Objectively measured physical activity and academic performance in school-aged youth: The UP&DOWN longitudinal study.

To examine the longitudinal relationships between objectively measured total volume and specific intensities of physical activity (PA) with academic performance in a large sample of youth aged 6-18 years. A longitudinal study of 1046 youth (10.04 ± 3.10 years) from Spain was followed over 2 years. PA (volume and intensity) was measured by accelerometry. Academic performance was assessed through grades reported on the transcript at the end of the academic year (Mathematics, Language, an average of these two core subjects, and grade point average [GPA]). Longitudinal relationships between PA and four indicators of academic performance were examined using covariance and regression analyses, adjusted for a variety of confounders. Youth Quartile 2 for PA volume at baseline obtained better scores than those who participated in Quartiles 1 or 4 volumes of PA in GPA 2 years later (p = 0.006). There were generally no longitudinal associations between specific PA intensities and any of the academic performance indicators (all p > 0.170). However, a change in light PA over 2 years was inversely associated with three academic indicators in youth (ßrange , -.103 to - 090; all P < 040). Findings suggest that participants in Quartile 2 volume of PA had a better GPA in comparison with Quartiles 1 and 4 volumes of PA during youth, but there was no association with changes in PA volume over time. PA intensity was generally unrelated to academic performance during youth. However, there was an inverted u-shape relationship between light PA changes and GPA.

Convergent validation of a questionnaire to assess the mode and frequency of commuting to and from school.

AIMS: The purposes of this research were to study the convergent validity of the Mode and Frequency of Commuting To and From School Questionnaire using objectively assessed steps and time spent in different physical activity intensities and to compare the self-reported versus objective journey time in Spanish youths. METHODS: Three hundred and eighty-nine Spanish youth aged 7-19 years were asked to complete the questionnaire and wore an accelerometer for five days. The objective commuting distance and time from home to school were estimated using Google MapsTM. RESULTS: There were significant differences between passive and walking participants on step numbers, sedentary time and physical activity levels (except for vigorous physical activity in children). For children, a mean difference of -4.03 minutes between objective measured and self-reported journey time was found (95% limits of agreement were 13.55 and -21.60 minutes). For adolescents, the mean difference was -1.39 minutes (95% limits of agreement were 15.23 and -18.02 minutes). CONCLUSIONS: The findings indicated that the Mode of Commuting To and From School Questionnaire showed a convergent validity to assess this behaviour in Spanish youths. Self-reported journey time for walking is comparable to Google MapsTM in adolescents but not in children.

Reliability and Validity of Field-Based Tests to Assess Upper-Body Muscular Strength in Children Aged 6-12 Years.

The aim of this study was to analyze the reliability and the validity of the handgrip, basketball throw and pushups tests in children aged 6-12 years. One hundred and eighty healthy children (82 girls) agreed to participate in this study. All the upper body muscular fitness tests were performed twice (7 days apart) whereas the 1 repetition maximum (1RM) bench press test was performed 2 days after the first session of testing. All the tests showed a high reproducibility (ICC > 0.9) except the push-ups test (intertrial difference = 0.77 ± 2.38, p < .001 and the percentage error = 9%). The handgrip test showed the highest association with 1RM bench press test (r = .79, p < .01; R2 = .621). In conclusion the handgrip and basketball throw tests are shown as reliable and valid tests to assess upper body muscular strength in children. More studies are needed to assess the validity and the reliability of the upper body muscular endurance tests in children.

Reliability and Validity of Tests to Assess Lower-Body Muscular Power in Children.

The purpose of this study was to analyze the reliability and the criterion-related validity of several lower-body muscular power tests (i.e., standing long jump [SLJ], squat jump, countermovement jump, and Abalakov jump) in children aged 6-12 years. Three hundred sixty three healthy children (168 girls) agreed to participate in this study. All the lower-body muscular power tests were performed twice (7 days apart), whereas the 1 repetition maximum (1 RM) leg extension test was performed 2 days after the first session of testing. All the tests showed a high reliability (intertrial difference close to 0 and no significant differences between trials, all p > 0.05). The association between the lower-body muscular power tests and 1 RM leg extension test was high (all p < 0.001). The SLJ and the Abalakov jump tests showed the highest association with 1 RM leg extension test (R = 0.700, test result, weight, height, sex, and age were added in the model). The SLJ test can be a useful tool to assess lower-body muscular power in children when laboratory methods are not feasible because it is practical, time efficient, and low in cost and equipment requirements.

Objectively measured physical activity has a negative but weak association with academic performance in children and adolescents.

AIM: There is an emerging body of evidence on the potential effects of regular physical activity on academic performance. The aim of this study was to add to the debate, by examining the association between objectively measured physical activity and academic performance in a relatively large sample of children and adolescents. METHODS: The Spanish UP & DOWN study is a 3-year longitudinal study designed to assess the impact, overtime, of physical activity and sedentary behaviours on health indicators. This present analysis was conducted with 1778 children and adolescents aged 6-18 years. Physical activity was objectively measured by accelerometry. Academic performance was assessed using school grades. RESULTS: Physical activity was inversely associated with all academic performance indicators after adjustment for potential confounders, including neonatal variables, fatness and fitness (all p < 0.05). This association became nonsignificant among quartiles of physical activity. There were only slight differences in academic performance between the lowest and the second quartile of physical activity, compared to the highest quartile, with very small effect size (d < 0.20). CONCLUSION: Objectively measured physical activity may influence academic performance during both childhood and adolescence, but this association was negative and very weak. Longitudinal and intervention studies are necessary to further our understanding.

Potential Energy as an Alternative for Assessing Lower Limb Peak Power in Children: A Bayesian Hierarchical Analysis.

The aim of this study was to analyze the use of potential energy (PE) as an alternative method to assess peak power of the lower limbs (PP) in children. 815 Spanish children (416 girls; 6-11 years old; Body Mass Index groups (n): underweight = 40, normal weight = 431, overweight = 216, obese = 128) were involved in this study. All participants performed a Countermovement Jump (CMJ) test. PP was calculated using Duncan (PPDUNCAN), Gomez-Bruton (PPGOMEZ) and PECMJ formulas. A model with PECMJ as the predictor variable showed a higher predictive accuracy with PPDUNCAN and PPGOMEZ than CMJ height (R2 = 0.99 and 0.97, respectively; ELPDdiff = 1037.0 and 646.7, respectively). Moreover, PECMJ showed a higher linear association with PPDUNCAN and PPGOMEZ across BMI groups than CMJ height (ßPECMJ range from 0.67 to 0.77 predicting PPDUNCAN; and from 0.90 to 1.13 predicting PPGOMEZ). Our results provide further support for proposing PECMJ as an index to measure PP of the lower limbs, taking into account the children's weight and not only the height of the jump. Therefore, we suggest the use of PECMJ in physical education classes as a valid method for estimating PP among children when laboratory methods are not feasible.

Accelerometer-measured physical activity and sedentary time are associated with maximal fat oxidation in young adults.

The present work aimed to examine the association between physical activity (PA) and sedentary behaviour with maximal fat oxidation (MFO) in young individuals. A total of 77 active adults (30 women; 22.8 ± 4.5 years) were included in this cross-sectional study in which PA and sedentary behaviour were measured using accelerometers for 7 consecutive days. PA was classified into different intensities (i.e. light, moderate, vigorous, and moderate-to-vigorous) and sedentary behaviour into sedentary time (i.e. time, number of bouts, and length of bouts) and sedentary breaks (i.e. time, number of breaks, and length of breaks). MFO was determined using a graded cycloergometer test through indirect calorimetry and relativized to lean mass (MFOLM) and lean leg mass (MFOLL). Positive associations were found for light and vigorous PA in relation with MFO, MFOLM and MFOLL, independently of cofounders (P ≤ 0.01). Moreover, a negative association was found between MFO and MFOLM and the length of sedentary bouts which was accentuated after adjusting by cardiorespiratory fitness (P ≤ 0.05). These results suggest that light and vigorous PA and sedentary behaviour are related to MFO during exercise. Despite this, further interventional studies are needed to clarify if increments of light and vigorous PA could enhance MFO in different populations.

Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD.

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (PostPRE), FBG obtained lower values in oxygen consumption (VO2, mean = -435.6 mL/min, Bayes Factor (BF10) > 100), minute ventilation (VE, -8.5 L/min, BF10 = 25), respiratory rate (RR, -3.3 breaths/min, BF10 = 2), heart rate (HR, -13.7 beats/min, BF10 > 100) and carbon dioxide production (VCO2, -183.0 L/min, BF10 = 50), and a greater value in expiratory time (Tex, 0.22 s, BF10 = 12.5). At the maximum value recorded in the post-training test (PostFINAL), FBG showed higher values in the total time of the test (Tt, 4.3 min, BF10 = 50) and respiratory exchange rate (RER, 0.05, BF10 = 1.3). Regarding inter group differences at PrePOST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO2 (EqCO2, -3.8 L/min, BF10 = 1.1) and compared to CG in VE (-8.3 L/min, BF10 = 3.6), VCO2 (-215.9 L/min, BF10 = 3.0), EqCO2 (-3.7 L/min, BF10 = 1.1) and HR (-12.9 beats/min, BF10 = 3.4). FBG also showed a greater PrePOST positive increment in Tex (0.21 s, BF10 = 1.4) with respect to CG. At PreFINAL, FBG presented a greater positive increment compared to CG in Tt (4.4 min, BF10 = 3.2) and negative in VE/VCO2 intercept (-4.7, BF10 = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO2. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme.

Chronic Effects of a Training Program Using a Nasal Inspiratory Restriction Device on Elite Cyclists.

This study compared the response of a 9-week cycling training on ventilatory efficiency under two conditions: (i) Combined with respiratory muscle training (RMT) using a new nasal restriction device (FeelBreathe) (FB group) and (ii) without RMT (Control group). Eighteen healthy elite cyclists were randomly separated into the FB group (n = 10) or Control group (n = 8). Gas exchange was measured breath by breath to measure ventilatory efficiency during an incremental test on a cycloergometer before (Pre) and after (Post) the nine weeks of training. The FB group showed higher peak power (Δ (95%HDI) (0.82 W/kg (0.49, 1.17)), VO2max (5.27 mL/kg/min (0.69, 10.83)) and VT1 (29.3 W (1.8, 56.7)) compared to Control at PostFINAL. The FB group showed lower values from Pre to PostPRE in minute ventilation (VE) (-21.0 L/min (-29.7, -11.5)), Breathing frequency (BF) (-5.1 breaths/min (-9.4, -0.9)), carbon dioxide output (VCO2) (-0.5 L/min (-0.7, -0.2)), respiratory equivalents for oxygen (EqO2) (-0.8 L/min (-2.4, 0.8)), heart rate (HR) (-5.9 beats/min (-9.2, -2.5)),, respiratory exchange ratio (RER) (-0.1 (-0.1, -0.0) and a higher value in inspiratory time (Tin) (0.05 s (0.00, 0.10)), expiratory time (Tex) (0.11 s (0.05, 0.17)) and end-tidal partial pressure of CO2 (PETCO2) (0.3 mmHg (0.1, 0.6)). In conclusion, RMT using FB seems to be a new and easy alternative ergogenic tool which can be used at the same time as day-to-day training for performance enhancement.

Trends of Sedentary Time and Domain-Specific Sedentary Behavior in Spanish Schoolchildren.

Purpose: To examine the temporal trends of accelerometer-based total daily sedentary time (ST) and self-reported domain-specific sedentary behavior (SB) on weekdays and weekends in Spanish children. Method: A total of 560 (50.53% girls) children (4th graders) in 2011/12 from 23 Spanish schools and 462 (48.70% girls) children (4th graders) in 2017/18 from 19 schools across Cadiz participated. Hip-worn accelerometers and questionnaires were used to assess total daily ST and self-reported time in SB modalities, respectively. Results: The objectively measured total daily ST tended to increase in boys on weekdays and weekends. Time spent watching television (TV) decreased during the week and weekend days, while time surfing on the internet increased on weekdays and weekends. Playing video-games increased in boys during the weekends. The trend to increase the time spent on educational activities with a computer during the weekdays and weekends was accompanied by a reduction of the same activities without using a computer. There was a trend to increase reading for fun, talking on the phone and total time in other SB, on weekdays and weekends in boys and girls. Conclusion(s): Spanish boys tended to increase objectively measured total daily ST. Moreover, SB modalities have changed in recent years in children, replacing TV viewing by computer use for both educational and non-educational purposes, as well as by the use of smartphones or other sedentary activities that does not imply the presence of a screen. These findings highlight the need to promote interventions to decrease total daily ST and reduce SB activities.

Criterion-Related Validity of Field-Based Fitness Tests in Adults: A Systematic Review.

We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19-64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July 2020. Each original study's methodological quality was classified as high, low and very low, according to the number of participants, the description of the study population, statistical analysis and systematic reviews which were appraised via the AMSTAR rating scale. Three evidence levels were constructed (strong, moderate and limited evidence) according to the number of studies and the consistency of the findings. We identified 101 original studies (50 of high quality) and five systematic reviews examining the criterion-related validity of field-based fitness tests in adults. Strong evidence indicated that the 20 m shuttle run, 1.5-mile, 12 min run/walk, YMCA step, 2 km walk and 6 min walk test are valid for estimating cardiorespiratory fitness; the handgrip strength test is valid for assessing hand maximal isometric strength; and the Biering-Sørensen test to evaluate the endurance strength of hip and back muscles; however, the sit-and reach test, and its different versions, and the toe-to-touch test are not valid for assessing hamstring and lower back flexibility. We found moderate evidence supporting that the 20 m square shuttle run test is a valid test for estimating cardiorespiratory fitness. Other field-based fitness tests presented limited evidence, mainly due to few studies. We developed an evidence-based proposal of the most valid field-based fitness tests in healthy adults aged 19-64 years old.

Maximal fat oxidation capacity is associated with cardiometabolic risk factors in healthy young adults.

It is unknown whether resting fat oxidation (RFO), maximal fat oxidation (MFO) and FatMax (intensity at which MFO is reached) are related to cardiometabolic risk (CMR). Thus the aim of this study was to examine the association of RFO, MFO and FatMax with CMR. 81 healthy adults (n = 31 women; 22.72 ± 4.40 years) participated in this cross-sectional study. Glucose and triglycerides were analysed in plasma. Body composition, anthropometry, physical activity, blood pressure (BP) and heart rate measurements were taken. RFO and MFO were determined through indirect calorimetry. Maximal oxygen uptake (VO2max) test was performed until exhaustion after MFO test. The CMR cluster was created from individual CMR factors: waist circumference, body fat percentage, systolic BP, diastolic BP, blood glucose and plasma triglycerides. Groups of high and low MFO and VO2max were created. RFO was not associated with CMR (p < 0.05). FatMax, MFO and VO2max were associated with individual CMR factors as waist circumference (R2 = 0.144; R2 = 0.241; R2 = 0.285; p = 0.001; respectively) and plasma triglycerides (R2 = 0.111; p = 0.004 and R2 = 0.130; p = 0.002 and R2 = 0.093; p = 0.008; respectively) and clustered CMR factors (R2 = 0.105; p = 0.008 and R2 = 0.162; p = 0.001 and R2 = 0.239; p = 0.001; respectively). VO2max was also associated with body fat percentage (R2 = 0.105; p = 0.003) and diastolic BP (R2 = 0.083; p = 0.01), even adjusting for sex or age (p < 0.05). Groups with high level of MFO or VO2max obtained lower CMR (p = 0.001), even adjusting for sex or age (p < 0.01). FatMax, MFO and, especially, VO2max are associated with CMR, regardless of age and sex. However, RFO is not associated with CMR.

The Federated Practice of Soccer Influences Hamstring Flexibility in Healthy Adolescents: Role of Age and Weight Status.

The aim of this study was to compare the hamstring flexibility between federated soccer and non-federated adolescents, and also to evaluate the effect of age and weight status on hamstring flexibility. The participants were 234 students (11-18 years old) divided into: (i) G1: non-federated (n = 127), and (ii) G2: federated in soccer (n = 107). The deep flexion of the trunk (DF) test and the sit and reach test (SRT) were performed. G2 showed higher values for the DF and SRT compared to G1 (p < 0.05). Both flexibility tests correlated positively (r = 0.4, p < 0.001). Body mass index (BMI) was negatively correlated with the DF test (r = -0.3, p < 0.001), but not with the SRT. Divided by BMI, the underweight and normal weight groups had higher scores in the DF test compared with the overweight and obese groups (p < 0.001). BMI was negatively correlated with hamstring flexibility. Federated soccer students present higher scores of hamstring flexibility.

Effects of a Rehabilitation Programme with a Nasal Inspiratory Restriction Device on Exercise Capacity and Quality of Life in COPD.

OBJECTIVE: The objective was to assess the effects of a nasal restriction device for inspiratory muscle training, called Feelbreathe®, added to a rehabilitation program (RP) on exercise capacity, quality of life, dyspnea and inspiratory muscle strength in patients with stable COPD. METHODS: Patients were randomized into three groups, one performed a supervised RP using the Feelbreathe® device (FB group), the second group developed the same RP with oronasal breathing without FB (ONB group) and the third was the control group (CG). We evaluated inspiratory muscle strength (PImax), dyspnea (mMRC), quality of life (CAT) and exercise capacity (6MWT) before and after 8-week of RP. RESULTS: A total of 16 patients completed the study, seven in FB group, five in ONB group and four in the CG. After the RP, the FB group showed a significant increase in PImax (93.3 ± 19.1 vs. 123.0 ± 15.8 mmHg) and in the 6MWT distance (462.9 ± 71.8m vs. 529.1 ± 50.1 m) and a decrease in the CAT score (9.7 ± 6.5 vs. 5.9 ± 6.0) and in the mMRC dyspnea score. FB provides greater improvement in PImax, dyspnea, quality of life and 6MWT than ONB. CONCLUSIONS: The Feelbreathe® device provides greater improvements in quality of life, dyspnea, exercise capacity and inspiratory muscle strength compared to patients that did not use it.

A New Nasal Restriction Device Called FeelBreathe® Improves Breathing Patterns in Chronic Obstructive Pulmonary Disease Patients during Exercise.

A device called FeelBreathe (FB)® was designed, developed, and patented for inspiratory muscle training. The main aim was to determine the acute responses on lung ventilation, gas exchange, and heart rate during exercise in patients with chronic obstructive pulmonary disease (COPD) with and without the use of FB. In this study, a randomized cross-over trial was performed with 18 men diagnosed with COPD (FEV1 between 30% and 70% of its predicted value). Each participant randomly conducted two trials with 30 min of rest between them with the same protocol on a treadmill for 10 min at a constant rate of 50% of VO2peak. Each test was performed randomly and in a crossover randomized design in two different conditions: (1) oronasal breathing; and (2) nasal breathing with FB (nasal ventilatory flow restriction device). It was observed that FB had positive effects on dynamic hyperinflation, breathing pattern, and breathing efficiency, with higher expiratory and inspiratory time. Despite these differences, blood oxygen saturation percentage, oxygen uptake, and heart rate showed a similar response for both conditions during exercise. The results suggest that exercise performed with FB improved ventilatory responses compared to the oronasal mode in COPD patients. This new tool could be used during most daily tasks and exercise programs.

Sun Protection Habits and Sun Exposure of Physical Education Teachers in the South of Spain.

The high prevalence and increasing incidence of skin cancer (SC) is a significant public health problem. We can address its main risk factor, which is incident and accumulated solar radiation, and its damages by disseminating knowledge and promoting changes in habits and attitudes toward the sun. The influence of teachers in the education of young people is crucial. Physical education teachers (PET) spend the majority of their time outdoors, thereby exposing themselves to solar radiation daily and greatly increasing the risk of SC. We carried out a case-control study matching for age and gender through surveys about photoexposure and photoprotection habits on a sample of 200 teachers (100 PET and 100 non-PET) on South of Spain. The results confirmed that there is a significant difference in sun exposure during the workday; PET group showed higher exposure (P < 0.01). We ascertained that photoprotection habits are deficient across the population. These data contribute to the understanding of the danger associated with poor sun protection among teachers (primary and secondary school teachers) and its mitigation. It is also worth noting that future prevention campaigns will be necessary for the subsequent correct transmission of the habits to students.

Teachers' knowledge about type 1 diabetes in south of Spain public schools.

AIMS: To evaluate the knowledge of teachers in educative public centres (pre-, primary, and secondary schools) about type 1 diabetes (T1D) in the Puerto Real University Hospital area (Cadiz, Spain). METHODS: Descriptive observational study in which 756 teachers' answers on the Test of Diabetes Knowledge for Teachers (TDKT) were analysed. Teachers from 44 educative public centres in the Puerto Real University Hospital area (Cadiz, Spain) were selected by randomized sampling (mean age, 44.3 ±â€¯8 years; 61.7% women). RESULTS: Although 43.2% survey respondents recognised having had or currently having children or adolescent students with T1D, most demonstrated they did not have enough knowledge about T1D (mean score, 6.0 ±â€¯4.3 points from a maximum of 16), and only 5.1% had sufficient knowledge (13-16 points) to be an effective support person to students with diabetes in school. However, the vast majority of survey respondents correctly answered questions about symptoms (74.2%) and hypoglycaemia treatment (85.9%). Univariate analysis of factors associated with teachers' knowledge about diabetes revealed that teachers with ≤ 15 years of teaching experience and physical education teachers had better knowledge than their co-workers. CONCLUSIONS: It is necessary to improve teachers' knowledge about diabetes in our health area with the aim of improving the security of children and adolescent students with T1D in school centres.

Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes. / Actitudes y percepción del profesorado de centros educativos públicos sobre la atención a alumnos con diabetes tipo 1.

OBJECTIVE: To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) METHODS: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. RESULTS: Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. CONCLUSIONS: The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies.

Physical Activity Coparticipation and Independent Mobility as Correlates of Objectively Measured Nonschool Physical Activity in Different School Grades. The UP&DOWN Study.

BACKGROUND: The aim was to investigate the association of (i) parental, sibling, and friend coparticipation in physical activity (PA); and (ii) independent mobility (IM) for walking, cycling, and taking public transport with objectively measured nonschool PA on week- and weekend days in different school grades. METHODS: A total of 1376 Spanish youngsters (50.8% boys; mean age 11.96 ± 2.48 years) participated in the study. Participants reported the frequency of their parental, sibling, and best friend coparticipation in PA with them and their IM for walking, cycling, and taking public transport. PA was objectively measured by accelerometry. RESULTS: Coparticipation in PA and IM were more frequently related to nonschool PA among adolescents than among children. Friend coparticipation in PA was positively associated with higher levels of nonschool PA in adolescents. IM for walking and IM for cycling in adolescents were related to nonschool PA on weekdays. CONCLUSIONS: Our results highlight the need for age-focused interventions and the integration of family and friends to promote PA in youth.

Actitudes y percepción del profesorado de centros educativos públicos sobre la atención a alumnos con diabetes tipo 1 / Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes

Objetivo: Evaluar las actitudes y la percepción del profesorado sobre la preparación de los centros públicos de educación infantil, primaria y secundaria del área del Hospital Universitario Puerto Real para atender a alumnos con diabetes tipo 1 (DM1). Métodos: Estudio observacional descriptivo en el que se analizan las respuestas a un cuestionario de actitud y percepción sobre la preparación del centro educativo (17 preguntas) para la atención de los alumnos con DM1 de 765 profesores (edad media: 44,3±8,8 años; 61,7% mujeres) de 44 centros educativos públicos del área del Hospital Universitario Puerto Real (Cádiz, España) seleccionados mediante muestreo aleatorio. Resultados: El 43,2% había tenido o tiene actualmente alumnos con DM1 y solo el 0,8% reconoce haber recibido formación sobre diabetes. El 18,9% refería que alguno de sus alumnos con DM1 había experimentado al menos un episodio de hipoglucemia en el colegio (el 42,5% de los profesores que tienen o han tenido alumnos con DM1) y la mitad opinaba que su centro educativo no está capacitado para atender las urgencias diabéticas. El 6,4% refería que su centro dispone de glucagón en su equipo de primeros auxilios y el 46,9% estaría dispuesto a administrarlo personalmente. Las mujeres, los profesores de educación física y los directores mostraron una percepción más positiva del centro educativo con respecto a sus compañeros. Los profesores con percepción positiva de la preparación del centro y con actitud positiva para administrar glucagón eran significativamente más jóvenes que aquellos con percepción y actitud no positiva. Conclusiones: Los resultados del estudio orientan a que los profesores de los centros educativos públicos de nuestra área sanitaria no han sido formados específicamente en la atención a pacientes con DM1 y perciben que sus centros educativos no están capacitados para atender urgencias diabéticas (AU)

Objective: To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) Methods: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. Results: Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. Conclusions: The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies (AU)