High Levels Of Physical Inactivity Research Articles

Physical Inactivity, Sedentary Behavior and Quality of Life in the Chilean Population: ENCAVI Results, 2015-2016.

Regular physical activity (PA) is indicated to be one of the main healthy habits that allow populations to achieve a good quality of life (QoL); however, levels of physical inactivity (PI) and sedentary behavior (SB) have risen worldwide, with negative health effects. The aim of this study is to analyze PI and SB levels, as well as their association with QoL in the Chilean population. A secondary analysis was performed based on the database from the 2015-2016 National Quality of Life Survey (ENCAVI) in Chile, using the modules for sociodemographic characteristics, health, and PA. Contingency tables and logistic regressions were conducted to determine the association between PI (low-intensity PA, LIPA; low-moderate PA, LMPA), SB (P75), and QoL adjusted for sociodemographic variables. Approximately 84%, 83%, and 47% of the participants presented LIPA, LMPA, and moderate-high SB, respectively. Participants that presented high PI and SB had lower QoL scores than those who were more active (p < 0.05). We observe that, in people with PI (LIPA), there is a higher risk of a low QoL regarding mental and physical components (OR 1.941; OR 1.189, p < 0.001) among females (OR 1.473; OR 1.513, p < 0.001) and those of a low educational level (OR 2.170; OR 1.410 p < 0.001). People with PI (LMPA) increased their risk for a low QoL in regard to mental and physical components (OR 1.750; OR 1.458, p < 0.001) among females (OR 1.528; OR 1.507, p < 0.001) and those of a low educational level (OR 2.195; OR 1.402 p < 0.001). We observe that people with SB (P75) increased their risk of a low QoL concerning physical and mental components (OR 1.475; OR 1.257, p < 0.001) for those of the female gender (OR 1.615; OR 1.563, p < 0.001) and a low educational level (OR 2.248; OR 1.423 p < 0.001). High levels of PI in both intensities and SB impact QoL in the Chilean population. It is crucial to generate public policies for more PA, especially for females and those of lower educational levels.

Don’t stop focusing when it gets harder! The positive effects of focused attention on affective experience at high intensities

ABSTRACT Experiencing negative affect during exercise partially explains high levels of physical inactivity. An important direction for research is to better understand how and why interindividual differences in affective experiences occur while exercising. The dual-mode theory suggests that the interaction of cognitive processes and interoceptive cues influence the affective response. Hence, attentional control in form of adopting an external or internal attentional focus could lead to different affective responses depending on intensity. This study examines possible interactions between self-selected running intensities and attentional focus on affect. Fifty-eight inexperienced runners (30.14 ± 9.19 years; 38% female) ran 9 × 3 min outdoors around a large pond. While running at three intensities, they were instructed to focus on their breathing, on the environment, or did not receive an instruction. Dependent measures were affect, heart rate, and speed. The results revealed a significant interaction between attentional focus and intensity on affect (p = .01, η2 p = .08). At subjectively perceived light intensity, participants’ affective outcomes benefit from non-focusing attention, whereas during hard intensity the opposite seems helpful: to focus on breathing or to the environment. These findings shed new light on the interaction of focusing attention and running intensity to improve the affective experience.

Metabolic Syndrome in Children With Myelomeningocele and the Role of Physical Activity: A Narrative Review of the Literature.

The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies. A literature review of articles published in English and French between 1990 and April 2020 was conducted. Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases. Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.

Interrelationship between physical activity and depression in nonalcoholic fatty liver disease.

BACKGROUNDNonalcoholic fatty liver disease (NAFLD) is associated with a sedentary lifestyle and depressive symptoms. It is also well established that physical inactivity and depressive symptoms are related. However, an investigation of the interaction between all of these factors in NAFLD has not been previously conducted.AIMTo investigate the interrelationship between physical inactivity and depressive symptoms in individuals with NAFLD.METHODSData from the Rancho Bernardo Study of Healthy Aging were utilized. 589 individuals were included in the analyses (43.1% male; 95.8% non-Hispanic white; aged 60.0 ± 7.0 years). NAFLD was defined by using the hepatic steatosis index, depression using the Beck Depression Inventory, and physical activity by self-report of number of times per week of strenuous activity. Multivariable generalized linear regression models with Gamma distribution were performed to investigate the proposed relationship.RESULTSAbout 40% of the sample had evidence of NAFLD, 9.3% had evidence of depression, and 29% were physically inactive. Individuals with NAFLD and depression were more likely to be physically inactive (60.7%) compared to individuals with neither NAFLD nor depression (22.9%), individuals with depression without NAFLD (37.0%), and individuals with NAFLD without depression (33.3%). After accounting for various comorbidities (i.e., age, sex, diabetes, hypertension, obesity), individuals with NAFLD and higher levels of physical activity were at a decreased odds of having depressive symptoms [16.1% reduction (95% confidence interval: -25.6 to -5.4%), P = 0.004], which was not observed in those without NAFLD.CONCLUSIONIndividuals with NAFLD have high levels of physical inactivity, particularly those with depressive symptoms. Because this group is at high risk for poor outcomes, practitioners should screen for the coexistence of depressive symptoms and NAFLD. This group should receive appropriate interventions aimed at increasing both participation and levels of intensity of physical activity.

Ayurvedic Perspectives towards Sleep and Its Significance

Ahara (food), Nidra (sleep), and Bramhacharya (celibacy) are three pillars of life. Sleep is equally important as food, hence we must know concept of sleep described in Ayurveda. It is also enumerated as the natural urge which should not be suppressed and if suppressed would lead to various diseases. Health of a person means healthy physical body and mind together. Ayurveda helps in keeping balance, harmony and equilibrium in all physiological activities of body and mind. Ayurveda is an eternal science.&#x0D; Conclusion: Causes of the rapid increase in non-communicable diseases are mostly related to Lifestyle such as physical inactivity etc. Increasing a sedentary lifestyle due to the growing use of technologies in daily life causes higher levels of physical inactivity. In modern era of civilization, due to growing use of technologies like Laptop, Tablet, Mobile phone and increasing competition, changing lifestyle especially sleeping pattern has become a leading cause for manifestation of many diseases like Hypertension, Migraine, Diabetes mellitus, Obesity etc. Hence, Nidra(sleep) being an integral part of our life plays an important role in promotion of health and prevention of diseases. It has been observed that all the living beings enjoy sleep to keep their body and mind active.

Systems science for developing policy to improve physical activity, the Caribbean

The World Health Organization (WHO) Global Action Plan on Physical Activity recommends adopting a systems approach to implementing and tailoring actions according to local contexts. We held group model-building workshops with key stakeholders in the Caribbean region to develop a causal loop diagram to describe the system driving the increasing physical inactivity in the region and envision the most effective ways of intervening in that system to encourage and promote physical activity. We used the causal loop diagram to inform how the WHO Global Action Plan on Physical Activity might be adapted to a local context. Although the WHO recommendations aligned well with our causal loop diagram, the diagram also illustrates the importance of local context in determining how interventions should be coordinated and implemented. Some interventions included creating safe physical activity spaces for both sexes, tackling negative attitudes to physical activity in certain contexts, including in schools and workplaces, and improving infrastructure for active transport. The causal loop diagram may also help understand how policies may be undermined or supported by key actors or where policies should be coordinated. We demonstrate how, in a region with a high level of physical inactivity and low resources, applying systems thinking with relevant stakeholders can help the targeted adaptation of global recommendations to local contexts.

Association between physical activity and income levels in chilean adults

The Chilean population reports high levels of physical inactivity. The relationship between income level, physical activity (PA) and sedentary behaviors is not well known. To describe the levels of PA and sedentary time, according to income levels in the Chilean population. Analysis of data from the Chilean National Health Survey 2016-2017, which included 5,130 participants (52.9% women). The levels of PA and sedentary time were measured by the Global Physical Activity Questionnaire. Income levels were established according to the self-reported income per capita of the households and presented as quintiles. PA levels according to income levels were estimated by linear regression analyses. Transport-related PA was higher in the lowest income quintiles (p = 0.039). There were no trends for income levels and PA domains including moderate, vigorous, total, occupational and leisure PA. The prevalence of leisure and occupational physical inactivities were higher in the lowest quintiles of income. Sitting time was higher in the higher income levels (p < 0.01). People in the lowest quintile for income spent more time in transport-related PA and less time sitting. However, physical inactivity prevalence during leisure and work time were higher in people with lower income.

Using Community-Based Participatory Research to Characterize Health and Lifestyle Behaviors of Montagnards, a Refugee-Origin Asian-American Subgroup

Montagnards, an indigenous multitribal refugee-origin population concentrated in North Carolina, remain an invisible, medically underserved, and socioeconomically underrepresented Asian American sub-group. Yet this group is resilient, with language diversity, rich cultural traditions and family caregiving in multigenerational households. Using community-based participatory research methods, we developed and administered a two-part survey to 144 Montagnard adults, documenting socioeconomic characteristics, health indicators and lifestyle behaviors. Forty-one percent of participants had no formal education, 76% had little/no English proficiency and 28% described having a very hard time paying their bills. Seventy-seven percent were overweight per BMI category, 79% had elevated blood pressure and 100% scored high for significant depressive symptoms. Participants reported high levels of physical inactivity and daily dietary intake of MSG. However, Montagnards reported limited tobacco and alcohol use, a diet of fresh vegetables and rice, and regular church attendance. These represent protective lifestyle behaviors and targets for culturally responsive health interventions.

A low-threshold intervention to increase physical activity and reduce physical inactivity in a group of healthy elderly people in Germany: Results of the randomized controlled MOVING study.

Lack of physical activity (PA) and a high level of physical inactivity (PI) are associated with a higher risk for mortality and responsible for several non-communicable diseases including cardiovascular disease. Higher age is associated with a decrease of PA and an increasing level of PI. Studies have shown that interventions in the elderly have the potential to increase the amount of PA and to decrease the level of PI. However, most interventions are complex, elaborated, time- and resource-consuming. Here, we examined the effect of individual feedback-letters reporting the measured PA and PI in a sample of elderly people in Germany. Primary outcomes of the study were overall PA and PI after 6 months in the intervention group compared to a control group. We examined data from the MOVING intervention study (RCT) for people aged ≥ 65 years living in the northeast of Germany. At baseline, 3 and 6-months follow-up, all study participants wore a 3-axis accelerometer over a period of seven consecutive days. After the baseline measurement, the participants were randomized into intervention and control group. Participants in the intervention group received automatically generated, individualized feedback letters reporting their PA and PI by mail after the baseline measurement and after the 3-months follow-up. A Two-Way Mixed ANOVA with repeated measures was calculated with light, moderate and overall PA as well as PI as dependent variables, and group (between subject) and time (inner subject) as factors. The analysis based on retrospective data from the MOVING study (2016-2018). N = 258 patients were recruited. N = 166 participants could be included in the analysis, thereof N = 97 women (58.4%). The mean age was 70.8 years (SD 4.8). At baseline, the participants had a mean wearing time of 5,934.5 minutes (SD = 789.5) per week, which corresponds to about 14 hours daily on average. The overall PA in the intervention group at the 6-months follow up was 2488.8 (95% CI 2358.9-2618.2) minutes and 2408.2 (95% CI 2263.0-2553.4) minutes in the control group. There was no statistically significant interaction effect (time*group) between the intervention and control group for the depending variables. Sensitivity analyses showed significant small positive effects of the interaction time*partnership, F(2, 300) = 3.020, p = 0.05, partial η2 = 0.020. On average, study participants had high levels of PA at baseline and showed a good adherence in wearing the accelerometer. Both is likely due to selection in the convenience study sample. Thus, some ceiling effect reduced the overall intervention effect somewhat. At baseline, the weekly average of PI was 3436.7 minutes, which correspondents to about 8.2 hours per day and about 57% of participants' daily waking time. The average level of PI could be slightly decreased in both study groups. DRKS00010410, 17 May 2017.

Is physical exercise a protective agent against the way we currently age? A narrative review.

Aging is an inherent process to living beings that involves a deterioration of homeostatic regulation and functional reserve. Currently, the aging population has high levels of physical inactivity that aggravates muscle disuse, which in turn drastically affects functional capacity and quality of life. The aim of this narrative review is to present aging conditions and the protective role of physical exercise in functional reserve and capacity in relation to how we currently age. The regular practice of physical exercise provokes several favorable responses to the preservation of neuromuscular and cardiorespiratory function, which has a direct impact on physical capacity, even benefiting cognitive function. Physical exercise has been shown to have a protective effect on different systems, apart from contributing to the preservation of functionality and self-efficacy, which is why it is essential for healthy aging, since it favors a better resolution to stressful events such as falls and/or diseases. In conclusion, even though physical exercise does not prevent the deleterious conditions of aging, its effects are positively related to the maintenance of systemic functional reserve and capacity, which translates into greater autonomy, independence and quality of life related to health in the last stage of the life cycle.

Is physical exercise a protective agent against the way we currently age? A narrative review.

Aging is an inherent process to living beings that involves a deterioration of homeostatic regulation and functional reserve. Currently, the aging population has high levels of physical inactivity that aggravates muscle disuse, which in turn drastically affects functional capacity and quality of life. The aim of this narrative review is to present aging conditions and the protective role of physical exercise in functional reserve and capacity in relation to how we currently age. The regular practice of physical exercise provokes several favorable responses to the preservation of neuromuscular and cardiorespiratory function, which has a direct impact on physical capacity, even benefiting cognitive function. Physical exercise has been shown to have a protective effect on different systems, apart from contributing to the preservation of functionality and self-efficacy, which is why it is essential for healthy aging, since it favors a better resolution to stressful events such as falls and/or diseases. In conclusion, even though physical exercise does not prevent the deleterious conditions of aging, its effects are positively related to the maintenance of systemic functional reserve and capacity, which translates into greater autonomy, independence and quality of life related to health in the last stage of the life cycle.

Levels of and determinants for physical activity and physical inactivity in a group of healthy elderly people in Germany: Baseline results of the MOVING-study.

Low levels of physical activity (PA) and high levels of physical inactivity (PI) are associated with higher mortality and cardiovascular diseases. Higher age is associated with a decrease of PA, only 2.4-29% of ≥60 year-olds achieve the PA times recommended by WHO. The aim of this study was to identify levels of and determinants for moderate PA, overall PA and PI in a sample of individuals aged ≥65 years. We analyzed baseline data from an intervention-study aiming to increase PA and decrease PI by automatically generated feedback letters to objectively measured PA and PI. Recruitment was multimodal including re-contacting participants of previous studies and advertisements in regional public buses and newspapers. At baseline, participants wore an accelerometer over a period of 7 consecutive days. PA was categorized using cut-points suggested by Freedsoon 1998 in light, moderate and vigorous physical intensity as well as physical inactivity. Potential determinants (self-efficacy, education) were measured by questionnaires or in a physical examination (BMI). Multiple linear regression models were fitted to identify determinants for PA and PI. N = 199 persons (mean age 71.0 years (SD 4.9), 59.3% female) participated in the study. The weekly amount of overall PA for men was on average 1,821 minutes (SD 479.1), for women on average 1,929 minutes (SD 448.8). 79.7% of the women and 72.8% of the men achieved the WHO recommendation of 30 minutes moderate PA/day at baseline. The time of PI during the observation time period of 7 days was on average 4,057 minutes in men and 3,973 minutes in women. In males, age was found to be a significant negative determinant for overall PA (p = 0.002) and for moderate PA (p<0.001). Higher education was positively associated with higher levels of overall PA (p = 0.013) and moderate PA (p = 0.06) in men. BMI was a significant negative determinant for overall PA both in men (p = 0.039) and women (p = 0.032) as well as for moderate PA for women (p = 0.009). Only in women, not in men, self-efficacy was to be a significant positive determinant for overall PA (p = 0.020) as well as negatively associated with PI (p = 0.006). The participants of our study showed high levels of PA. This is likely due to selection bias in this convenience sample. However, also levels of PI are very high and those correspond with average levels in the German population. The determinants for higher PA and lower PI differed between males and females. Thus, strategies for improving PA and decrease PI are likely different with respect to sex and should take individual factors (e.g. age, BMI) into account. DRKS00010410 Date: 17 May 2017.

A Lower Leg Physical Activity Intervention for Individuals With Chronic Venous Leg Ulcers: Randomized Controlled Trial.

BackgroundIndividuals with venous leg ulcers (VLUs) suffer disproportionately with multiple chronic conditions, are often physically deconditioned, and demonstrate high levels of physical inactivity.ObjectiveThe primary objective of this randomized controlled trial was to establish the feasibility of a mobile health (mHealth) physical activity exercise app for individuals with VLUs to improve lower leg function.MethodsIn a 6-week study, adults with VLUs were recruited from 2 wound centers in South Carolina, United States, and enrolled if they were aged 18 years or older with impaired functional mobility and an ankle-brachial index between 0.8 and 1.3. Participants were randomized 1:1 to receive evidence-based, phased, nonexertive physical conditioning activities for lower leg function (FOOTFIT) or FOOTFIT+ with an added patient-provider communication feature. The mHealth Conditioning Activities for Lower Leg Function app also provided automated educational and motivational messages and user reports. Foot movement on the VLU-affected leg was tracked by a Bluetooth-enabled triaxial accelerometer. The study was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework to assess the feasibility of reach, adherence, acceptability, implementation, and maintenance.ResultsA total of 24 patients were recruited, enrolled, and randomized in the study. Most patients reported difficulty following the protocol for exercising and using the accelerometer and mobile phone and did not use the provider contact feature. However, all patients were adherent to the 6-week exercise program more than 85% of the time for duration, whereas 33% (8/24) of patients adhered more than 85% for the frequency of performing the exercises. Across the three exercise levels, adherence did not differ between the two groups. Confidence limits around the difference in proportions ranged from −0.4 to 0.7. Providers in FOOTFIT+ were inconsistent in checking participant progress reports because of lack of time from competing work commitments. The technology became outdated quickly, making maintenance problematic. Participants said they would continue to exercise their foot and legs and liked being able to follow along with the demonstrations of each level of exercise provided through the app.ConclusionsThe findings of this study suggest that despite initial interest in using the app, several components of the program as originally designed had limited acceptability and feasibility. Future refinements should include the use of more modern technology including smaller wearable accelerometers, mobile phones or tablets with larger screens, an app designed with larger graphics, automated reporting for providers, and more engaging user features.Trial RegistrationClinicalTrials.gov NTC02632695; https://clinicaltrials.gov/ct2/show/NCT02632695

Prevalence of Physical Inactivity and Sedentary Behavior Among Adults in Armenia.

Physical inactivity and sedentary behavior are risk factors for developing non-communicable diseases. This study analyzed current levels of physical inactivity and sedentary behaviors among the adult population of Armenia. Data were collected through a national STEPS survey of non-communicable diseases risk factors on a nationally-representative sample of 2,380 participants aged 18–69 years in Armenia in 2016. The Global Physical Activity Questionnaire was used to assess physical activity levels. Two out of ten people (21.6%) in Armenia did not meet the minimum levels of physical activity recommended by WHO to protect health. 13.2% of population spent over 8 h per day sitting, 47.2% were inactive at work and 32.4% did not do any transport-related physical activity. Only 13.8% of participants were physically active during leisure time. Specific groups with relatively high levels of physical inactivity were older adults, residents of Yerevan, people with lower levels of education, the unemployed and people who were retired. Sedentary behavior was more common among men, students, people who were retired, unemployed, residents of Yerevan, and adults aged under 30 and over 45 years.

Social Capital and Physical Activity Level in an Urban Adult Population

ABSTRACTBackground: Despite several studies on the concept of social capital in relation to health during the last two decades, the majority of these works have been conducted in developed countries.Purposes: This study examines the correlation between domains of social capital (reciprocity, trust, and social network) and physical activity level in an Iranian adult population. In addition, the study explores to find whether this relation is affected by socioeconomic status. Method: A total of 2000 questionnaires were distributed among adults living in 12 neighborhoods of Bandar Abbas city, Iran. Of this population, 1828 qualified questionnaires were utilized for further analysis. Results: High level of physical inactivity (62.3%) was reported by the participants. Discussion: Norms of reciprocity and neighborhood trust associated with the higher physical activity level among men and women. However, social network contributed to a higher level of physical activity among women group. The study indicated the correlation of socioeconomic variables with social capital indicators and physical activity level. Translation to Health Education Practice: Findings suggest that programming efforts and research should focus on increasing organized activities that support neighborhood participation and social activity to promote social interaction and trust among residents.A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars

The Gap between Knowledge and Practice of Physical Activity in Medical Students of Delhi

Introduction: The lifestyle today has become more sedentary, and obesity and many non-communicable diseases are increasing among people. Medical students have a very demanding stressful life and have often been found to develop an unhealthy lifestyle. Objectives: To find out the level of physical activity among the medical students, the gaps between their knowledge and practice and the prevalence of obesity among the students. Methods: A cross-sectional study was done among 101 medical students of 3rd year (35.6% were females and 64.4% were males) in a medical college in Delhi and assess their knowledge and practices of physical activities using a predesigned standard questionnaire (IPAQ). Data were analysed using Statistical Package for Social Sciences (SPSS) version 21 and descriptive statistics was presented. Result: Thirty five (34.7%) partcipants only had knowledge of recommended physical activities but only twenty nine (28.7%) participants believed that the recommended physical activity is more than or equal to 150 minutes in a week. 41 (40.6%) had Low activity, 45 (44.6%) were sufficiently active or Moderately active, and 15 (14.8%) had High activity. 20 (19.8%) were overweight and 31 (30.7%) were obese. Males [26(40%)] were found to be significantly more obese than females [5(13.8%)] (P=0.001). Conclusion: There is a high level of physical inactivity and obesity among medical students. Knowledge about physical activity has been increasing over the years among the medical students, but that knowledge is not converting into practice. There is a dire need for health promotional activity and behaviour change communication for increasing physical activity among medical students.

Prevalence and correlates of physical activity across kidney disease stages: an observational multicentre study.

People with chronic kidney disease (CKD) report high levels of physical inactivity, a major modifiable risk factor for morbidity and mortality. Understanding the biological, psychosocial and demographic causes of physical activity behaviour is essential for the development and improvement of potential health interventions and promotional initiatives. This study investigated the prevalence of physical inactivity and determined individual correlates of this behaviour in a large sample of patients across the spectrum of kidney disease. A total of 5656 people across all stages of CKD (1-2, 3, 4-5, haemodialysis, peritoneal dialysis and renal transplant recipients) were recruited from 17 sites in England from July 2012 to October 2018. Physical activity was evaluated using the General Practice Physical Activity Questionnaire. Self-reported cardiorespiratory fitness, self-efficacy and stage of change were also assessed. Binominal generalized linear mutually adjusted models were conducted to explore the associations between physical activity and correlate variables. This cross-sectional observational multi-centre study was registered retrospectively as ISRCTN87066351 (October 2015). The prevalence of physical activity (6-34%) was low and worsened with disease progression. Being older, female and having a greater number of comorbidities were associated with greater odds of being physically inactive. Higher haemoglobin, cardiorespiratory fitness and self-efficacy levels were associated with increased odds of being active. Neither ethnicity nor smoking history had any effect on physical activity. Levels of physical inactivity are high across all stages of CKD. The identification of stage-specific correlates of physical activity may help to prioritize factors in target groups of kidney patients and improve the development and improvement of public health interventions.

The International Impact of the Active Healthy Kids Global Alliance Physical Activity Report Cards for Children and Youth.

In response to growing concerns over high levels of physical inactivity among young people, the Active Healthy Kids Global Alliance developed a series of national Report Cards on physical activity for children and youth to advocate for the promotion of physical activity. This article provides updated evidence of the impact of the Report Cards on powering the movement to get children and youth moving globally. This assessment was performed using quantitative and qualitative sources of information, including surveys, peer-reviewed publications, e-mails, gray literature, and other sources. Although it is still too early to observe a positive change in physical activity levels among children and youth, an impact on raising awareness and capacity building in the national and international scientific community, disseminating information to the general population and stakeholders, and on powering the movement to get kids moving has been observed. It is hoped that the Report Card activities will initiate a measurable shift in the physical activity levels of children and contribute to achieving the 4 strategic objectives of the World Health Organization Global Action Plan as follows: creating an active society, creating active environments, creating active lives, and creating active systems.

Transport barriers and its health implications in Asunción

IntroductionAsunción is the capital of Paraguay, a landlock country in South America. The level of urbanisation in the city is increasing at a fast rate without proper planning. Local transport problem-symptoms can be related to health issues in the city, yet there are no official studies. This is a pioneering work describing transport-and-health-links in Asunción city. ScopeTransport-and-health-links in Asunción in relation to the international context are investigated. Local transport problem-symptoms affecting health are identified and discussed based on impact on physical activity, space usage, air pollution, and noise pollution. A comprehensive framework for future empirical research and planning is proposed, and policies and recommendations are given. FindingsAsunción city and peripheral areas have high rates of private vehicle usage – triggered by fast-growing urban sprawl and city population – as well as low levels of public transport service. Virtually no collaboration between transport and health authorities/planners has been identified. Infrastructure has greatly favoured usage of private vehicles, and the rate of obesity is increasing in the country and over 30% of the population have very high levels of physical inactivity. Barriers that hold back progress in transport (and could positively affect health) are identified. For the way forward, key considerations to improve polarised perceptions of users regarding private vehicle usage and lack of awareness regarding benefits and externalities of different modes of transport are indicated. In addition, suggestion of young adults on alternative usage of spaces to enhance active mobility are mentioned.

Physical Activity Promotion and Exercise in Pediatric Oncology - Structural Requirements and Financing Options Based on the Leipzig Movement Concept

Regular physical activity is an important requirement for the development and the general health in childhood and adolescence. However, patients during and after treatment for childhood cancer show high levels of physical inactivity, and only a marginal extent of physical activity. In addition to the negative side effects of treatment, this lack of physical activity and exertion has further negative implications for their health, such as decrease in physical performance and health related quality of life. In order to reduce these negative effects and provide access to regular physical activity for children and adolescents with cancer, childhood cancer patients should participate in targeted physical exercise therapy sessions at the treating hospital. Physical activity promotion for children and adolescents with cancer is an effective measure to enhance or preserve functional mobility, physical performance and health related quality of life. Both the behavioral level (person) and the setting (environment) should be taken into account for a sustainable implementation of physical activity promotion in the treatment of childhood cancer. The Leipzig Movement Concept promotes physical activity both during and after treatment for childhood cancer. On the basis of the modular concept, factors influencing physical activity in childhood cancer, alongside requirements for the successful and long-term implementation of physical activity programs and clinical exercise therapy are described. Furthermore financing options, based on Book V § 43 of the German Social Welfare Code, are presented.