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      Health-Related Quality of Life and Adherence to Physical Activity and Screen Time Recommendations in Schoolchildren: Longitudinal Cohort Ciao Corona

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          Abstract

          Objectives: We investigated changes in adherence to physical activity (PA) and screen time (ST) recommendations of children and adolescents throughout the pandemic, and their association with health-related quality of life (HRQOL).

          Methods: 1,769 primary (PS, grades 1–6) and secondary (SS, 7–9) school children from Ciao Corona, a school-based cohort study in Zurich, Switzerland, with five questionnaires 2020–2022. HRQOL was assessed using the KINDL questionnaire. PA (≥60 min/day moderate-to-vigorous PA) and ST (≤2 h/day ST) recommendations followed WHO guidelines.

          Results: Adherence to PA recommendations dropped in 2020 (83%–59% PS, 77%–52% SS), but returned to pre-pandemic levels by 2022 (79%, 66%). Fewer children met ST recommendations in 2020 (74% PS, 29% SS) and 2021 (82%, 37%) than pre-pandemic (95%, 68%). HRQOL decreased 3 points between 2020 and 2022, and was 9.7 points higher (95% CI 3.0–16.3) in March 2021 in children who met both versus no recommendations.

          Conclusion: Adherence to WHO guidelines on PA and ST during the pandemic had a consistent association with HRQOL despite longitudinal changes in behavior.

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            World Health Organization 2020 guidelines on physical activity and sedentary behaviour

            Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.
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              Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls

              Most studies have some missing data. Jonathan Sterne and colleagues describe the appropriate use and reporting of the multiple imputation approach to dealing with them
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                Author and article information

                Contributors
                Journal
                Int J Public Health
                Int J Public Health
                Int J Public Health
                International Journal of Public Health
                Frontiers Media S.A.
                1661-8556
                1661-8564
                19 July 2023
                2023
                19 July 2023
                : 68
                : 1606033
                Affiliations
                [1] 1 Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich , Zurich, Switzerland
                [2] 2 ISGlobal , Barcelona, Spain
                [3] 3 Universitat Pompeu Fabra (UPF) , Barcelona, Spain
                [4] 4 CIBER Epidemiología y Salud Pública (CIBERESP) , Madrid, Spain
                Author notes

                Edited by: Alberto Borraccino, University of Turin, Italy

                Reviewed by: Teresa Santos, European University of Lisbon, Portugal

                *Correspondence: Sarah R. Haile, sarah.haile@ 123456uzh.ch
                Article
                1606033
                10.3389/ijph.2023.1606033
                10394228
                37538234
                56d5995e-5516-4034-8596-8851a4fefeaa
                Copyright © 2023 Haile, Gunz, Peralta, Ulytė, Raineri, Rueegg, Yasenok, Radtke, Puhan and Kriemler.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 27 March 2023
                : 07 July 2023
                Funding
                This study is part of Corona Immunitas research network, coordinated by the Swiss School of Public Health (SSPH+), and funded by fundraising of SSPH+ that includes funds of the Swiss Federal Office of Public Health and private funders (Vontobel Foundation, Blumenau-Léonie Hartmann Stiftung, Gaydoul Foundation) (ethical guidelines for funding stated by SSPH+ will be respected), by funds of the Cantons of Switzerland (Vaud, Zurich, and Basel) and by institutional funds of the Universities. Additional funding, specific to this study, was available from the University of Zurich Foundation.
                Categories
                Public Health Archive
                Original Article

                Public health
                physical activity (pa),screen time,youth,mental health and wellbeing,sars-cov-2
                Public health
                physical activity (pa), screen time, youth, mental health and wellbeing, sars-cov-2

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