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The aim of this study was to examine the trend in socioeconomic inequalities in child undernutrition in Nigeria. The study analysed cross-sectional data from the Nigeria Demographic and Health Survey (NDHS) 2003 to 2013. The outcome variables were stunting, wasting and underweight among children under-five years. The magnitude of child undernutrition in Nigeria was estimated via a concentration index, and the socioeconomic factors contributing to child undernutrition over time were determined using the decomposition method. The concentration index showed an increase in childhood wasting and underweight in Nigeria over time. The socioeconomic factors contributing to the increase in child undernutrition were: child's age (0-23 months), maternal education (no education), household wealth index (poorest household), type of residence (rural) and geopolitical zone (North East, North West). To address child undernutrition, there is a need to improve maternal education and adopt effective social protection policies especially in rural communities in Nigeria.

Objectives. To assess changes in walking and cycling in the United States between 2001 and 2009. Methods. The 2001 and 2009 National Household Travel Surveys were used to compute the frequency, duration, and distance of walking and cycling per capita. The population-weighted person and trip files were merged to calculate the prevalence of any walking and cycling and of walking and cycling at least 30 minutes per day. Results. The average American made 17 more walk trips in 2009 than in 2001, covering 9 more miles per year, compared with only 2 more bike trips, and 5 more miles cycling. At the population level, the prevalence of “any walking” remained unchanged (about 18%), whereas walking at least 30 minutes per day increased from 7.2% to 8.0%. The prevalence of “any cycling” and cycling 30 minutes per day remained unchanged (1.7% and 0.9%, respectively). Active travel declined for women, children, and seniors, but increased among men, the middle aged, employed, well-educated, and persons without a car. Conclusions. Walking increased slightly, whereas cycling levels stagnated, and the overall prevalence of active travel remained low. Improved infrastructure for walking and cycling must be combined with programs to encourage active travel among more groups, especially children, seniors, and women.

Background Sporting or physical recreation event participation can affect different domains of mental and social well-being if sufficiently frequent, yet previous research has focused mainly on the physical health benefits of single-location or infrequent mass-participation events. We examined overall and domain specific subjective well-being of adult participants of “parkrun”, a weekly, community-based, highly accessible and widespread running event. Methods Data were from a national online survey of 865 adult Australian parkrunners. Scores on nine individual measures and the global Personal Well-being Index (PWI) were compared to national, normative data. Regression models tested associations between personal well-being and perceived benefits of parkrun (mental health and connection to community). Results Of 100 scores, 28% of means for parkrunners fell outside overall and age and gender subgroups normative ranges. Satisfaction with health was higher for male, those aged over 45 and overall parkrunners; only parkrunners aged 18–24 fell below their age group norm. S atisfaction with life as a whole was positively associated with perceived mental health benefits of parkrun, but not perceived community connection for women, and neither measure for men. PWI was positively associated with perceived community connection for men and with mental health benefit for women. Conclusions Australian parkrunners mostly reflect the general population on personal well-being, except report superior satisfaction with physical health. Women’s personal well-being may benefit from parkrun through improved mental health and men’s from community connectedness. parkrun may facilitate positive expression of identity and continuation of healthy habits among athletes, and non-demanding, health enhancing activity and social interaction for non-athletes.

Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. Cross-sectional data from the most recent Demographic and Health Surveys (2006-2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2. Stunting was highest in Burundi (57.7%) and Malawi (47.1%) in East Africa; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa. The prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target of improving maternal, infant and young child nutrition by 2025.

There are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only ( n  = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.

Introduction: Child undernutrition is a major public health problem. One third of all undernourished children globally reside in Sub-Saharan Africa (SSA). The aim of this study was to systematically review studies to determine the factors associated with stunting, wasting and underweight in SSA and contribute to the existing body of evidence needed for the formulation of effective interventions. Methods: This systematic review was conducted using the 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Five computerized bibliographic databases were searched: Scopus, PubMed, PsycINFO, CINAHL and Embase. The included studies were rated using eight quality-appraisal criteria derived from the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist: sample size, sampling methodology, response rate, outcome measures, statistical analyses, control for confounding, study limitation, and ethical consideration. Results: Of a total of 2810 articles retrieved from the five databases, 49 studies met our inclusion criteria. The most consistent factors associated with childhood stunting, wasting and underweight in SSA were: low mother’s education, increasing child’s age, sex of child (male), wealth index/SES (poor household), prolonged duration of breastfeeding (>12 months), low birth weight, mother’s age (<20 years), source of drinking water (unimproved), low mother’s BMI (<18.5), birth size (small), diarrhoeal episode, low father’s education and place of residence (rural). Conclusions: The factors that predispose a child to undernutrition are multisectoral. To yield a sustainable improvement in child nutrition in SSA, a holistic multi-strategy community-based approach is needed that targets the factors associated with undernutrition, thereby setting the region on the path to achieving the WHO global nutrition target by 2025.

Total testosterone (TT) is known to influence health and virility in men. Among men from United States and Europe, numerous sociodemographic and lifestyle factors were reported to be associated with TT. However, associations with TT and Leydig cell function in the Middle East are poorly described. A cross-sectional, population-based sample had a structured interview, physical examinations, and blood tests in two hospitals in Jerusalem, Israel. A subsample (25- to 44-year-old men, n = 286: 124 Israelis, 162 Palestinians) had sex hormone measurements. The primary outcomes were TT and free testosterone/luteinizing hormone (FT/LH) ratio, representing Leydig cell function. Associations with sociodemographic and lifestyle factors, body mass index (BMI), and physical activity (PA) were evaluated using multivariable linear regression. Compared with Palestinians, Israelis had similar TT (4.81 vs. 5.09 ng/mL, p = .405) and higher FT/LH (31.2 vs. 25.8 ng/IU, p = .002). In ln-transformed values, marital status had a stronger association in Palestinians (P for interaction = 0.03). Age, BMI, and PA had a stronger association with TT in Israelis with significant interactions with ethnicity. BMI <25 and a higher PA quartile were associated with a higher TT (p < .001). Among Israelis, age (p = .007), married marital status (p = .007), and BMI <25 were significantly associated with FT/LH. No associations of any factors were identified among Palestinians. Associations with several modifiable factors identified in Western samples were replicated in Israelis and to a lesser degree in Palestinians. Different relationships of several factors with TT and FT/LH could result from ethnically diverse genetic, sociodemographic, and behavioral characteristics that warrant further research.

Dance is a promising health resource for older adults, but empirical evidence remains inconsistent. The lack of synthesised evidence regarding program design, dose, and delivery limits understanding of factors influencing participation and health outcomes. This scoping review aimed to map the scope, range, and effectiveness of dance programs for older people, and identify gaps and opportunities for future research and practice. Searches across five databases (September 2023) identified 148 studies evaluating 116 dance programs (≥4 weeks) for older adults (≥55 years, N = 8060), Dance interventions delivered to clinical groups were excluded. Intervention design and delivery were charted against the TIDieR reporting checklist. Program outcomes including adherence, safety, and positive tests were charted into established taxonomies. Demographic information, program details, and implementation were often insufficiently reported. Participant groups differed by age range, with underserved communities underrepresented. Programs varied extensively in key factors including dose, prospective 'active ingredients', delivery approach, facilitator expertise, and class size. While dance was physically safe, adherence rates in older adults are comparable to other community exercise programs. Less than 40% of health assessments showed positive change, with more consistent benefits to physical endurance, strength, and function, moderate impacts on psychosocial health, and limited benefits to cognitive and brain health, and falls and falls risk. Dance is a meaningful, safe, adaptable, and low-cost health resource for older adults. Key opportunities for advancing research include improved access for underserved groups, program suitability assessments, strategies to support adherence and engagement including theory-informed approaches, and incorporation of participant and practitioner insights. Identification of key 'active ingredients' and dance program factors may improve understanding of causal pathways and mechanisms to optimise engagement and health impacts. Stronger reporting practices will facilitate comparisons across studies and more robust evidence synthesis. This review provides a critical knowledge foundation to guide future approaches in dance for health and offers reporting recommendations.

Background Feasible and cost-effective as well as population specific instruments for monitoring physical activity (PA) levels are needed for the management and prevention of non-communicable diseases. The WHO-endorsed Global Physical Activity Questionnaire (GPAQ) has been widely used in developing countries, but the evidence base for its validity, particularly for rural populations, is still limited. The aim of the study was to validate GPAQ among rural and urban residents in Bangladesh. Methods A total of 162 healthy participants of both genders aged 18–60 years were recruited from Satia village ( n  = 97) and Dhaka City ( n  = 65). Participants were invited to take part in the study and were asked to wear an accelerometer (GT3X) for 7 days, after which they were invited to answer the GPAQ in a face to face interview. Results Valid accelerometer data (i.e., ≥10 h of wear times over ≥3 days) were received from 155 participants (rural = 94, urban = 61). The mean age was 35 (SD = ±9) years, 55% were females and 19% of the participants had no schooling, which was higher in the rural area (21% vs 17%). The mean ± SD steps/day was 9998 ± 3936 (8658 ± 2788 and 12,063 ± 4534 for rural and urban respectively, p  = 0.0001) and the mean ± SD daily moderate-to-vigorous physical activity (MVPA) was 58 ± 30 min (51 ± 26 for rural and 69 ± 34 for the urban, p  = 0.001) for accelerometer. In case of GPAQ, rural residents reported significantly higher moderate work related PA (MET-minutes/week: 600 vs. 360 p  = 0.02). Spearman correlation coefficients between GPAQ total MVPA MET-min/day and accelerometer MVPA min/day, counts per minute (CPM) or steps counts/day were acceptable for urban residents (rho: 0.46, 0.55 and 0.63, respectively; p  < 0.01) but poor for rural residents. The overall correlation between the GPAQ and accelerometer for sitting was low (rho: 0.23; p  < 0.001). GPAQ-Accelerometer correlation for MVPA was higher for females (rho: 0.42), ≤35 age group (rho: 0.31) and those with higher education attainment (rho: 0.48). The Bland-Altman plots illustrated bias towards over estimation of GPAQ MVPA with increased activity levels for urban and rural residents. Conclusion GPAQ is an acceptable measure for physical activity surveillance in Bangladesh particularly for urban residents, women and people with high education. Given waist worn accelerometers do not capture the typical PA in rural context, further study using a physical activity diary and a combination of multiple sensors (e.g., wrist, ankle and waist worn accelerometers) to capture all movement is warranted among rural population with purposive sampling of all education levels.

ObjectivesCompared with sighted individuals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness.DesignA systematic review of articles reporting physical activity interventions in visually impaired individuals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure.SettingMost interventions were conducted in a group setting, with some including an at-home, self-directed component.ParticipantsFollowing identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment.Primary and secondary outcome measuresOutcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait.ResultsEighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and diverse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale.ConclusionsPhysical activity interventions in individuals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger sample sizes, stronger designs and longer follow-up periods are needed.PROSPERO registration numberCRD42018103638.