The association of telomere length with body mass index and immunological factors differs according to physical activity practice among children and adolescents.

BACKGROUND: This study aims to verify the relationship between screen and sleep time, body mass index (BMI) and immunological factors with telomere length according to leisure-time physical activity (PA) in children and adolescents. METHODS: A cross-sectional study involving a sample of 476 schoolchildren of both sexes, aged seven to 17 years, from a community in southern Brazil. Behavioral variables (PA, sleep time, and screen time) were self-reported using a questionnaire. PA was classified as inactive and any PA (doing some physical activity). The associations of screen time, sleep time, BMI, and immunologic factors with telomere length were tested using multiple linear regression models, with the sample divided according to the schoolchildren's leisure-time physical activity practices. RESULTS: An inverse association between BMI and telomere length (ß: -0.239; 95% CI: -0.468; -0.010) and a direct association of leukocytes (ß: 0.151; 95% CI: 0.029; 0.278) and neutrophils (ß: 0.131; 95% CI: 0.008; 0.254) with telomeres were found in the inactive students. No association was found between screen time and sleep time and telomeres. No association was found among students who engaged in any PA. CONCLUSION: The associations between telomeres, BMI, and immunologic factors were found only in inactive students. These results suggest that the association between BMI and immunological factors and telomere length may be influenced by physical activity.

Does Playing Mahjong Benefit Older Individuals? A Scoping Review.

Playing mahjong is a popular intellectual and social leisure activity in Asian countries. It is culturally believed that this activity is beneficial to cognitive and psychological functioning in older adults. However, empirical evidence of the benefits of playing mahjong is scant and scattered across the Western and Asian literature. This scoping review comprehensively examined previous studies of the relationships between playing mahjong and cognitive, psychological, and functional abilities in older adults, highlighted gaps in the literature, and identified directions for future research. A systematic search of the literature was conducted across thirteen Western and Asian databases. Fifty-three studies, including forty-seven observational and six intervention studies, were identified. Overall, the results of the observational studies suggested that more mahjong-playing experience was associated with better cognitive, psychological, and functional abilities. As an intervention, playing mahjong was found to enhance general cognitive abilities and short-term memory and relieve depressive symptoms. However, because most of the reviewed studies adopted a correlational methodology, the neural mechanism underlying the benefits of playing mahjong awaits further elucidation. The findings of this review suggest that more randomized controlled trials should be conducted to explore the effects of playing mahjong on higher-level cognitive functioning in older populations.

Screen time, sleep duration, leisure physical activity, obesity, and cardiometabolic risk in children and adolescents: a cross-lagged 2-year study.

BACKGROUND: Considering the previous research that suggested that screen time (ST), sleep duration, physical activity (PA), obesity and cardiometabolic risk factors are related, it is essential to identify how these variables are associated over time, to provide knowledge for the development of intervention strategies to promote health in pediatric populations. Also, there is a lack of studies examining these associations longitudinally. The aims of the present study were: (1) to investigate the longitudinal relationships between ST, sleep duration, leisure PA, body mass index (BMI), and cardiometabolic risk score (cMetS) in children and adolescents; and (2) to verify scores and prevalence of cMetS risk zones at baseline and follow-up. METHODS: This observational longitudinal study included 331 children and adolescents (aged six to 17 years; girls = 57.7%) from schools in a southern city in Brazil. ST, sleep duration, and leisure PA were evaluated by a self-reported questionnaire. BMI was evaluated using the BMI z-scores (Z_BMI). The cMetS was determined by summing sex- and age-specific z-scores of total cholesterol/high-density lipoprotein cholesterol (HDL-C) ratio, triglycerides, glucose, and systolic blood pressure and dividing it by four. A two-wave cross-lagged model was implemented. RESULTS: ST, sleep duration, and leisure PA were not associated with cMetS after 2-years. However, it was observed that higher ST at baseline was associated with shorter sleep duration at follow-up (B=-0.074; 95%IC=-0.130; -0.012), while higher Z_BMI from baseline associated with higher cMetS of follow-up (B = 0.154; 95%CI = 0.083;0.226). The reciprocal model of relationships indicated that the variance of ST, sleep time, leisure PA, Z_BMI, and cMetS explained approximately 9%, 14%, 10%, 67% and 22%, respectively, of the model. Individual change scores and prevalence indicated that cMetS had individual changes from 2014 to 2016. CONCLUSION: Sleep duration, ST and leisure PA were not associated with cMetS after 2 years. ST showed an inverse association with sleep duration, and Z_BMI was positively associated with cMetS after a 2-year follow-up. Finally, the prevalence of no clustering of risk factors increased after two years. These findings suggest the need to promote healthy lifestyle habits from childhood and considering individual factors that can influence cardiometabolic health in children and adolescents.

Socio-demographic and other factors contributing to excessive leisure screen time in preadolescent children.

OBJECTIVES: Excessive screen use in early school age is associated with worsened health habits and negative child development in later age. We aimed to assess the time spent on modern and traditional screen-based devices and examine its associations with socio-demographic characteristics. METHODS: This population-based cross-sectional observation study was conducted in Czechia, Slovakia and Finland between April and June 2021. Participants (N = 1,915) were parents/caregivers of children attending elementary school grades 1 to 3, selected by stratified random sampling. Children's daily leisure screen time (LST) based on parental reports was the main outcome. Descriptive statistics, mean comparison and linear regression analysis were used for the analysis. RESULTS: The average daily LST was found to be as high as 3.5 hours and significantly associated with most socio-demographic variables. Eighty percent of children exceeded the threshold of two hours of LST per day, which was formerly introduced by the American Academy of Pediatrics. The most important predictor of LST in children was having their screen-based device(s) for their exclusive personal use (EPU). Linear regression with all predictors assessed together confirmed the significant effect of the screen-based devices' EPU, the child's sex and grade, the child's birth order and the parent's education, even when controlled for media parenting practices. CONCLUSIONS: Given the widespread availability of smartphones for exclusive personal use among young children, the regulation of EPU and the reinforcement of effective media parenting practices, particularly in families with lower education and income, are critical public health strategies to mitigate the negative impact of excessive screen time on child development and overall well-being.

Beyond The Books: Role of Extracurricular Activities In Medical Students.

ABSTRACT: Extracurricular activities (ECAs) in the field of medicine can be research related and non-research related activities that allows students to develop skills to be a good doctor in the future. Building a curriculum vitae, becoming a team player, managing stress, building good communication skills and good academics highlights the value of extracurricular activities. Challenges like time constraints, and resource limitation hinders the participation which needs to be addressed to encourage the medical students to take part in extracurricular activities.

Effects of Occupational and Leisure-Time Physical Activity on the Risk of Dementia: Results From the Copenhagen City Heart Study.

Leisure-time physical activity (LTPA) decreases the risk of dementia, whereas occupational physical activity (OPA) possibly increases the risk. Yet, previous findings are mixed. We therefore aimed to investigate the effect of LTPA and OPA, respectively, on dementia among men and women. In this observational, longitudinal study, we used data from the second wave of a population-based cohort from the municipality of Copenhagen as baseline. Data were collected in 1981-1983, and 10 343 participants were followed until the end of 2016. LTPA and OPA were self-reported, and information on dementia diagnoses and redemption of dementia medication was obtained at an individual level from national health registers. We used Poisson regression to analyze the association between LTPA/OPA and dementia and adjusted for self-reported age, socioeconomic factors, stress, and cardiovascular risk factors (smoking, alcohol, body mass index, and blood pressure). A higher level of LTPA was associated with a lower dementia risk among men, but we found no clear association among women. OPA and dementia were not associated among men, but occupationally active women who reported OPA in terms of walking, lifting, and heavy work had a higher risk of dementia than women with sedentary jobs. This study supported earlier findings of a protective effect of LTPA on dementia among men. Women in physically demanding jobs possibly have a higher risk of dementia, yet this finding warrants further investigation in future studies.

Organized afterschool activities as a developmental context for children and adolescents.

The last 40 years have been marked by a growing appreciation of organized afterschool activities as a developmental context, with evidence that these activities are linked to academic, social, and behavioral outcomes at least in the short term. In this chapter, we focus on research that builds on these earlier advances to extend afterschool research in two areas that are critical to the future of this field. First, we feature research that examines organized activities longitudinally from kindergarten through the end of high school, enabling us to study organized activities in relation to academic, social-emotional, behavioral, and health outcomes in both the short-run and long-run, including into adulthood. We then turn to a second advance: research focused on organized activities that serve minoritized children and adolescents. These studies identify the barriers minoritized youth often face and how activities can be designed to support their positive development, including efforts to provide culturally responsive programming. Promising directions for future research are presented in a third section.

Risk of SARS-CoV-2 infection in professional settings, shops, shared transport, and leisure activities in France, 2020-2022.

PURPOSE: The aim of the study was to identify settings associated with SARS-CoV-2 transmission throughout the COVID-19 pandemic in France. METHODS: Cases with recent SARS-CoV-2 infection were matched with controls (4:1 ratio) on age, sex, region, population size, and calendar week. Odds ratios for SARS-CoV-2 infection were estimated for nine periods in models adjusting for socio-demographic characteristics, health status, COVID-19 vaccine, and past infection. RESULTS: Between October 27, 2020 and October 2, 2022, 175,688 cases were matched with 43,922 controls. An increased risk of infection was documented throughout the study for open-space offices compared to offices without open space (OR range across the nine periods: 1.12 to 1.57) and long-distance trains (1.25 to 1.88), and during most of the study for convenience stores (OR range in the periods with increased risk: 1.15 to 1.44), take-away delivery (1.07 to 1.28), car-pooling with relatives (1.09 to 1.68), taxis (1.08 to 1.89), airplanes (1.20 to 1.78), concerts (1.31 to 2.09) and night-clubs (1.45 to 2.95). No increase in transmission was associated with short-distance shared transport, car-pooling booked over platforms, markets, supermarkets and malls, hairdressers, museums, movie theatres, outdoor sports, and swimming pools. The increased risk of infection in bars and restaurants was no longer present in restaurants after reopening in June 2021. It persisted in bars only among those aged under 40 years. CONCLUSION: Closed settings in which people are less likely to wear masks were most affected by SARS-CoV-2 transmission and should be the focus of air quality improvement. CLINICALTRIALS: GOV (03/09/2022): NCT04607941.

The mediating role of individual evaluation, anxiety, and depression in the association between leisure activity and cognitive function among Chinese older adults.

The purpose of this research was to investigate the association between leisure activity and cognitive function in Chinese older adults, and to explore the mediating role of individual evaluation, anxiety and depression. Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), Pearson correlation analyses were employed to examine the relationships among various indicators. A multiple mediation model was constructed to investigate the mediating pathways through which leisure activities impact cognitive function in elderly individuals. Leisure activities, individual evaluation, anxiety, and depression were significantly correlated with cognitive function (p < 0.01). Leisure activities not only directly positively impacted cognitive function in elderly individuals (effect = 0.3780; 95% CI = [0.3459, 0.4101]), but also exerted indirect effects through five pathways. Individual evaluation, anxiety, depression, they plays a mediating role in the association between leisure activity and cognitive function in older adults in China. Leisure activities can positively impact cognitive function in elderly individuals by enhancing individual evaluation and subsequently reducing anxiety and depression.

Effect of leisure activity on frailty trajectories among Chinese older adults: a 16-year longitudinal study.

BACKGROUND: While the significant association between leisure activities and frailty risk among older adults is well-established, the impact of integrated leisure activity scores and different categories of them on frailty trajectories over time remains unclear. METHODS: This study utilized longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which enrolled participants aged 65 years and older between 2002 and 2018. Frailty trajectories were derived using group-based trajectory modelling, and based on these trajectories, subjects were classified into various categories. Leisure activity was measured by integrated scores as well as three distinct categories: physically, cognitively, and socially stimulating activity. The effect of leisure activity on frailty trajectories was examined using multinomial logistic regression. RESULTS: By analysing data from 2,299 older adults, three frailty trajectories were identified: non-frail, moderate progressive, and high progressive. The results indicated that an increase in the score of integrated leisure activity was associated with 11% (odds ratio [OR] 0.89; 95% Confidence Interval [CI] 0.85-0.93) and 14% (OR 0.86; 95% CI 0.80-0.91) decrease in the likelihood of being in the moderate and high progressive frailty trajectories, respectively. Engaging in physically stimulating activity lowered the odds of belonging to the moderate and high progressive trajectory by 43% (OR 0.57; 95% CI 0.40-0.81; OR 0.57; 95% CI 0.36-0.92, respectively). Participation in socially stimulating activity showed a lower odd of being in the moderate progressive trajectory (OR 0.68; 95% CI 0.49-0.93) and the high progressive trajectory (OR, 0.61; 95% CI, 0.39-0.95). The effects of leisure activities on frailty trajectories were observed not to vary by age, education level and retirement status. CONCLUSIONS: This study suggests that older adults should be encouraged to increase both the amount and variety of their leisure activities. Physically stimulating activities should be considered the primary choice, followed by socially and cognitively stimulating activities.

Longitudinal associations between leisure activities and subjective happiness among middle-aged and older adults people in China: national cohort study.

Background: Leisure activities serve as key measures to enhance the subjective happiness of middle-aged and older adults individuals and to positively address the challenges of an aging society; however, the trajectory of changes in their participation in leisure activities and how these changes relate to shifts in subjective happiness have not been adequately explored. Methods: This study selected data from the China Health and Aging Longitudinal Study (CHARLS), which included a total of 5,190 middle-aged and older adults people. Linear and nonlinear latent growth models, parallel latent growth models and cross-lagged models were constructed to investigate the influence and lagged relationship between the trajectory of changes in the level of participation in leisure activities on the trajectory of changes in the subjective well-being of middle-aged and older adults people. Results: The initial level of physical activity participation of middle-aged and older adults people significantly predicted the initial level (ß = 1. 203, p < 0.001) and rate of change (ß = -0.138, p = 0.016) of their subjective well-being, and the trajectory of change of middle-aged and older adults people's physical activity also significantly predicted the rate of change of their subjective well-being (ß = 0.582, p = 0.003). Meanwhile, the initial level of social activity of middle-aged and older adults people also effectively predicted the initial level of their subjective well-being (ß = 0.048, p < 0.001). At the same time, the covariates (gender, age, level of education, marital status, chronic disease) also predicted the initial level and rate of change of leisure activity participation level and subjective well-being. Finally, the cross-lagged model test confirmed the predictive effect of leisure activity participation level on subjective well-being of middle-aged and older adults people. Conclusion: This study confirms that the level of participation in leisure activities of Chinese middle-aged and older adults people has a significant predictive effect on their subjective happiness and that there is a significant correlation between the trajectory of changes in the level of participation in leisure activities and the trajectory of changes in subjective happiness.

Leisure Screen Time and Food Consumption among Brazilian Adults.

BACKGROUND: Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years). METHODS: Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators. RESULTS: Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both). CONCLUSIONS: Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

Leisure Sedentary Behavior, Physical Activities, and Cardiovascular Disease Among Individuals With Metabolic Dysfunction-Associated Fatty Liver Disease.

BACKGROUND: Metabolic dysfunction-associated fatty liver disease is a significant risk factor for cardiovascular disease (CVD). This study assesses the association between leisure-time physical activity, sedentary behavior, and CVD risk among patients with metabolic dysfunction-associated fatty liver disease, considering genetic predisposition to CVD. METHODS: This cohort study included 157 794 participants with metabolic dysfunction-associated fatty liver disease from the UK Biobank who were free of CVD at baseline. The study measured leisure-time sedentary behaviors (watching TV, using a computer, and driving) and physical activities (walking for pleasure, light and heavy do-it-yourself activities, strenuous sports, and other exercises) in terms of frequency and duration over the 4 weeks before assessment. Both a Cox proportional hazard model and an isotemporal substitution model were utilized in the study to assess the association between leisure sedentary behavior, physical activities, and CVD risk. RESULTS: During a median 12.5 years of follow-up, 26 355 CVD cases were reported, including 19 746 coronary heart disease, 4836 stroke, and 7398 heart failure cases. High physical activity levels were linked to a significantly lower risk of CVD (21%), coronary heart disease (20%), stroke (15%), and heart failure (31%). In contrast, individuals with >6.5 h/d of sedentary behavior faced a 16% to 21% higher risk of these conditions compared with those with ≤3.5 h/d. Notably, replacing 30 minutes of inactivity with physical activity reduced CVD risks by 3% to 16%, particularly with strenuous sports. A significant interaction was observed between physical activity, sedentary behavior, and genetic predisposition in relation to stroke risk. CONCLUSIONS: Among patients with metabolic dysfunction-associated fatty liver disease, higher leisure-time physical activity levels correlate with reduced CVD risks, while increased sedentary behavior is linked to higher CVD risks. Replacing sedentary time with physical activity consistently shows benefits in reducing CVD outcomes, irrespective of genetic predisposition.

Causal associations of physical activity and leisure sedentary behaviors with age at onset of Huntington's disease: A mendelian randomization study.

BACKGROUND: Huntington's disease (HD) is a neurodegenerative disorder for which effective therapies are currently lacking. Studies suggest that increasing physical activity (PA) and reducing leisure sedentary behavior (LSB) mitigate the progression of HD, but their causal relationship with the age at onset (AAO) of HD remains uncertain. To investigate this, we conducted the Two-sample Mendelian Randomization (MR). METHODS: Exposure were retrieved from the UK BioBank's (UKB) Genome-Wide Association Study (GWAS). PA included accelerometer-based average PA, vigorous PA, self-reported moderate-to-vigorous PA (MVPA), and light do-it-yourself activity. LSB included television (TV) time, computer time, and driving time. Outcome came from the GWAS of the GEM-HD Consortium. We applied several MR methods such as inverse variance weighted (IVW), MR-Egger regression, weighted median (WM) for sensitivity analysis. RESULTS: Increases in light PA (ß = 8.53 years, 95 % CI = 10.64 to 44.09, P = 0.001) and accelerometer-based vigorous PA (ß = 5.18, 95 % CI = 0.92 to 9.43, P = 0.017) delayed AAO of HD, while longer TV time was associated with earlier AAO of HD (ß = -2.88 years, 95 % CI = -4.99 to -0.77, P = 0.007). However, other PA and LSB phenotypes did not significantly affect AAO of HD. CONCLUSION: The study revealed a unidirectional causality between PA, LSB and the AAO of HD. Increasing PA and reducing TV time delay HD onset. Therefore, we recommend increasing physical activity and reducing sedentary behavior to delay the occurrence of motor symptoms for premanifest HD individuals.

Leisure television watching exerts a causal effect on gastroesophageal reflux disease: evidence from a two-step mendelian randomization study.

BACKGROUND: Previous studies have shown that physical activity (PA) and leisure sedentary behaviors (LSB, including leisure television watching) are linked to gastroesophageal reflux disease (GERD). However, the associations between PA/LSB and GERD remain controversial. In this study, we aimed to reveal whether these associations reflect causal relationships and reveal the potential mechanisms of these relationships using bidirectional and two-step Mendelian randomization (MR) analyses. METHODS: We obtained genome-wide association study (GWAS) summary statistics for PA/LSB, four common risk factors (including cigarettes smoked per day, alcoholic drinks per week, triglycerides, total cholesterol) and GERD from published GWASs. A bidirectional MR analysis was performed to identify causal relationships between PA/LSB and GERD. Then, a series of sensitivity analyses were performed to verify the robustness of the results. Finally, a mediation analysis via two-step MR was conducted to investigate any effects explained by common risk factors in these relationships. RESULTS: Genetically predicted per 1-SD increase in leisure time television watching significantly increased the risk of GERD in the bidirectional MR analysis (OR = 1.33; 95% CI: 1.14-1.56; P = 2.71 × 10- 4). Sensitivity analyses successfully verified the robustness of the causal relationship. Further mediation analysis showed that this effect was partly mediated by increasing cigarettes smoked per day, with mediated proportions of 18.37% (95% CI: 11.94-39.79%). CONCLUSION: Our findings revealed a causal relationship between leisure television watching and an increased risk of GERD, notably, the causal effect was partially mediated by cigarettes smoked per day. These findings may inform prevention and management strategies directed toward GERD.

Factors Associated With Leisure-Time Bicycling Among Adults in the United States: An Urban-Rural Comparison.

BACKGROUND: Bicycling is a healthy form of physical activity that can be performed by most adults as part of leisure-time (LT) activity. However, little is known about LT bicycling behaviors, especially in the rural areas of the United States. This study sought to contrast the prevalence and factors associated with LT bicycling in populations living in urban settings with those living in rural settings. METHODS: The 2019 Behavior Risk Factor Survey, which contains information regarding LT physical activity behaviors among adults (N = 396,261) in the United States, was used to determine the prevalence, demographic profile, and likelihood of meeting the physical activity guidelines of LT bicyclists. The 2013 National Center for Health Statistics Urban/Rural Classification Scheme was used to classify respondents living in rural and urban settings. RESULTS: Among US adults, 3.8% (95% CI, 3.7-3.9) reported LT bicycling activity, the sixth most common physical activity. Adults living in urban counties compared with rural counties had a greater prevalence of LT bicycling (3.9% vs 2.3%, respectively), with adults living in rural counties having a 34% lower probability of LT bicycling. Rural bicycling prevalence rates were lower across all demographics. Urban bicyclists, compared with rural bicyclists, cycled more months of the year. Overall, 85.5% of all bicyclists met the aerobic physical guidelines, with no differences between urban and rural bicyclists. CONCLUSIONS: Bicycling remains an important LT physical activity among adults in the United States. However, a rural-urban difference in the prevalence does exist for LT bicycling. The reasons for this disparity warrant further investigation.

Promoting digital inclusion for enhanced resident wellbeing: an examination of aged residential care facility websites.

AIM: Digital inclusion has a positive impact on health and wellbeing through fostering connectivity and access to information. In Aotearoa New Zealand, 4% of older adults live in aged residential care (ARC) facilities and are vulnerable to social isolation. This study explored whether ARC facilities provide opportunities to socially connect online and whether the COVID-19 pandemic affected the provision of these opportunities. METHOD: Information on technology and internet provision from 558 ARC facilities was extracted from facilities' own or related websites in 2019 and 2021. ARC facilities were categorised according to whether they provided digital devices, internet access and internet-based leisure activities, or made no reference to technology. RESULTS: In 2019, 392 (70%) of 558 ARC facilities publicised availability of internet-based technologies for residents; however, only 46 (8%) mentioned providing access to computer devices. In 2021 (during the pandemic), there was a small increase to 421 (76%) and 54 (10%) of facilities respectively. Facilities mentioning internet-based leisure activities were 63 (11%) in 2019 and 55 (10%) in 2021. Those not referring to technology had reduced from 166 (30%) in 2019 to 137 (24%) in 2021. CONCLUSION: Few ARC facilities enabled residents to fully access the digital world, even after periods of isolation due to COVID-19. Aged care providers could be more proactive by providing internet access and digital learning opportunities.

[Disability and participation in active leisure activities: results from a Chilean population-based survey]. / Discapacidad y participación en actividades de ocio activo: resultados de una encuesta poblacional chilena.

Leisure activities are necessary to improve the quality of life and good health of the population. Some studies in developed countries have described that people with disabilities participate less in leisure activities. The aim of this study was to estimate the association between disability and participation in active leisure activities in the population aged 18 years or older in Chile, during 2015. An analytical cross-sectional study was conducted using data from the Chilean II National Survey on Disability (ENDISC II) 2015. The independent variable was disability, and the dependent variable was participation in active leisure activities in the last six months. Poisson regression models were developed and prevalence ratios (PR) and the 95% confidence intervals (95%CI) were estimated. In total, 12,236 participants were included. Chileans with moderate and severe disability were less likely to participate in active leisure activities (PR = 0.96; 95%CI: 0.93-0.99 and PR = 0.78; 95%CI: 0.72-0.84, respectively), compared to Chileans without disability. When stratified by age group, this association remained significant only in those older than 45 years. In conclusion, people with disabilities in Chile participate less in active leisure activities compared to people without disabilities, although only if they are older than 45 years. Social recreation programs should prioritize the incorporation of older people with disabilities.

Las actividades recreativas son necesarias para mejorar la calidad de vida y el buen estado de salud de la población. Algunos estudios en países desarrollados han descrito que las personas con discapacidad participan menos en actividades recreativas. El objetivo de este estudio fue estimar la asociación entre la discapacidad y la participación en actividades de ocio activo en la población de 18 o más años de Chile, durante el año 2015. Se efectuó un estudio transversal analítico con los datos de la II Encuesta Nacional de la Discapacidad (ENDISC II) 2015 de Chile. La variable independiente fue la discapacidad y la variable dependiente fue la participación en actividades de ocio activo en los últimos seis meses. Se elaboraron modelos de regresión de Poisson y se estimaron razones de prevalencia (RP) con sus intervalos de 95% de confianza (IC95%). Se incluyeron a 12.236 participantes. Los chilenos con discapacidad moderada y severa tuvieron menos probabilidades de participar en actividades de ocio activo (RP = 0,96; IC95%: 0,93-0,99 y RP = 0,78; IC95%: 0,72-0,84, respectivamente), en comparación con los chilenos sin discapacidad. Cuando se estratificó por grupos de edad, esta asociación se mantuvo significativa solo en los mayores de 45 años. En conclusión, las personas con discapacidad de Chile participan menos en actividades de ocio activo en comparación con las personas sin discapacidad, aunque solo si son mayores de 45 años. Los programas sociales de recreación deberían priorizar la incorporación de personas mayores con discapacidad.

Atividades recreativas são necessárias para melhorar a qualidade de vida e a saúde da população. Alguns estudos em países desenvolvidos relataram que as pessoas com deficiência participam menos de atividades recreativas. O objetivo deste estudo foi estimar a associação entre deficiência e participação em atividades de lazer ativas na população com 18 anos ou mais no Chile, em 2015. Foi realizado um estudo transversal analítico usando dados da II Pesquisa Nacional sobre Deficiência (ENDISC II), 2015, no Chile. A variável independente foi a deficiência e a variável dependente foi a participação em atividades de lazer ativas nos últimos seis meses. Foram criados modelos de regressão de Poisson e estimadas as razões de prevalência (RP) com seus intervalos de 95% de confiança (IC95%). Um total de 12.236 participantes foi incluído. Os chilenos com deficiência moderada e grave tinham menor probabilidade de participar de atividades de lazer ativas (RP = 0,96; IC95%: 0,93-0,99 e RP = 0,78; IC95%: 0,72-0,84, respectivamente) em comparação com os chilenos sem deficiência. Quando estratificada por faixa etária, essa associação permaneceu significativa apenas para aqueles com mais de 45 anos de idade. As pessoas com deficiência no Chile participam menos de atividades de lazer ativas em comparação com as pessoas sem deficiência, mas somente se tiverem mais de 45 anos. Os programas de recreação social devem priorizar a inclusão de pessoas mais velhas com deficiência.

Social participation of women with breast cancer compared to the general population 5 years after primary surgery-what role do medical data and cancer-related complaints play?

PURPOSE: This study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients' social participation is investigated. METHODS: A total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi2-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby. RESULTS: Compared to the general population, patients show lower levels of social participation in the domains "socio-cultural participation" and "participation in institutions," while no significant differences for "social participation in the private sphere" and "social participation via social media" were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation. CONCLUSIONS: Our study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients' reintegration into society through appropriate therapeutic interventions.

Using a participatory action research approach to explore, understand and evaluate well-being among children living in socially deprived areas in Southern Sweden: a study protocol.

INTRODUCTION: Research suggests that participating in after-school leisure activities has been related to promoting health, well-being and safety among children living in disadvantaged neighbourhoods. The United Nations Child Rights Convention emphasises the inclusion of children in decisions that concern them. However, children seldom are involved in designing implementing and evaluating health promotional environments. The aim of this programme is through a participatory process with children, parents/guardians, and peer-activity leaders explore, measure and evaluate the impact on children's overall well-being related to the social context in an already established health promotion environments in Southern Sweden. METHODS AND ANALYSIS: The project is based on a previously implemented unique community-based participatory research (CBPR) model for equal health in three socially disadvantaged areas in Malmö. All activity house (AAH) is a meeting place for children established in schools but after school time by the culture department of the Malmö municipality. In AAH migrant children participate in need-driven after school activities that they themselves create and develop. To increase participation of the children and ensure that these environments are based on their needs, 30 children (10-12 years), parents/guardians (30), peer-activity leaders (15), and researchers create CBPR teams in the areas and engage in a participatory process. The children reflect, analyse and write about their well-being; identify and discuss key factors in an iterative process, which also includes a strategic group of stakeholders. The children then develop and validate (with 100 other children from AAH) the Socioculturally Aligned Survey Instrument for Children survey inspired by the KIDSSCREEN V.27. The survey tool so developed will further be used to evaluate AAH and will be distributed to all children participating in their activities. ETHICS AND DISSEMINATION: This programme has been approved by the Swedish Ethical Review Authority. The results from this programme will be published as reports and scientific publication.