Knowledge, attitudes, and practices of cardiopulmonary rehabilitation among physiotherapists in Lebanon

Background Insufficient physical activity is one of the leading mortality risks worldwide for cardiovascular and pulmonary diseases. Physiotherapists (PT) are core healthcare professionals who play a major role in the prevention of disease complications and in inspiring a healthy lifestyle. To identify challenges in the promotion of cardiopulmonary rehabilitation (CR) in Lebanon, a survey was conducted among PT and physiotherapy students. The aim was to assess the knowledge, attitudes, and practices of CR in Lebanon. Results The response rate was 46.1% (N = 322). Results show that 24.5% of respondents have good to excellent knowledge about CR. More than 60% of the respondents indicate possible barriers to starting a CR program, and one of two respondents identify the absence of skills as a main barrier. Findings highlight the importance of the role of PT as a mediator to increase a healthy lifestyle among patients and to promote the prevention of cardiovascular diseases and pulmonary diseases in the country. Conclusions and recommendations Our results support the evidence and clinical guidelines that PT play a major role by increasing the participation of patients in CR. A cost-effective CR program needs to be covered by the private and public system in Lebanon.

Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

Background Suboptimal cardiovascular health (CVH) and social determinants of health (SDOH) have a significant impact on maternal morbidity and mortality. We aimed to evaluate the association of SDOH with suboptimal CVH among pregnant women in the United States. Methods and Results We examined cross‐sectional data of pregnant women aged 18 to 49 years from the National Health Interview Survey (2013–2017). We ascertained optimal and suboptimal CVH based on the presence of 0 to 1 and ≥2 risk factors (hypertension, diabetes, hyperlipidemia, current smoking, obesity, and insufficient physical activity), respectively. We calculated an aggregate SDOH score representing 38 variables from 6 domains (economic stability; neighborhood, physical environment, and social cohesion; community and social context; food; education; and healthcare system) and divided into quartiles. We used Poisson regression model to evaluate the association of SDOH with suboptimal CVH and risk factors. Our study included 1433 pregnant women (28.8±5.5 years, 13% non‐Hispanic Black). Overall, 38.4% (95% CI, 33.9–43.0) had suboptimal CVH versus 51.7% (95% CI, 47.0–56.3) among those in the fourth SDOH quartile. Risk ratios of suboptimal CVH, smoking, obesity, and insufficient physical activity were 2.05 (95% CI, 1.46–2.88), 8.37 (95% CI, 3.00–23.43), 1.54 (95% CI, 1.17–2.03), and 1.19 (95% CI, 1.01–1.42), respectively among those in the fourth SDOH quartile compared with the first quartile. Conclusions Over 50% of pregnant women with the highest SDOH burden had suboptimal CVH, highlighting the public health urgency for interventions in socially disadvantaged pregnant women with renewed strategies toward improving modifiable risk factors, especially smoking and insufficient physical activity.

The effect of remote work on the successful development of engineering company

The purpose of the present study is to identify the main advantages and problems of remote work for both employers and employees, and possible ways to solve them. The article shows a significant number of studies dealt with non-standard forms of labor organization, clarifies the essence of remote work, and examines the main aspects for its effective organization. The main advantages and problems of remote work for employers and employees, as well as possible ways to solve them, are identified based on an expert survey involving 36 experts. According to the conducted study, it can be concluded that the acceleration of scientific and technological progress and adverse epidemiological conditions contribute to the spread of remote work worldwide. This phenomenon has two aspects. On the one hand, remote work, firstly, reduces the unemployment rate and improves the image of the company; secondly, offers flexible working hours; thirdly, protects/retains customers and saves time/transport costs. On the other hand, remote work is associated with the difficulty in maintaining efficiency and teamwork at a high level; secondly, it restricts communication, makes it impossible to perform certain tasks at home; and thirdly, remote work leads to insufficient physical activity, causes difficulties with integration into the corporate culture, etc.

Health Awareness in the Field of Physical Activity in Slovakia

Objectives:The aim of this study was to provide up-to-date information on the prevalence of insufficient physical activity in Slovaks according to gender and age in 2019. Design: Pilot study Participants: A cross-sectional survey conducted in 2019 (men n = 1,298; women n = 1,316) monitored 2,614 partici- pants in the age category 15 - 64 years from all over Slovakia. Methods:We statistically analyzed the questionnaire survey on Health Awareness in Slovakia using the Chi-square test and Fisher's test, in which the level of significance was determined p-value ≤ 0.05.Results:Young men preferred active sports compared to young women who preferred to spend time on social networks. Older men preferred light physical activity compared to older women, who preferred reading books and magazines. Conclusion:With increasing age, the performance of physical activity in Slovaks decreased.

Stages of Change in Physical Activity and Neighborhood Walkability Among Older Adults living in the Urban Setting

Insufficient physical activity (PA) is considered an independent risk factor for chronic diseases. Although older adults living in lower-income areas often experience obstacles to walking locally, few studies have compared their walking experiences and the degree of readiness to change on engaging in PA. The purpose of this study was to compare perceptions of neighborhood walkability by the stages of change among older adults living in a lower-income community. Participants were recruited in 2018 at a regional health clinic in Flint, MI. To be eligible, participants had to be over 65 years old and Flint residents. Of the 132 participants, the mean age was 69.74 (SD=5.00) years old. The majority of respondents were female (66%); African American (77%); single, divorced, or widowed (75%); and educated below a GED level (84%). The results showed that older adults at the pre-contemplation/contemplation stage (PC/C) were less likely to perceive the availability of sidewalks on most streets and more likely to complain about much traffic along the street than those at the action/maintenance stage (A/M) (p<0.05). After controlling for covariates, multiple regression analysis showed that those at PC/C were less likely to state that their neighborhoods were accessible (β = .17*) and to perceive the presence of walking hazard (e.g., lack of sidewalks) (β = -.17*). Those who engaged in PA less than 30 minutes per day perceived the neighborhoods were accessible (β = .23*). Findings suggest that it is essential to develop friendly support systems and accommodations to encourage walking in lower-income communities.

Health trajectories after age 60: the role of individual behaviours and social contexts

This study aimed to detect different health trajectories after age 60, and to explore to what extent individual and social factors may contribute to healthier ageing. Twelve-year health trajectories were identified in subjects from the Swedish National Study on Aging and Care-Kungsholmen (N=3108), integrating five indicators related to diseases, physical and cognitive function, and disability by means of nominal response models. Growth mixture models were applied to explore health trajectories in terms of rate and pattern of change. Baseline information about health-related behaviours and social context was collected through standardized questionnaires. The strength of the associations was estimated using logistic regression, and their impact through population attributable fractions (PAF). Three trajectories were identified grouping 78%, 18%, and 4% of people with respectively increasing rates of health decline Compared to the best trajectory, subjects in the middle and worst trajectories became functionally dependent 12.0 (95%CI:11.4-12.6) and 12.1 (95%CI:11.5-12.7) years earlier, respectively. Insufficient physical activity (OR:3.38, 95%CI:2.58-4.42), financial strain (OR:2.76, 95%CI:1.77-4.30), <12 years education (OR:1.53, 95%CI:1.14-2.04), low social connections (OR:1.45, 95%CI:1.09-1.94), low social participation (OR:1.39, 95%CI:1.06-1.83) and a body mass index ≥25 (OR:1.34, 95%CI:1.03-1.75) were associated with belonging to the middle/worst trajectories. The highest PAFs were observed for insufficient physical activity (27.1%), low education (19.3%) and low social participation (15.9%); a total PAF of 66.1% was obtained when considering all significant exposures together. Complementarily considering life-long factors belonging to the socioeconomic, psychosocial, and behavioural dimensions should be central to any strategy aimed at fostering health in older age.

Qualitative views of Nigerian school principals and teachers on the barriers and opportunities for promoting students’ physical activity behaviours within the school settings

Background Insufficient physical activity (PA) is a growing public health challenge among Nigerian adolescents. Significant information gap exists on the school-related factors which influence the participation of adolescents in school-based physical activity programmes in Nigeria. This study was conducted to document the qualitative views of school principals and teachers on the barriers and opportunities for promoting the physical activity behaviours of adolescents within the school settings in light of the socio-ecological model. Methods This was a qualitative study conducted in 12 public and private schools in two local government areas of Oyo state, Nigeria. Two key sources and data collection methods (i.e key informant interviews and focus group discussions) were used. Six key informant interviews were held with school principals and six focus group discussions with classroom teachers using pre-tested guides. Data was analysed using thematic analysis. Results Fourteen sub-themes were identified as barriers to PA and linked to different levels of the socio-ecological model. Three themes were categorised as parental factors, three themes as socio-cultural and religious factors while the school-related factors had eight sub-themes. Specifically, the school-related barriers were the declining number of trained physical health education teachers, limited opportunities for continuing education and low prioritisation of physical health education. Other school-related factors such as increasing demand for classroom academic time, negative attitudinal dispositions of other teachers and inadequate funding for schools which hampered the provision of facilities and equipment were identified as factors that limit the effective implementation of policies and programmes for physical activity in schools. Opportunities to promote PA within the school settings during assemblies, breaktime, after-school and inter-house sports competition exist. However, these opportunities are hampered by competing academic time, security threats, fear of causalities to students due to poor supervision after school, poor funding and brawling associated with competitive school-based sporting events. Conclusions Factors that contribute to insufficient physical activity among in-school adolescents in the school settings are multi-factorial. Implementation of holistic, multi-component interventions which address the social-cultural and school-level factors and enhance students’ opportunities for physical activity in schools are recommended.

Inadequate Mental Health Literacy and Insufficient Physical Activity Potentially Increase the Risks of Anxiety and Depressive Symptoms in Chinese College Students

Objective: The present study aimed to examine the interactive associations between physical activity and mental health literacy with anxiety and depressive symptoms in Chinese college students.Methods: A cross-sectional study was conducted from May to July 2020. A total of 7,512 students were recruited from two medical colleges in Hefei and Anqing city in Anhui Province, China. Physical activity, mental health literacy, anxiety and depressive symptoms were measured by self-reported validated instruments. Analyses were conducted with logistic regression models.Results: The prevalence of anxiety and depressive symptoms was 8.6% and 16.4%, respectively. Insufficient physical activity was significantly associated with depressive symptoms (OR = 1.359, 95%CI 1.184–1.561) and anxiety symptoms (OR = 1.492, 95%CI: 1.237–1.799). Inadequate mental health literacy was significantly associated with depressive symptoms (OR = 3.089, 95%CI: 2.607–3.662) and anxiety symptoms (OR = 3.675, 95%CI: 2.861–4.721). Low physical activity rank (OR = 1.438, 95%CI: 1.151–1.798) was significantly related with depressive symptoms but not anxiety symptoms. The students who had inadequate mental health literacy and insufficient physical activity had the highest risks of depressive symptoms (OR = 5.049, 95% CI: 3.649–6.987) and anxiety symptoms (OR = 5.270, 95% CI: 3.338–8.321).Conclusion: These finding indicated that Chinese college students having insufficient physical activity and inadequate mental health literacy are at risk of exhibiting anxiety and depressive symptoms. Early intervention programs for college students with mental health problems should be considered to enhance their mental health literacy and to increase their physical activities.

A national and sub-national metaregression of the trend of insufficient physical activity among Iranian adults between 2001 and 2016

Insufficient physical activity (IPA) caused approximately 5% of mortalities in 2017 in Iran, almost double its global average. Despite the relatively considerable burden, a knowledge gap exists regarding the trend of IPA in recent years. We described the trend of IPA prevalence utilizing the data from six rounds of STEPwise approach to risk factor Surveillance (STEPS) in Iran. We estimated the physical activity status of Iranian adults from 2006 to 2016 after adjusting for years of schooling, urbanization percentage, and wealth index. We used the spatiotemporal model to interpolate and extrapolate the IPA prevalence for the years in-between the series and from 2001 to 2006, respectively. We used the data of 177,910 participants from six STEPS surveys and found that the national prevalence of IPA had steadily increased over the course of 16 years and had almost doubled in this time period (23.1% in 2001 to 55.4% in 2016). The increase was persistent across all age and gender strata and in every province. Moreover, IPA was more prevalent among women than their male peers regardless of their age category or province of residence. The prevalence of IPA in Khuzestan (highest prevalence) was almost double compared to that in Lorestan (lowest prevalence) in 2016. The IPA prevalence increased considerably and almost doubled in 16 years among Iranian adults, particularly women. Policies need to target IPA as a high priority contributing to the burden of Non-communicable diseases.

Physical Activity and Rehabilitation – A Key to Healthy Aging

A doctrine was established regarding the so called “new beginning” – the transition to the post-retirement period for a full-value experience of the available compensatory reserves and creation of overcoming strategies for opposing and coping with the obstacles in the still uncommon lifestyle of the senior citizen. By outlining the role of physical activity in a synthesized format, a successful attempt for data classification worldwide was made; in one fourth of the elderly people there is insufficient physical activity, more evident in the women and for Bulgaria this percent is higher (95%). The role and effect of categorized physical exercises for mobility, flexibility, and stretching, aerobic and anaerobic movements have been pointed out. Moreover, the review discusses the preventive effects of rehabilitation, including psychological ones and the role of it in helping patients live with socially significant diseases, coping with disability. The contribution of physical activity and rehabilitation as protective factors of non-infectious diseases is associated with good mental health, improved quality of life and well-being. Within this meaning, while contemporary medicine adds years to life, physical activity and mostly rehabilitation is a significant reason for adding a meaningful life in the course of aging and old age.