Comparing national device-based physical activity surveillance systems: a systematic review.

BACKGROUND: Physical activity surveillance systems are important for public health monitoring but rely mostly on self-report measurement of physical activity. Integration of device-based measurements in such systems can improve population estimates, however this is still relatively uncommon in existing surveillance systems. This systematic review aims to create an overview of the methodology used in existing device-based national PA surveillance systems. METHODS: Four literature databases (PubMed, Embase.com, SPORTDiscus and Web of Science) were searched, supplemented with backward tracking. Articles were included if they reported on population-based (inter)national surveillance systems measuring PA, sedentary time and/or adherence to PA guidelines. When available and in English, the methodological reports of the identified surveillance studies were also included for data extraction. RESULTS: This systematic literature search followed the PRISMA guidelines and yielded 34 articles and an additional 18 methodological reports, reporting on 28 studies, which in turn reported on one or multiple waves of 15 different national and 1 international surveillance system. The included studies showed substantial variation between (waves of) systems in number of participants, response rates, population representativeness and recruitment. In contrast, the methods were similar on data reduction definitions (e.g. minimal number of valid days, non-wear time and necessary wear time for a valid day). CONCLUSIONS: The results of this review indicate that few countries use device-based PA measurement in their surveillance system. The employed methodology is diverse, which hampers comparability between countries and calls for more standardized methods as well as standardized reporting on these methods. The results from this review can help inform the integration of device-based PA measurement in (inter)national surveillance systems.

Sharp increase in inequality in education in times of the COVID-19-pandemic.

The COVID-19-pandemic forced many countries to close schools abruptly in the spring of 2020. These school closures and the subsequent period of distance learning has led to concerns about increasing inequality in education, as children from lower-educated and poorer families have less access to (additional) resources at home. This study analyzes differences in declines in learning gains in primary education in the Netherlands for reading, spelling and math, using rich data on standardized test scores and register data on student and parental background for almost 300,000 unique students. The results show large inequalities in the learning loss based on parental education and parental income, on top of already existing inequalities. The results call for a national focus on interventions specifically targeting vulnerable students.

The effects of medical school on health outcomes: evidence from admission lotteries.

This paper estimates the effects of attending medical school on health outcomes by exploiting that admission to medical school in the Netherlands is determined by a lottery. Among the applicants for medical school, people who attended medical school have on average 1.5 more years of completed education than people who did not. They are also more likely to have been exposed to a health-related education curriculum. The results show only modest impacts on health outcomes. Attending medical school reduces alcohol consumption and being underweight somewhat, and has a small positive impact on self-reported health status. It has, however, a small negative effect on the frequency of physical exercise and no significant impact on smoking, and being overweight or obese. Attending medical school does have a large positive impact on the probability of being registered for donations of organs.