Insufficient physical activity is a leading risk factor for non-communicable diseases, and has a negative effect on mental health and quality of life. We describe levels of insufficient physical ...activity across countries, and estimate global and regional trends.
We pooled data from population-based surveys reporting the prevalence of insufficient physical activity, which included physical activity at work, at home, for transport, and during leisure time (ie, not doing at least 150 min of moderate-intensity, or 75 min of vigorous-intensity physical activity per week, or any equivalent combination of the two). We used regression models to adjust survey data to a standard definition and age groups. We estimated time trends using multilevel mixed-effects modelling.
We included data from 358 surveys across 168 countries, including 1·9 million participants. Global age-standardised prevalence of insufficient physical activity was 27·5% (95% uncertainty interval 25·0–32·2) in 2016, with a difference between sexes of more than 8 percentage points (23·4%, 21·1–30·7, in men vs 31·7%, 28·6–39·0, in women). Between 2001, and 2016, levels of insufficient activity were stable (28·5%, 23·9–33·9, in 2001; change not significant). The highest levels in 2016, were in women in Latin America and the Caribbean (43·7%, 42·9–46·5), south Asia (43·0%, 29·6–74·9), and high-income Western countries (42·3%, 39·1–45·4), whereas the lowest levels were in men from Oceania (12·3%, 11·2–17·7), east and southeast Asia (17·6%, 15·7–23·9), and sub-Saharan Africa (17·9%, 15·1–20·5). Prevalence in 2016 was more than twice as high in high-income countries (36·8%, 35·0–38·0) as in low-income countries (16·2%, 14·2–17·9), and insufficient activity has increased in high-income countries over time (31·6%, 27·1–37·2, in 2001).
If current trends continue, the 2025 global physical activity target (a 10% relative reduction in insufficient physical activity) will not be met. Policies to increase population levels of physical activity need to be prioritised and scaled up urgently.
None.
The Surgical CAse REport (SCARE) guidelines were first published in 2016 as a tool for surgeons to document and report their surgical cases in a standardised and comprehensive manner. However, with ...advances in technology and changes in the healthcare landscape, it is important to revise and update these guidelines to ensure they remain relevant and valuable for surgeons.
The updated guidelines were produced through a Delphi consensus exercise. Members of the SCARE 2020 guidelines Delphi group, editorial board members, and peer reviewers were invited to participate. Potential contributors were contacted by e-mail. An online survey was completed to indicate their agreement with the proposed changes to the guideline items.
A total of 54 participants were invited to participate and 44 (81.5%) completed the survey. There was a high degree of agreement among reviewers, with 36 items (83.7%) meeting the threshold for inclusion.
Through a completed Delphi consensus exercise we present the SCARE 2023 guidelines. This will provide surgeons with a comprehensive and up-to-date tool for documenting and reporting their surgical cases while highlighting the importance of patient-centred care.
Background
Concerns about ethical conflicts, moral distress, and burnout in veterinary practice are steadily increasing. Root causes of these problems have not been rigorously identified. Little ...research has been done to evaluate the existence of moral distress in North American veterinarians or to explore its impact on career sustainability and poor well‐being.
Hypothesis/Objectives
Ethical conflict and resultant moral distress are common occurrences in contemporary veterinary practice and negatively impact daily practice life, but may not be identified or labeled by veterinarians as such.
Animals
No animals were used in this study.
Methods
Mixed methods sequential explanatory design; confidential and anonymous on‐line sampling of 889 veterinarians in North America.
Results
A majority of respondents reported feeling conflict over what care is appropriate to provide. Over 70% of respondents felt that the obstacles they faced that prevented them from providing appropriate care caused them or their staff moderate to severe distress. Seventy‐nine percent of participants report being asked to provide care that they consider futile. More than 70% of participants reported no training in conflict resolution or self‐care.
Conclusions and Clinical Importance
Veterinarians report widespread ethical conflict and moral distress across many practice types and demographics. Most veterinarians have little to no training on how to decrease the impact of these problems. Ethical conflict and resulting moral distress may be an important source of stress and poor well‐being that is not widely recognized or well defined. Well‐researched and effective tools used to decrease moral distress in human healthcare could be adapted to ameliorate this problem.
In this update of Clark and Watson (1995), we provide a synopsis of major points of our earlier article and discuss issues in scale construction that have become more salient as clinical and ...personality assessment has progressed over the past quarter-century. It remains true that the primary goal of scale development is to create valid measures of underlying constructs and that Loevinger's theoretical scheme provides a powerful model for scale development. We still discuss practical issues to help developers maximize their measures' construct validity, reiterating the importance of (a) clear conceptualization of target constructs, (b) an overinclusive initial item pool, (c) paying careful attention to item wording, (d) testing the item pool against closely related constructs, (e) choosing validation samples thoughtfully, and (f) emphasizing unidimensionality over internal consistency. We have added (g) consideration of the hierarchical structures of personality and psychopathology in scale development, discussion of (h) codeveloping scales in the context of these structures, (i) "orphan," and "interstitial" constructs, which do not fit neatly within these structures, (j) problems with "conglomerate" constructs, and (k) developing alternative versions of measures, including short forms, translations, informant versions, and age-based adaptations. Finally, we have expanded our discussions of (l) item-response theory and of external validity, emphasizing (m) convergent and discriminant validity, (n) incremental validity, and (o) cross-method analyses, such as questionnaires and interviews. We conclude by reaffirming that all mature sciences are built on the bedrock of sound measurement and that psychology must redouble its efforts to develop reliable and valid measures.
Public Significance Statement
Over the past 50 years, our understanding has greatly increased regarding how various psychological problems are interrelated and how they relate to various aspects of personality. In this context, this article describes a "best practice" process and relevant specific issues for developing measures to assess personality and psychological problems.
PDF
