14th Dec 2023

Introduction: During childhood cancer treatment, there is a detrimental impact on physical activity (PA) and increased sedentary behaviour not only for the child but also for all family members. Participating in family-based PA would help maintain a child’s fitness during treatment, this is preferable to recovering deficits post-treatment. This study aimed to explore parents’ perceptions of barriers and facilitators for family-based PA during a child’s cancer treatment.
Methods: Semi-structured interviews (n =18) with parents of children who have received treatment explored barriers and facilitators to PA. Parents were eligible if their child was initially diagnosed: 1) between the ages of 3 and 16 years old; 2) over three months ago and it was no more than five years since treatment completion. Interviews were transcribed and inductively analysed using reflexive thematic analysis.
Results: Parents’ perceived barriers and facilitators to their family being physically active were organised into themes: a) initial impact of treatment, b) psychological repercussions from treatment, c) social and interpersonal connections, and d) life out and about. Key subthemes were a) the child’s health and knowledge surrounding treatment side-effects, b) competing demands and c) maintaining stability within the household. Providing support for families and equipping parents with knowledge whilst using the family unit to support PA were key facilitators to PA.
Conclusions: This study identified barriers and facilitators to family-based PA from the parents’ perspective. The connections within the family are key facilitators of PA for all family members. Future research should develop interventions to address barriers such as knowledge of treatment side-effects and time spent in the hospital to promote PA in families when a child is undergoing cancer treatment.

24th Nov 2023

Background: Previous literature has indicated that health-related outcomes and behaviours in university students are poor relative to the general population. The increased number of students presenting as trans and gender diverse (TGD) and from minoritised ethnicity backgrounds, combined with substantial contextual shifts related to the COVID-19 pandemic, mean that up-to-date information is unavailable. The aim of the present study was therefore to characterise the current self-reported movement, dietary and lifestyle behaviours, mental health, and Body Mass Index (BMI) of UK university students.
Methods: An online, self-report survey was administered across three years (2021-2023). Three independent cohorts of university students’ (n=6,358) completed the survey on four key topic areas. One-way ANOVAs were used to assess differences between genders, and independent samples t-tests were used to assess differences between ethnic groups.
Results: 30% of students were not meeting physical activity guidelines, 54% were sedentary for ≥6 hours per day, 83% had poor diet quality, 51% were in high or increased risk groups for alcohol consumption, 18% experienced terrible or poor sleep quality, and 32% were overweight or obese. Gender differences were present for all variables other than walking physical activity (WPA) (P<0.05) and differences between ethnic groups were present for all variables other than sedentary behaviour (SB), diet quality score (DQS), WPA and BMI (P<0.05).
Conclusion: The findings of the current study provide an update on the current landscape of university students’ health and health-related behaviours. Overall, these results indicate that students health-related outcomes and behaviours are poor, and that gender and ethnic disparities remain prevalent.

25th Sep 2023

This systematic review aimed to analyze the effects of different exercise protocols on physical fitness, quality of life, cancer-related fatigue, and sleep quality in patients with different types of cancer undergoing neoadjuvant treatment. A comprehensive search of existing literature was carried out using four electronic databases: PubMed, Scopus, Web of Science, and Cochrane Library (published until October 19, 2022). All databases were searched for randomized controlled trials, quasi-experimental investigations, and pre-post investigations assessing the effects of exercise in cancer patients during neoadjuvant treatment. Excluded articles included multicomponent interventions, such as exercise plus diet or behavioral therapy, and investigations performed during adjuvant treatment or survivorship. Twenty-seven trials involving 999 cancer patients were included in this review. The interventions were conducted in cancer patients undergoing neoadjuvant treatment for rectal (n = 11), breast (n = 5), pancreatic (n = 4), esophageal (n = 3), gastro-esophageal (n = 2), and prostate (n = 1) cancers, and leukemia (n = 1). Exercise interventions appeared to improve cardiorespiratory fitness, muscle strength, body composition, and quality of life, although many investigations lacked a between-group analysis. In conclusion, despite limited evidence, exercise interventions applied during neoadjuvant treatment demonstrate promising potential in enhancing cardiorespiratory fitness, muscle strength, body composition, and overall quality of life. However, a scarcity of evidence remains on the effects of exercise on cancer-related fatigue and sleep quality.

26th Jun 2023

Background
The World Health Organization released guidelines on physical activity (PA), sedentary behaviour (SB), and sleep for the early years with the aim of improving health and developmental outcomes in young children. Several studies have reported the adherence to these movement guidelines but very little is known about the levels of adherence to these guidelines in Scotland. The purpose of this study was to conduct a pilot study examining adherence to the 24hr movement guidelines among preschoolers in Scotland.
Methods
A total of 56 preschoolers (aged 3 to 4.9y) from Scotland were recruited in this cross-sectional study. Each participant was asked to wear an ActiGraph accelerometer on the waist for a minimum of 4 days. Parent/guardians of the participating children were asked to provide data on their child’s screen time, sleep and whether children were restrained for >1hr at a time. Meeting the 24-h movement guidelines was defined according to the WHO guidelines. Descriptive analysis was used to present the number and percentage of children meeting the guidelines.
Results
The proportion of children who met the PA, SB, and sleep guidelines were 43.2% (n = 19), 11.9% (n = 5), and 91.3% (n = 42), respectively. For the combination of guidelines, 31.3% (n=15) of the participating children met the PA and sleep guidelines combined but very few met the PA and SB guidelines (4.4%), as well as the sleep and SB guidelines (11.1%). Overall, none of the participants met all movement guidelines combined.
Conclusion
This is a small study, but it suggests that programs to promote pre-schoolers adherence to the 24hr movement guidelines in should be developed.

02nd Jun 2023

Introduction: The COVID-19 pandemic and the war in Ukraine have profoundly impacted the mental health of school-age children. Adhering to recommendations regarding 24-h behaviour, including physical activity, minimizing sedentary behaviour, and ensuring adequate sleep, can maintain mental health. This study assessed the associations between 24-h behaviours and mental health among Ukrainian children and adolescents in the unique context of war and the pandemic.
Methods: A cross-sectional survey online was conducted among parents of Ukrainian children aged 7-18 (n=1243, 51% boys) in 2022 using questionnaires Q-RAPF and RCADS-P-25. Compositional Data Analysis (CoDA) was employed to analyze the data. The models were adjusted for gender, age, body mass index, and combat activity by the place of residence.
Results: CoDA analysis revealed that increasing moderate-to-vigorous physical activity (β=-0.09, p<0.01) and sleep duration (β=-0.15, p<0.01) were significantly associated with improved mental health. Conversely, increased sedentary behaviour (β=0.19, p<0.001) was associated with increased anxiety and depression t-scores. The impact of war exacerbated the detrimental effects of a sedentary lifestyle on mental health (β_interaction=0.23, p<0.001).
Conclusions: Our findings highlight the importance of promoting balanced 24-hour activity behaviors in Ukrainian children and adolescents to support their mental health, especially during times of crisis. Interventions should focus on increasing physical activity levels, reducing sedentary behavior, and promoting sufficient sleep duration. In addition, public health policies and school-based programs should incorporate strategies to enhance activity behaviors and mental well-being in this vulnerable population.

31st May 2023

Introduction: A combine approach to modifiable lifestyle behaviors is crucial given their potential synergistic effects on health. This study will determine differences in children’s time allocation, considering sex and period of the week, and identify family determinants associated with children’s time use.
Methods: We use cross-sectional data from 3-10-year-old Portuguese children (n=8472), collected in 2016/17. Parents reported children’s time use in different behaviors, children’s participation in sports, and family socioeconomic factors. Correlations between time use indicators were made. Multiple linear regressions were performed: 1)using screen time as dependent variable (independent variables: indoor play, outdoor play, school commute, study time, sleep duration; control variables: child characteristics); and 2)using children’s time use indicators as dependent variables (independent variables: family characteristics).
Results: Boys accumulated more screen- and outdoor time; girls more indoor time. But time-use in different activities was similar between sexes. The time spent in different activities was correlated, particularly during the weekdays. Relevant effect on the time spent using screen media devices came from the sleep duration (more sleep=less screen). Also, children engaged in organized sports, spent less time on screen. Lastly, the time devoted for each task or activity was determined by a set of family sociodemographic factors (e.g., urbanization, and parental employment).
Conclusions: Identifying time spent in multiple activities that differ by sex (and associated determinants) can contribute to promotion strategies to increase physical activity and decrease sedentary behavior in young children.

20th May 2023

Humans went through three important leaps until they became an intelligent living thing. These leaps are respectively;
1: Bipedal leap,
2: Cognitive flip leap,
3:Cognitive threshold leap.
1: Bipedal leap: 6-7 million years ago, changing living conditions (Habitat) forced this creature to walk on two legs in shallow waters or marshes and swamps. This is walking on two legs, which initiated radical changes in the skeletal structure of this creature, as required by the laws of physics. The most effective of these changes is forcing this creature to have a vertical body. Australopithecus.
2: Cognitive flip leap: Two million years ago, when the vertical angle of the trunk reached a certain level, the embryo-fetus in the womb turned 180 degrees, did a somersault and turned its head to the mother’s diaphragm. All this happens in accordance with the laws of physics. It is this mind flip that triggered and initiated the growth of the skull, and therefore the brain. Homo habilis.
3: Cognitive threshold leap: When the brain growth reached a certain level (650-700 cc), he was able to reason to use stick and stone as a defensive and offensive weapon, and this accelerated the transition and transformation to Homo sapiense. Homo erectus.
He later developed fire management, use and language, because he now had the brain capacity to do all these things.

14th May 2023

Introduction: The prevalence of obesity in children and adolescents grows rapidly. WHO advocates that young people, under the age of 18, should practice at least 60 minutes of MVPA a day, and says that additional time brings even more health benefits, improving muscle and cardiorespiratory fitness, bone health, metabolic and cardiovascular markers. The aim of our work is to estimate the effects of replacing the minutes needed to accomplish 60 minutes/day of moderate to vigorous physical activity, from sedentary behavior time, on health markers, using the isotemporal substitution method.

Method: A sample of 285 Portuguese children and adolescents was categorized in two groups based on body fat percentage. The daily mean moderate to vigorous physical activity was determined using accelerometry. Capillary blood samples and blood pressure were obtained using standard procedures. Data were analyzed by isotemporal substitution analyses estimating the effect of reallocating, from sedentary behavior, the time needed to accomplish 60 minutes of moderate to vigorous physical activity, on health markers.

Results: The replacement of sedentary behavior with moderate to vigorous physical activity reduced the percentage of body fat (B= 2,57; 95%IC: 1,93-3,22), and improved cardiorespiratory fitness in both groups, normoponderal (B= 2,13 ; 95%IC: 1,52-2,74), overweight (B= 2,05; 95%IC 0,74-3,36).

Conclusion: Adding the extra time needed to accomplish the 60 min/day moderate to vigorous physical activity recommendation seems to favorably affect the body composition and cardiorespiratory fitness in normoponderal and overweight children and adolescents.

Acknowledgements: FCT-FCT/UIDB/00617/2020 and LA/P/0064/2020

12th May 2023

Introduction
Type 1 Diabetes (T1D) is a condition requiring 24-hour management. The way in which an individual combines their 24-hour movement behaviours (24-h MBs), which is comprised of physical activity (PA), sedentary behaviour (SB), and sleep, throughout the day can have a significant impact on physical and mental health.

Aims
This mixed methods systematic review aimed to investigate 24-h MBs’ relationship with glycaemic control and psychosocial outcomes in adolescents (11-18 years) with T1D.

Methods
Ten databases were searched for quantitative and qualitative English language articles reporting at least one of the behaviours and their relationship with outcomes. There were no restrictions on article publication dates or study design. Articles were subjected to title and abstract screening, full text screening, data extraction and quality assessment. Data were summarised narratively, and a meta-analysis was conducted where possible.

Results
From 9922 studies, 84 were included for data extraction (quantitative (n = 76), qualitative (n = 8)). Meta-analyses revealed a significant favourable association between PA and HbA1c (-0.22 [95% CI: -0.35, -0.08; I2 = 92.7%; p = 0.001). SB had an insignificant unfavourable association with HbA1c (0.12 [95% CI: -0.06, 0.28; I2 = 86.1%; p = 0.07]) and sleep had an insignificant favourable association (-0.03 [95% CI: -0.21, 0.15; I2 = 65.9%; p = 0.34]).

Conclusions
Importantly, no study investigated how combinations of behaviours collectively interacted and impacted on outcomes.

28th Apr 2023

Introduction: During a child’s cancer treatment there is a detrimental impact on physical activity (PA) for all family members. This study aimed to explore parents’ experience of family-based PA, perceived effects of PA on mental and physical health, and perceived barriers and facilitators to PA for the family during a child’s cancer treatment.
Methods: Parents of children who have received cancer treatment (n=18) participated in a semi-structured interview to explore their family’s PA. Parents were eligible if their child was initially diagnosed: 1) between 3 and 16 years old; 2) over three months ago and was within 5 years of treatment completion. Interviews were transcribed and analysed using reflexive thematic analysis.
Results: Parents’ perceived barriers to their family being physically active included: side effects from treatment on the physical capability of the child; parents trust in others to be physically active with their child; lack of knowledge of feasible activities and safe, accessible locations to visit. Barriers to parent PA included: change of priorities; tiredness; lacking motivation and confidence in their PA ability; not wanting to leave their child (or having someone trusted to leave their child with); and limited access to PA facilities or resources. Parents recognised PA could help to process events, function as a distractor, and improve mental and physical health.
Conclusions: This study identified parents’ perceived barriers, facilitators and experiences of family-based PA. Parents recognised the benefits of PA; however, PA was not prioritised for themselves or for the child receiving treatment. Future research should develop interventions addressing these barriers to promote PA in families when a child is undergoing treatment.