Clusters of 24-hour movement behavior and diet and their relationship with health indicators among youth: a systematic review.

Movement-related behaviors (physical activity [PA], sedentary behavior [SB], and sleep) and diet interact with each other and play important roles in health indicators in youth. This systematic review aimed to investigate how PA, SB, sleep, and diet cluster in youth by biological sex; and to examine which cluster are associated with health indicators. This study was registered in PROSPERO (number: CRD42018094826). Five electronic databases were assessed. Eligibility criteria allowed studies that included youth (aged 19 years and younger), and only the four behaviors {PA, SB, sleep, and diet (ultra-processed foods [UPF]; fruits and vegetables [FV])} analyzed by applying data-based cluster procedures. From 12,719 articles screened; 23 were included. Of these, four investigated children, and ten identified clusters by biological sex. Sixty-six mixed cluster were identified including, 34 in mixed-sex samples, 10 in boys and 11 in girls. The most frequent clusters in mixed-sex samples were "High SB UPF Low Sleep", "Low PA High SB Satisfactory Sleep", and "High PA". The main difference in profiles according to sex was that girls' clusters were characterized by high sleep duration, whereas boys' clusters by high PA. There were a few associations found between cluster types and health indicators, highlighting that youth assigned to cluster types with low PA exhibited higher adiposity. In conclusion, the youth presented a range of clusters of behaviors, typically exhibiting at least one unhealthy behavior. Similar patterns were observed in both sexes with the biggest difference in time of sleep for girls and PA for boys. These findings underscore the importance of intervention strategies targeting multiple behaviors simultaneously to enhance health risk profiles and indicators in children and adolescents.

Psychosocial mediators and moderators of a school-based physical activity intervention among Brazilian adolescents.

School-based interventions are needed due to the low levels of physical activity (PA) in adolescents. The aim is to examine the mediation effects of psychosocial factors (attitude, self-efficacy, social support from parents, friends, general teachers, and PE teachers, and environment school perception) and moderation by sex, school grade, and socioeconomic level of a school-based PA intervention on the PA practice among adolescents. The Movimente Programme is a randomised controlled trial at schools in southern Brazil (n = 921 adolescents). Strategies included teacher training, educational actions, and environmental changes. Adolescents self-reported their weekly PA. Potential psychosocial mediators and moderators were investigated through validated questionnaires in a Brazilian sample. The product of the coefficients with percentile bootstrapping 95% confidence interval was performed. The Movimente Programme was related to positive changes in adolescents' perception of the school environment and social support from general and physical education teachers. Most psychosocial variables (attitude, self-efficacy, social support from friends, and social support from teachers) were associated with PA, but none mediated the impact of the Movimente Programme on PA. Results varied according to sex and school grade. The Movimente Programme increased the adolescents' perception of the school environment and social support from teachers, but no mediators were confirmed.

Volatile Organic Compounds from Offspring of Stingless Bee Sacrificed in Hygienic Behavior Test.

This study shows the profile of volatile organic compounds (VOCs) from pupae and larvae of Melipona quadrifasciata anthidioides Lepeletier subjected to three death induction techniques for hygienic behavior (HB) studies: freezing in liquid nitrogen (LN2), freezing in a freezer (FRZ) and piercing of offspring with an entomological pin (PIN). The VOCs from larvae and pupae were obtained through headspace solid-phase microextraction and characterized using gas chromatography coupled to mass spectrometry. In addition, an HB test was performed on the colonies. The main classes of VOCs were hydrocarbons, terpenes and alcohols. Multivariate analysis was applied and showed that there was a separation in the compound profiles between the different treatments. The HB test in the colonies showed that 24 hours after the application of the techniques, the bees removed more dead larvae in LN2 treatment (83.5 %), while after 48 hours more larvae were removed in the LN2 and FRZ treatments (92.3 %). When compared to pupae removal, larvae removal was significantly faster in LN2.

Association of sleep timing and sleep variability with health-related outcomes in a sample of Brazilian adolescents.

OBJECTIVES: This cross-sectional study aimed to examine the relationships of sleep timing and sleep variability with depressive symptoms, health-related quality of life (HRQoL), daytime sleepiness, and body mass index (BMI) in adolescents. METHODS: Adolescents from three schools (n = 571, 56% female, 16.3 ± 1.0 years) had their sleep examined by actigraphy, their anthropometrics assessed, and answered a survey. Sleep timing was examined by combining groups of median-dichotomized onset and wakeup times (early onset and early wakeup; early onset and late wakeup; later onset and early wakeup; later onset and later wakeup); sleep variability was based on within-participant standard deviations of onset and wakeup; and sleep duration as the length of time between onset and wakeup. The sleep variables were separated for weekdays and weekend. Mixed linear models were fitted to compare each sleep variable with health-related outcomes. RESULTS: Higher values of daytime sleepiness were observed in adolescents from the late-early and late-late timing group during the week. Greater sleep midpoint and wakeup variability on weekdays were related with higher daytime sleepiness. Adolescents in the late-late and early-late groups showed higher daytime sleepiness. Increased of all sleep variability variables was related with greater daytime sleepiness. Higher depressive symptoms scores were found among adolescents in the late-early subgroup and with the increase of sleep variability. Participants with greater sleep onset variability and sleep midpoint variability reported less HRQoL. CONCLUSIONS: Not only sleep duration, but sleep timing and variability also relate to health outcomes, and should be addressed by policies and interventions among adolescents.

Quality of life and metamemory in higher education students during the COVID-19 pandemic / Qualidade de vida e metamemória em estudantes do nível superior durante a pandemia da COVID-19

ABSTRACT Purpose: to analyze the quality of life and metamemory and verify their predictors in students during the COVID-19 pandemic. Methods: a cross-sectional survey carried out through online collection with the application of an initial questionnaire to characterize the sample, the WHOQOL-brief to investigate the quality of life, and the Metamemory Questionnaire in Adults (short version) - MIAr to evaluate metamemory in a group of undergraduate and postgraduate students. Data were analyzed using descriptive and inferential statistics. Multiple linear regression was performed to verify the predictor variables. A significance level of 5% (p ≤ 0.05) was considered. Results: 977 university students participated in the study, the majority (70.73%) of whom were females and with an income range below three minimum wages (63.56%). For quality of life, income range, being in the risk group for COVID-19, and age were predictors for both the undergraduate and postgraduate groups. In contrast, on an excellent metamemory, the predictors were male gender and age. Conclusion: for students, during the COVID-19 pandemic, the main predictor of quality of life was having a higher income bracket, and the main predictor of metamemory was being a male.

RESUMO Objetivo: analisar a qualidade de vida e a metamemória e verificar seus preditores em estudantes durante a pandemia da COVID-19. Métodos: trata-se de uma pesquisa transversal realizada por meio de coleta online com a aplicação de um questionário inicial para caracterizar a amostra, do WHOQOL-bref para investigar a qualidade de vida e do Questionário de Metamemória em Adultos (versão reduzida) - MIAr para avaliar a metamemória, em um grupo de estudantes de graduação e outro de pós-graduação. Os dados foram analisados por meio de estatística descritiva e inferencial. Realizou-se a regressão linear múltipla para verificar as variáveis preditoras. Foi considerado o nível de significância de 5% (p≤0,05). Resultados: participaram do estudo 977 universitários, sendo a maioria (70,73%) do gênero feminino e com faixa de renda menor que três salários-mínimos (63,56%). Para a qualidade de vida, tanto para o grupo de graduandos quanto de pós-graduandos, a faixa de renda, o grupo de risco para COVID-19 e a idade foram preditores, enquanto para uma boa metamemória os preditores foram o gênero masculino e a idade. Conclusão: para os estudantes, durante a pandemia da COVID-19, o principal preditor da qualidade de vida foi possuir maior faixa de renda e o da metamemória foi ser do gênero masculino.

Panorama da Saúde Auditiva infantil no Sistema Único de Saúde no estado de Sergipe / Children's Hearing Health Panorama in the Unified Health System in the state of Sergipe

RESUMO Objetivo Descrever o panorama da saúde auditiva infantil no Sistema Único de Saúde do estado de Sergipe. Método Estudo quantitativo e retrospectivo, composto por quatro etapas: 1) Busca no Cadastro Nacional de Estabelecimento de Saúde das instituições conveniadas ao Sistema Único de Saúde no estado de Sergipe que realizam serviços obstétricos e dos serviços que atuam na saúde auditiva; 2) Obtenção de dados de cobertura da Triagem Auditiva Neonatal (TAN), por meio do DATASUS (de 2012 a 2020); 3) Coleta de dados em prontuários das instituições com obstetrícia e/ou que realizam a TAN; e 4) Entrevista aos responsáveis das crianças em reabilitação auditiva. Os resultados foram sumarizados por meio de estatística descritiva (frequência absoluta e relativa, medidas de tendência central e de dispersão). Resultados Dos 29 estabelecimentos com obstetrícia, um realiza a TAN. Há dois Centros de Referência em Saúde Auditiva (CRSA) com habilitação para implante coclear e dois Centros Especializados em Reabilitação. De 2012 a 2020 a cobertura da TAN no estado foi inferior a 40% e quando realizada na maternidade, houve ausência de encaminhamentos para a realização do Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e do diagnóstico audiológico. Observou-se cobertura considerável no CRSA com menor taxa de evasão para realizar PEATE e com taxa de diagnóstico de 4,8%. O tempo médio da TAN universal à reabilitação foi superior ao recomendado. Conclusão Existe necessidade de aumentar a cobertura da TAN, ajustar a rede de saúde auditiva para a articulação nos diferentes níveis de atenção e diminuir o tempo para identificação, diagnóstico e início da reabilitação.

ABSTRACT Purpose To describe the panorama of children's hearing health in the Unified Health System of the state of Sergipe. Methods A quantitative and retrospective study consisting of four steps: 1) Search the National Registry of Health Establishments of institutions affiliated to the Health Unic System in the state of Sergipe that perform obstetric services and hearing health services; 2) Collecting Neonatal Hearing Screening (NHS) coverage data through DATASUS (from 2012 to 2020); 3) Data collection from medical records of institutions with obstetrics and that perform NHS; and 4) Interview with the guardians of children undergoing auditory rehabilitation. The results were summarized using descriptive statistics (absolute and relative frequency, measures of central tendency, and dispersion). Results Only one out of the 29 establishments with obstetrics performs NHS. Two of the Hearing Health Reference Centers (HHRC) are qualified for cochlear implants and two Specialized Centers are qualified for Rehabilitation. From 2012 to 2020, NHS coverage in the state was less than 40%, and when performed in the maternity ward, there were no referrals for Brainstem Auditory Evoked Response (BERA) and audiological diagnosis. The HHRC showed considerable coverage and a lower evasion rate to perform BERA, with a diagnosis rate of 4.8%. The mean time from the NHS to rehabilitation was longer than recommended. Conclusion NHS coverage must be increased, adjusting the hearing health network to articulate the different levels of care, and reducing the time for identification, diagnosis, and start of rehabilitation.

Children's Hearing Health Panorama in the Unified Health System in the state of Sergipe. / Panorama da Saúde Auditiva infantil no Sistema Único de Saúde no estado de Sergipe.

PURPOSE: To describe the panorama of children's hearing health in the Unified Health System of the state of Sergipe. METHODS: A quantitative and retrospective study consisting of four steps: 1) Search the National Registry of Health Establishments of institutions affiliated to the Health Unic System in the state of Sergipe that perform obstetric services and hearing health services; 2) Collecting Neonatal Hearing Screening (NHS) coverage data through DATASUS (from 2012 to 2020); 3) Data collection from medical records of institutions with obstetrics and that perform NHS; and 4) Interview with the guardians of children undergoing auditory rehabilitation. The results were summarized using descriptive statistics (absolute and relative frequency, measures of central tendency, and dispersion). RESULTS: Only one out of the 29 establishments with obstetrics performs NHS. Two of the Hearing Health Reference Centers (HHRC) are qualified for cochlear implants and two Specialized Centers are qualified for Rehabilitation. From 2012 to 2020, NHS coverage in the state was less than 40%, and when performed in the maternity ward, there were no referrals for Brainstem Auditory Evoked Response (BERA) and audiological diagnosis. The HHRC showed considerable coverage and a lower evasion rate to perform BERA, with a diagnosis rate of 4.8%. The mean time from the NHS to rehabilitation was longer than recommended. CONCLUSION: NHS coverage must be increased, adjusting the hearing health network to articulate the different levels of care, and reducing the time for identification, diagnosis, and start of rehabilitation.

OBJETIVO: Descrever o panorama da saúde auditiva infantil no Sistema Único de Saúde do estado de Sergipe. MÉTODO: Estudo quantitativo e retrospectivo, composto por quatro etapas: 1) Busca no Cadastro Nacional de Estabelecimento de Saúde das instituições conveniadas ao Sistema Único de Saúde no estado de Sergipe que realizam serviços obstétricos e dos serviços que atuam na saúde auditiva; 2) Obtenção de dados de cobertura da Triagem Auditiva Neonatal (TAN), por meio do DATASUS (de 2012 a 2020); 3) Coleta de dados em prontuários das instituições com obstetrícia e/ou que realizam a TAN; e 4) Entrevista aos responsáveis das crianças em reabilitação auditiva. Os resultados foram sumarizados por meio de estatística descritiva (frequência absoluta e relativa, medidas de tendência central e de dispersão). RESULTADOS: Dos 29 estabelecimentos com obstetrícia, um realiza a TAN. Há dois Centros de Referência em Saúde Auditiva (CRSA) com habilitação para implante coclear e dois Centros Especializados em Reabilitação. De 2012 a 2020 a cobertura da TAN no estado foi inferior a 40% e quando realizada na maternidade, houve ausência de encaminhamentos para a realização do Potencial Evocado Auditivo de Tronco Encefálico (PEATE) e do diagnóstico audiológico. Observou-se cobertura considerável no CRSA com menor taxa de evasão para realizar PEATE e com taxa de diagnóstico de 4,8%. O tempo médio da TAN universal à reabilitação foi superior ao recomendado. CONCLUSÃO: Existe necessidade de aumentar a cobertura da TAN, ajustar a rede de saúde auditiva para a articulação nos diferentes níveis de atenção e diminuir o tempo para identificação, diagnóstico e início da reabilitação.

Effects of a self-care educational program via telerehabilitation on quality of life and caregiver burden in amyotrophic lateral sclerosis: a single-blinded randomized clinical trial protocol.

Introduction: The implementation of a telerehabilitation protocol for self-care in the routine of caregivers of individuals with amyotrophic lateral sclerosis (ALS) has been associated with reduced levels of stress and improved quality of life. Moreover, it may reduce the difficulty of traveling to perform physical or other self-care activities. Thus, this study designed a clinical trial protocol to investigate the effects of a self-care education program via telerehabilitation on the burden and quality of life of caregivers of individuals with ALS. Methods: This single-blinded randomized clinical trial will recruit 26 caregivers and randomly allocate them to the experimental (EG = 13) or control group (CG = 13). The EG will receive an informative booklet and participate in a 6-week synchronous telerehabilitation program with a neuropsychologist, nutritionist, and physiotherapist to discuss physical and mental health. The CG will receive an informative booklet on self-care and physical activity and weekly phone calls for 6 weeks to solve questions about the booklet. Outcomes will include the caregiver burden (Zarit scale), quality of life (World Health Organization Quality of Life BREF), pain (McGill Pain Questionnaire), stress (Perceived Stress Scale), and depression (Beck Depression Inventory), which will be evaluated at the baseline after the six-week program and 30 days after the program. Additionally, we will assess daily the nocturnal awakenings, sleep patterns, level of physical activity, and heart rate variability. Discussion: This study aimed to investigate the effectiveness of telerehabilitation for caregivers of individuals with ALS. If effective, this program could be disseminated among health professionals, increasing the possibility of remotely monitoring individuals with difficulty performing physical activities. Trial registration number: NCT05884034 (clinicaltrials.gov).

Screen Time Correlates of Bullying Perpetration and Victimization in Brazilian Adolescents.

This study is an investigation of the associations of time spent in different screen time activities with bullying among Brazilian adolescents. In this cross-sectional study, adolescents answered questions related to bullying in the past 30 days and reported the weekly volume of screen time spent studying, working, watching videos, playing video games, and using social media applications. Multilevel logistic regression models were used. Our results indicate that higher social media use was associated with higher odds of bullying victimization among males but not females. Excessive use of screen time for work and social media purposes was associated with a higher likelihood of bullying victimization.

Cross-Sectional Associations of Screen Time Activities With Alcohol and Tobacco Consumption Among Brazilian Adolescents.

Objectives: Little is known about the association between specific types of screen time and adolescents' substance use. Thus, this study aimed to investigate the associations between screen time for studying, working, watching movies, playing games, and using social media and frequency of alcohol and tobacco use. Methods: In this cross-sectional study, Brazilian adolescents answered survey questions related to frequency of tobacco and alcohol consumption, and reported their daily volume of five types of screen time. Multilevel ordered logistic regression models were performed. Results: Each 1-hour increase in ST for studying was associated with 26% lower odds of smoking (OR = 0.74; 95% CI: 0.61-0.90) and 17% lower odds of drinking alcohol (OR = 0.83; 95% CI: 0.76-0.91) in the past 30 days. The increase of 1 hour of social media use was associated with 10% greater odds of smoking (OR = 1.10; 95% CI: 1.02-1.18) and a 13% greater chance of consuming alcohol (OR = 1.13; 95% CI: 1.08-1.18) in the past 30 days. Conclusion: The association between screen time and substance use appears to be type-specific. Future longitudinal research is needed to explore causal relationships.

Obesogenic behavior clusters associated with weight status among Brazilian students: a latent class analysis.

This study aimed to examine the association between clusters of physical activity (PA), diet, and television viewing (TV) with weight status among a representative sample of Brazilian students. Data from the National Health School-based Survey (PeNSE) 2015 were analyzed (n = 16,521; mean age 14.8, standard deviation 0.03 year). PA (minutes/week spent in leisure-time, and commuting to/from school), TV (hours/day), and weekly consumption of deep-fried empanadas, candies, sodas, ultra-processed foods, fast foods, green salads or vegetables, and fruits were self-reported on the validated PeNSE questionnaire. Latent class analysis defined behavior classes, and binary logistic regression assessed the association between clustering and weight status. Six classes' types with positive and negative behaviors were identified. Adolescents belonging to the "low TV time and high healthy diet" class had higher chances of being overweight (including obesity) compared to their peers in the "moderate PA and mixed diet" class. No associations were found in the other clusters. Mixed classes with healthy and unhealthy behaviors characterized adolescents' lifestyles and these profiles were related to weight status.

Obesogenic behavior clusters associated with weight status among Brazilian students: a latent class analysis / Agrupamentos de comportamentos obesogênicos associados com status de peso em estudantes brasileiros: uma análise de classe latente

Abstract This study aimed to examine the association between clusters of physical activity (PA), diet, and television viewing (TV) with weight status among a representative sample of Brazilian students. Data from the National Health School-based Survey (PeNSE) 2015 were analyzed (n = 16,521; mean age 14.8, standard deviation 0.03 year). PA (minutes/week spent in leisure-time, and commuting to/from school), TV (hours/day), and weekly consumption of deep-fried empanadas, candies, sodas, ultra-processed foods, fast foods, green salads or vegetables, and fruits were self-reported on the validated PeNSE questionnaire. Latent class analysis defined behavior classes, and binary logistic regression assessed the association between clustering and weight status. Six classes' types with positive and negative behaviors were identified. Adolescents belonging to the "low TV time and high healthy diet" class had higher chances of being overweight (including obesity) compared to their peers in the "moderate PA and mixed diet" class. No associations were found in the other clusters. Mixed classes with healthy and unhealthy behaviors characterized adolescents' lifestyles and these profiles were related to weight status.

Resumo O estudo objetivou examinar a associação entre agrupamentos de atividade física (AF), dieta e tempo de televisão (TV) com o status do peso em uma amostra representativa de estudantes brasileiros. Foram analisados ​​dados da Pesquisa Nacional de Saúde do Escolar (PeNSE) 2015 (n = 16.521; idade média 14,8, desvio padrão de 0,03 ano). AF (minutos/semana no lazer e deslocamento para/da escola), assistir televisão (TV) (horas/dia), consumo semanal de doces, refrigerantes, alimentos ultraprocessados/fast-foods, saladas/vegetais e frutas foram coletadas por questionário validado. Análise de classes latentes definiu os perfis de comportamento e a regressão logística binária a associação entre agrupamento e status de peso. Foram identificadas seis classes com comportamentos positivos e negativos. Adolescentes pertencentes à classe "baixo tempo de TV e alta alimentação saudável" apresentaram maior probabilidade de ter sobrepeso/obesidade em comparação com seus pares na classe "AF moderada e dieta mista". Não foram encontradas associações nos outros perfis. Classes com comportamentos saudáveis ​​e não saudáveis ​​caracterizaram o estilo de vida dos adolescentes e estiveram relacionadas com o status de peso.

National policies on physical activity from 64 countries with different economies: a scoping review with thematic analysis.

In 2018, the World Health Organization (WHO) launched a Global Action Plan on Physical Activity (PA), which included 20 policy actions for creating active societies, environments, people and systems. The objective of this scoping review was to summarize the themes/contents of national PA policies/plans conforming to the WHO's proposals and the country's economy. This review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews. A systematic search of electronic databases (Web of Science, Medline/PubMed, LILACS, PsycINFO, Scopus and SPORTDiscus) and 441 government documents/websites from 215 countries/territories was conducted (February 2021). Documents on national-level policies, published in English, Spanish and Portuguese since 2000, were eligible. The information on content and structure was systematically extracted and summarized into dimensions proposed by the WHO: active societies, environments, people and systems. The search identified 888 article references and 586 potentially relevant documents. After the screening, 84 policy documents from 64 countries were eligible. Most documents (n = 46) provided detailed PA policies/plans amid other health topics (e.g. non-communicable diseases, named 'general documents'), and 38 were PA-specific. The content analysis merged 54 visions, 65 missions, 108 principles, 119 objectives, 53 priorities, 105 targets, 126 indicators and 1780 actions/strategies from 38 PA-specific and 46 general documents. Among the PA-specific documents, the active system's dimension was the most contemplated in the principles (n = 43), priorities (n = 51) and action/strategies (n = 530) elements. At the same time, the objectives (n = 39), targets (n = 52) and indicators (n = 58) presented contents more frequently related to the active people dimension. For the general documents, all principles (n = 4), objectives (n = 14) and priorities (n = 7) were related to the dimension of active people, while target (n = 51), indicator (n = 53) and actions/strategies (n = 292) elements presented content related to all dimensions. The increase in countries with national PA policies/plans should be followed by improving the current ones because important dimensions seem to be not considered in these documents. This will facilitate a global PA agenda that considers the complexity and multidimensionality of PA promotion.

Influence of Teachers' Vocal Quality on Students' Learning and/or Cognition: A Scoping Review.

OBJECTIVE: To verify if the teacher's vocal quality can influence the student's cognition. METHODS: The present study is a scoping review performed to answer the research question: Can the teacher's vocal quality influence the student's learning and cognition?. To verify if the teacher's vocal quality can influence the student's cognition. The electronic search was performed in PubMed, Lilacs, SciELO, Scopus, Web of Science, Embase, and databases, in addition to a manual search in citation and gray literature. Two independent authors performed selection and extraction. Data were extracted about the study design: the sample, the cognitive tests used, the assessed cognitive skills, the type of altered voice (real or simulated), the assessment of the vocal quality, alone or associated with environmental noise, and the main outcomes evaluated. RESULTS: The initial research identified 476 articles, and 13 were selected for analysis. Seven (54%) studies evaluated the impact of altered voices in an isolated way on cognitive abilities. From these, they verified that the altered voices could negatively influence children's cognitive performance. Other 6 studies (46%) associated altered voices with competitive noise in their analysis, and 4 concluded that competitive noise rather than altered voices influenced students' cognitive performance. CONCLUSION: The altered voice seems to affect the cognitive tasks involved in the learning process. The competitive noise associated with the presentation of deviant voices had a stronger influence on cognitive performance than altered voice alone, demonstrating that cognitive performance is sensitive to the stages of information acquisition (input of acoustic signals).

Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews.

BACKGROUND: Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents. METHODS: We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary. RESULTS: An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted. CONCLUSIONS: These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.

Independent and joint associations of cardiorespiratory fitness and weight status with health-related quality of life among Brazilian adolescents.

PURPOSE: To investigate the independent and joint associations of cardiorespiratory fitness and body mass index (BMI) with five dimensions of Health-Related Quality of Life (HRQoL) in a cross-sectional sample of Brazilian adolescents. METHODS: 619 Brazilian schoolchildren answered a survey, BMI categories (healthy weight and overweight/obesity) were assessed by their weight and height, and they participated in a 20-m shuttle run test. HRQoL was measured using the KIDSCREEN-27 across five dimensions: Physical Well-Being, Psychological Well-Being, Autonomy and Parent Relation, Peers and Social Support, and School Environment. Sex, age, maternal education, physical activity level, and habitual sedentary behaviour were assessed and used as adjusting variables. Cardiorespiratory fitness was categorized in tertiles and independent and joint associations were tested using mixed-effects linear regressions. RESULTS: Higher levels of cardiorespiratory fitness were favourably associated with the physical well-being, psychological well-being, and peer and social support dimensions of HRQoL. Adolescents with overweight/obesity presented higher scores on peer and social support dimensions when compared to healthy-weight adolescents. Independent of the adolescents' BMI categories, better cardiorespiratory fitness was positively associated with physical and psychological well-being when compared with the category of overweight/obesity and low cardiorespiratory fitness. In addition, adolescents with overweight/obesity combined with intermediate cardiorespiratory fitness or high cardiorespiratory fitness had higher scores on the peer and social support dimension. CONCLUSION: Cardiorespiratory fitness is a strong correlate of HRQoL across most of the dimensions measured, while BMI was a correlate of one dimension of HRQoL. Future studies should evaluate these relationships prospectively and experimentally.

From awareness to action: Effects of a school-based intervention on TV viewing behavior stages and screen time guidelines knowledge in Brazilian adolescents / Da conscientização à ação: Efeitos de uma intervenção escolar nos estágios de mudança de comportamento para assistir TV e no conhecimento das diretrizes de tempo de tela em adolescentes brasileiros

The aims of the study were to verify the effect of an intervention on the stage of behavior change for TV viewing and to identify the possible mediating role of knowledge on screen time guidelines among Brazilian students. This study is a multicomponent school-based intervention conducted with 727 students (54.3% female, 13 years; 427 in the intervention group and 300 in the control group). The intervention was performed in 2017 with baseline and post-intervention assessments (over one academic year). Teacher training was carried out at the beginning of the intervention along with en-vironmental improvements, while educational curriculum such as the delivery of folders and posters were performed throughout the year. The stages of behavior change for TV viewing and knowledge of screen time guidelines were measured by a self-reported questionnaire and the structural equation modeling approach was performed. The intervention had no significant effects on stages of behavior change for TV (p = 0.744) nor did it result in significant changes on knowledge of screen time guide-lines (p = 0.741). While there was no mediation between knowledge of screen time guidelines and the effect of the intervention on stages of behavior change for TV (95%CI: -0.45;0.63), an associa-tion was found between knowledge of screen time guidelines and stages of behavior change for TV (p<0.001). In conclusion, intervention had no significant effect on the stages of behavior change for TV and no mediating effect was observed. However, enhancing awareness on screen time guidelines may positively impact the adolescent's intention to reduce TV time

Os objetivos do estudo foram verificar o efeito de uma intervenção nos estágios de mudança de comporta-mento para assistir TV e identificar o papel mediador do conhecimento sobre as recomendações de tempo de tela. A intervenção multicomponente, randomizada e controlada obteve a participação de 727 alunos em 2017 (54,3% meninas, 13 anos; 427 no grupo intervenção e 300 no grupo controle). A formação dos pro-fessores foi realizada no início da intervenção juntamente com as melhorias ambientais, enquanto as ações educativas foram realizadas ao longo do ano. Os estágios de mudança de comportamento para assistir TV e o conhecimento sobre as recomendações do tempo de tela foram mensurados por questionário auto reportado, pré e pós-intervenção (um ano letivo). Para análise dos dados foi realizada uma modelagem de equações estru-turais. Não houve efeito da intervenção nos estágios de mudança de comportamento para TV (p = 0,744) e também não houve mudanças significativas no conhecimento dos estudantes sobre as recomendações do tempo de tela (p = 0,741). Embora não tenha havido mediação entre conhecimento das recomendações do tempo de tela e o efeito da intervenção nos estágios de mudança de comportamento para TV (IC95%: -0,45;0,63), foi encontrada associação entre o conhecimento das recomendações e os estágios de mudança de comportamento para TV (p < 0,001). Conclui-se que a intervenção não teve efeito significativo nos estágios de mudança de comportamento para TV e efeito mediador. No entanto, aumentar a conscientização sobre as recomendações de tempo de tela pode impactar positivamente na intenção do adolescente de reduzir o tempo de TV

A systematic review of the clustering and correlates of physical activity and sedentary behavior among boys and girls.

Identifying the clustering and correlates of physical activity (PA) and sedentary behavior (SB) is very important for developing appropriate lifestyle interventions for children and adolescents. This systematic review (Prospero CRD42018094826) aimed to identify PA and SB cluster patterns and their correlates among boys and girls (0-19 years). The search was carried out in five electronic databases. Cluster characteristics were extracted in accordance with authors' descriptions by two independent reviewers and a third resolved any disagreements. Seventeen studies met the inclusion criteria and the population age ranged from six to 18 years old. Nine, twelve, and ten cluster types were identified for mixed-sex samples, boys, and girls, respectively. While girls were in clusters characterized by "Low PA Low SB" and "Low PA High SB", the majority of boys were in clusters defined by "High PA High SB" and "High PA Low SB". Few associations were found between sociodemographic variables and all cluster types. Boys and girls in "High PA High SB" clusters had higher BMI and obesity in most of the tested associations. In contrast, those in the "High PA Low SB" clusters presented lower BMI, waist circumference, and overweight and obesity. Different cluster patterns of PA and SB were observed in boys and girls. However, in both sexes, a better adiposity profile was found among children and adolescents in "High PA Low SB" clusters. Our results suggest that it is not enough to increase PA to manage the adiposity correlates, it is also necessary to reduce SB in this population.

The relationship between physical activity and depressive symptoms is domain-specific, age-dependent, and non-linear: An analysis of the Brazilian national health survey.

Although there is consistent evidence of the beneficial effects of leisure physical activity (PA) on mental health, the role of PA in the domestic, transport, and occupational domains is inconclusive. This study aimed to analyze the relationship between domain-specific PA and depressive symptoms and examine whether the association is moderated by age in a representative sample of the Brazilian population. Cross-sectional data of 89,923 (52.4% female) individuals aged ≥15 years were analyzed. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Physical activity (min/week) performed in different domains (domestic, transport, occupation, and leisure) was self-reported. Generalized additive models with penalized splines were used to explore associations. Lower leisure-time PA and higher levels of PA in the domestic, occupational, and transport domains at distinct PA thresholds were associated with higher depressive symptoms. Leisure PA, even at lower levels, was associated with lower depressive symptoms compared to no PA at all. The increase in depressive symptoms as a function of occupational PA was observed only at PA levels higher than 40 h/week. Although non-leisure PA levels were related to higher depressive symptoms among the total sample, higher domestic and transport PA levels were related to lower depressive symptoms among older adults. This study provides insights into the non-linearity and age-group dependence of the relationship between domain-specific PA and depressive symptoms in a middle-income country. The evidence suggests that care should be taken on recommending PA regardless of context or domain.