressure of 0.02 mmHg was observed for each additional minute per day in MVPA, which was related to a negative association between time in MVPA and waist circumference and sum of skinfolds. Conclusion: Not accounting for the potential moderation and mediation role of adiposity may lead to misinterpretations in the MVPA and blood pressure relationship.

Clustering of cardiometabolic risk factors and the continuous cardiometabolic risk score in children from Southern Brazil: a cross-sectional study.

PURPOSE: The present study aimed to verify the clustering of cardiometabolic risk factors for cardiovascular diseases (CVD) and its relationship with the continuous cardiometabolic risk score (cMetS). METHODS: Cross-sectional study with 631 children aged 6 to 9 years. Cardiorespiratory fitness, glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, and waist circumference were assessed. The number of children in whom the risk factors were not independently distributed was analyzed. Z-scores were computed for each risk factor to calculate the cMetS. RESULTS: There was a high proportion of children with clustering of risk factors for CVD. The clustering of risk factors was apparent in 11.3% of the children for four or more risk factors, and 21.9% had three or more risk factors. The cMetS showed a linear relationship with the increase in the number of risk factors. A cMetS value higher than 0.91 indicated clustering of cardiometabolic risk factors amongst children. CONCLUSION: The use of clustering of cardiometabolic risk factors identified a high proportion of children with the presence of relevant cardiometabolic alterations. A cMetS value higher than 0.91 (relative to an international standard) indicated higher clustering of cardiometabolic risk factors amongst children. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00845-9.

Constructs of poor sleep quality in adolescents: associated factors.

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.

Depressive symptoms in older adults: the role of physical activity and social support

Abstract Objective To evaluate the role of social support in the association between physical activity (PA) in its various domains and depressive symptoms in older adults. Methods This was a cross-sectional study involving 399 older adults seen at basic health units in the municipality of Recife, state of Pernambuco, northeastern Brazil. Linear regression was implemented using the forward method to assess the association between PA and its domains and depressive symptoms, as well as to test the possible moderating component of social support in this association. Results Of the total sample, 17.6% reported not practicing PA; 6.7% presented depressive symptoms, with a mean score of 1.59 points. A total of 18.6% of the older adults assessed reported not having social support. Older adults who did not practice total, transportation or domestic PA showed increased scores of depressive symptoms when compared to older adults who practiced PA in these domains. Older adults with social support also had fewer depressive symptoms. Practicing domestic, leisure and total PA, and/or having social support, decreased depressive symptoms in older adults. Having social support or practicing PA decreased depressive symptoms in older adults in a similar way. Conclusions Older adults with social support and who practiced PA, especially domestic and total PA, presented the lowest scores of depressive symptoms. The data showed the importance of providing elements to strengthen social support and PA practice in older adults living in poor communities as a strategy to prevent and reduce depressive symptoms.

Violence and psychosocial stress: A 10-year time trend analysis.

AIM: The aim of this study was to analyze the temporal trend of psychosocial stress and its association between exposure to violence in adolescents. METHODS: This is a cross-sectional study of temporal trends based on three school-based and statewide surveys with regular intervals of five years. The target population consisted of high school students from public schools. A total of 4,207 adolescents were evaluated in 2006, 6,264 in 2011, and 6,002 in 2016. The psychosocial stress indicator was the dependent study variable and was analyzed according to questions: a) Feeling of loneliness; b) Feeling of sadness; c) Difficulty sleeping due to worry; d) Number of close friends; e) Suicide ideation. Exposure variables were exposure to physical violence, involvement in fights and bullying. Logistic and linear regressions were used to verify the temporal trend of psychosocial stress, and to analyze the association between exposure of violence and psychosocial stress. RESULTS: Regardless of gender, the psychosocial stress score increasing trend between 2006 and 2016. The girls showed a variation in the feeling of loneliness from 18.7% to 22.8%, and suicide ideation increased from 10.4% to 14.2% between 2006 and 2016. All types of violence were associated with greater psychosocial stress for both boys and girls. CONCLUSION: Adolescents had a higher prevalence of feelings of loneliness, difficulty sleeping due to worry and suicide ideation during the period from 2006 to 2016, regardless of gender. Exposure to violence is associated with psychosocial stress in both genders, however, the strongest associations occurred in girls.

Cardiometabolic risk factors in children and adolescents from southern Brazil: comparison to international reference values.

OBJECTIVES: To compare cardiometabolic risk factors of Brazilian children and adolescents with international reference values. Cardiometabolic risk factors constitute the Metabolic Syndrome, whose evaluation is important to assess pediatric populations' health and potential to experience metabolic disorders. METHODS: Cross-sectional study that included 2,250 randomly selected children and adolescents (55.6% girls), aged 6 to 17. Cardiometabolic parameters (body mass index [BMI], waist circumference [WC], systolic and diastolic blood pressures [SBP and DBP], total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], TC:HDL-C ratio, triglycerides [TG], glucose and peak oxygen uptake [VO2peak]), and clustered risk scores were compared to international age- and sex-specific reference values. A clustered risk score was calculated by summing the WC, glucose, SBP, TG, and the TC:HDL-C ratio Z-scores divided by five. A second clustered was calculated including VO2peak (inverted) Z-score, but divided by six. RESULTS: The clustered risk score, considering the all ages sample, was better in the Brazilian boys (-0.20 [-0.41;0.01] and -0.18 [-0.37;0.01], including or not VO2peak, respectively) but not significantly, and worse in girls (0.24 [0.05;0.43] and 0.28 [0.11;0.44], including or not VO2peak, respectively) than the international reference. Additionally, Brazilian youth had a statistically better profile in TC, LDL-C, HDL-C, TC:HDL-C ratio, and VO2peak (only girls) as well as a worse profile in BMI, WC, SBP, DBP, TG (only girls), and VO2peak (only boys). CONCLUSIONS: The clustered cardiometabolic risk score (including or not VO2peak), considering the all ages sample, was better in the Brazilian boys, but not significantly, and worse in girls compared to the international reference.

Depressive symptoms in older adults: the role of physical activity and social support.

OBJECTIVE: To evaluate the role of social support in the association between physical activity (PA) in its various domains and depressive symptoms in older adults. METHODS: This was a cross-sectional study involving 399 older adults seen at basic health units in the municipality of Recife, state of Pernambuco, northeastern Brazil. Linear regression was implemented using the forward method to assess the association between PA and its domains and depressive symptoms, as well as to test the possible moderating component of social support in this association. RESULTS: Of the total sample, 17.6% reported not practicing PA; 6.7% presented depressive symptoms, with a mean score of 1.59 points. A total of 18.6% of the older adults assessed reported not having social support. Older adults who did not practice total, transportation or domestic PA showed increased scores of depressive symptoms when compared to older adults who practiced PA in these domains. Older adults with social support also had fewer depressive symptoms. Practicing domestic, leisure and total PA, and/or having social support, decreased depressive symptoms in older adults. Having social support or practicing PA decreased depressive symptoms in older adults in a similar way. CONCLUSIONS: Older adults with social support and who practiced PA, especially domestic and total PA, presented the lowest scores of depressive symptoms. The data showed the importance of providing elements to strengthen social support and PA practice in older adults living in poor communities as a strategy to prevent and reduce depressive symptoms.

Prevalence of alcohol consumption and factors associated with binge drinking behavior among adolescents in the state of Pernambuco, Brazil, 2016

To investigate the prevalence of alcohol consumption and the factors associated with binge drinking behavior amongadolescents in the state of Pernambuco, Brazil. A cross-sectional study with a probabilistic sample of 6,002 adolescents composed of students from public high schools in Pernambuco, Brazil, aged 14 to 19 years. Binge drinking behavior was used as a dependent variable. The following were evaluated as possible risk factors: sociodemographic variables (gender, maternal education, marital status, work, religion); indicators of psychosocial stress (feelings of sadness; suicidal thoughts; feelings of loneliness;friends) and health risk behaviors (physical inactivity; number of sexual partners; drug use; and involvement in fights in the last year). Logistic regression was used to estimate odds ratios (OR). A total of 6,002 adolescents participated, with 75% reporting having consumed alcoholic beverages at least once in their lives. The prevalence of binge drinking in the last month was 17%. Adolescents without a religion had 81% (95%CI: 1.51; 2.16) more chance of consuming alcohol in excess. Adolescents who felt sad were 29% more likely to binge drink (95%CI: 1.08; 1.54), and adolescents who had already thought about suicide had 41% (95%CI: 1.13; 1.76) more chance to drink excessively. Adolescents who used illicit drugs had 4.6 times the chance (95%CI: 3.51; 6.17)of excessive drinking. Adolescents who engaged in four or more fights during the year were twice as likely to binge drink as those who did not fight (95%CI: 1.36; 2.88). The prevalence of alcohol consumption and binge drinking behavior was high. Sociodemographic factors, psychosocial stress and health risk behaviors were associated with binge drinking.

A Novel Monitoring System (AUT FIT) for Anthropometrics and Physical Fitness in Primary School Children in Austria: A Cross-Sectional Pilot Study.

Monitoring of anthropometric and physical fitness parameters in primary school children is important for the prevention of future health problems. Many of the existing test batteries that are useful for monitoring require expensive test materials, specialized test administrators, and a lot of space. This limits the usefulness of such tests for widespread use. The aim of this pilot study was to design and evaluate monitoring tools for anthropometrics and physical fitness tests in primary schools, called AUT FIT. The test battery consists of height, weight, and waist circumference measurement and eight fitness tests (6 min run, V sit-and-reach, jumping sideways, standing long jump, medicine ball throw, 4 × 10 m shuttle run, ruler drop, single leg stand). Data of 821 children aged 7 to 10 years were gathered. Most AUT FIT tests showed excellent test-retest and interrater reliability and were easy to implement. Criterion-related validity was evident by a strong correlation between physical education teacher rankings and rank scores for motor fitness. Nationwide implementation in the Austrian school system could be an important component for monitoring and improving the health and fitness of primary school children.

Constructs of poor sleep quality in adolescents: associated factors / Os construtos de baixa qualidade de sono em adolescentes: fatores associados / Constructos de calidad deficiente del sueño en adolescentes: factores asociados

This study aims to evaluate factors associated with sleep quality (overall and by domains) in adolescents. A cross-sectional study. This study was conducted with 1,296 first-year high school students from public schools in the Northern Region of the State of Pernambuco, Brazil. Demographic, socioeconomic, and behavioral data were obtained with a questionnaire. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) Body mass index (BMI) was calculated based on the ratio of weight and height squared. Multilevel linear and logistic regressions evaluated factors associated with sleep quality. We observed 53% of adolescents reported poor sleep quality. Adolescents at higher risk of clinical depression were 3.45 times more likely to have poor sleep quality (95%CI: 2.04; 5.81), and each additional unit in the social anxiety score presented 1.03 (95%CI: 1.01; 1.05) higher odds of adolescents having poor sleep quality. Adolescents with depressive symptoms had higher sleep latency, greater sleep disturbance, and greater daytime sleep dysfunction. Social anxiety was associated with sleep latency, sleep disturbance, and daytime sleep dysfunction. Higher risk of clinical depression was associated with all domains related to sleep quality. Negative health perception was associated with sleep disturbance, and physical inactivity was associated with daytime sleep dysfunction. Social anxiety and especially higher risk of clinical depression were determinants of poor sleep quality. Changes in sleep latency, sleep disturbance and daytime sleep dysfunction seems to be relevant to poor sleep quality.

O estudo buscou avaliar os fatores associados à qualidade do sono (global e por domínios) entre adolescentes. Foi realizado um estudo transversal com 1.296 estudantes de primeiro ano do ensino médio em escolas públicas na Região Norte do Estado de Pernambuco, Brasil. Foram obtidos dados demográficos, socioeconômicos e comportamentais através de um questionário. A qualidade do sono foi medida com o Pittsburgh Sleep Quality Index (PSQI). O índice de massa corporal (IMC) foi calculado como peso dividido por altura ao quadrado. Os fatores associados à qualidade do sono foram avaliados através da regressão linear multinível e logística. Observamos que 53% dos adolescentes relatavam baixa qualidade de sono. Os adolescentes com risco maior de depressão clínica apresentaram 3,45 vezes maior probabilidade de apresentar baixa qualidade de sono (IC95%: 2,04; 5,81), e cada unidade adicional na escala de ansiedade social apresentou 1,03 vezes maiores chances (IC95%: 1,01; 1,05) de baixa qualidade de sono. Os adolescentes com sintomas depressivos mostraram maior latência do sono, maior transtorno do sono e maior disfunção diurna do sono. A ansiedade social mostrou associação com latência do sono, transtorno do sono e disfunção diurna do sono. O risco maior de depressão esteve associado a todos os domínios relacionados à qualidade. Autoavaliação de saúde negativa esteve associada ao transtorno do sono, e inatividade física esteve associada à disfunção diurna do sono. Ansiedade social, e principalmente risco maior de depressão clínica, foram determinantes na baixa qualidade do sono. Mudanças na latência do sono, transtorno do sono e disfunção diurna do sono parecem ser relevantes para a baixa qualidade do sono.

El objetivo de este estudio fue evaluar factores asociados con la calidad del sueño (general y por ámbitos) en adolescentes. Se realizó un estudio transversal con 1.296 estudiantes del primer año de escuela secundaria, procedentes de escuelas públicas en la Región Norte del Estado de Pernambuco, Brasil. Se obtuvieron datos demográficos, socioeconómicos y comportamentales, a través de un cuestionario. La calidad del sueño se midió usando el Pittsburgh Sleep Quality Index (PSQI). El índice de masa corporal (IMC) se calculó de la ratio de peso y altura al cuadrado. Las regresiones logísticas y lineales multinivel evaluaron factores asociados con calidad del sueño deficiente. Observamos que un 53% de los adolescentes informaron de una calidad de sueño deficiente. Los adolescentes con mayor riesgo de depresión clínica fueron 3,45 veces más propensos a tener una calidad de sueño deficiente (95%CI: 2,04; 5,81), y cada unidad adicional en la puntuación de ansiedad social presentaba 1,03 (95%CI: 1,01; 1,05) mayores posibilidades de adolescentes sufriendo por calidad de sueño deficiente. Los adolescentes con síntomas depresivos presentaban mayor latencia de sueño, mayores perturbaciones en el sueño, y mayor disfunción durante el día de sueño. La ansiedad social estuvo asociada con la latencia de sueño, perturbaciones de sueño y disfunción del sueño durante el día. Un mayor riesgo de depresión clínica estuvo asociado con todos los ámbitos relacionados con calidad del sueño. Una percepción negativa de salud respecto a la perturbación de sueño e inactividad física estuvo asociada con un sueño deficiente durante el día. La ansiedad social y, especialmente, un mayor riesgo de depresión clínica fueron determinantes en una escasa calidad de sueño. Los cambios en la latencia del sueño, trastornos del sueño y disfunción del sueño durante el día parecieron relevantes para la deficiente calidad del sueño.

Association between body mass index, physical activity and motor competence in children: moderation analysis by different environmental contexts.

BACKGROUND: Although the association between body mass index (BMI), physical activity (PA) and motor competence (MC) has been widely investigated, the influence of different environmental contexts is not well defined. AIM: To analyse the relationship between BMI, PA and MC and the moderating role of the environmental context. SUBJECTS AND METHODS: A cross-sectional study was performed with 668 children (318 boys) aged 5-7 years (north-eastern district - Brazil). MC (Körper koordination test fur Kinder; KTK), BMI and PA (parent reporting) were assessed. To classify three contexts of the environment a variable was created based on the presence of a sports court in school and/or environment for play or sports practice out of school. Multilevel mixed-effects linear regressions, interaction test and estimation of coefficients in moderation analysis were used. RESULTS: BMI (ß = -2.93; p < .01) and age (ß = 19.02; p < .01) were associated, and PA was not associated (ß = 0.07; p = .05) with MC. The strength of the association between BMI and MC changed based on the environmental contexts. The better the environment context the weaker the association between BMI and MC (ß = -2.93, p < .01 to ß = -2.38, p = .33 to ß = 0.26, p = .94). CONCLUSIONS: The association between BMI and MC is moderated by environmental contexts.

Effects of a Physical Education Intervention on Academic Performance: A Cluster Randomised Controlled Trial.

BACKGROUND: We investigated the effects of three different interventions on academic performance in students enrolled in the first year of high school. METHODS: This was a cluster randomised controlled trial conducted with 1200 students enrolled in the first year of high school. Schools were randomly assigned to: 1. Doubling physical education (PE) classes (3:20 h of PE/week); 2. workshop with the PE teachers; 3. workshop with the PE teachers and doubling the PE classes; and 4. control group (1:40 h of PE/week). We assured that the schools within the groups were equal regarding: The structural condition of the sports court; number of PE teachers; number of school classes; and the average number of students per classroom. RESULTS: Overall, the intervention was not effective in improving the students' academic performance. However, the subgroup analysis showed that the workshop intervention group increased the academic performance of students who had failed an academic year (from 16 years of age), compared to their peers in the doubling the PE classes (1.3 points on average) and the control groups (1.4 points on average). CONCLUSIONS: Enhancing the pedagogical skills of the teachers is a promising approach in improving the academic performance of students who failed an academic year.