Displaying publications 61 - 80 of 83 in total

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  1. Abdullah N, Kueh YC, Kuan G, Wong MS, Lee YY
    Malays J Med Sci, 2024 Aug;31(4):138-148.
    PMID: 39247105 DOI: 10.21315/mjms2024.31.4.11
    BACKGROUND: Abdominal bloating (AB) is a common, bothersome symptom that negatively affects most adults. Although social support may help people suffering from AB, limited validated questionnaire is available. This study aimed to validate the newly developed Abdominal Bloating Social Support (SS-Bloat) scale for the Malaysian context.

    METHOD: We conducted a cross-sectional study in which we used purposive sampling and a self-administered questionnaire. Based on the literature review, experts' input and in-depth interviews, new items were generated for SS-Bloat scale. Content validity was assessed by experts and pre-tested with 30 individuals with AB. Construct validity was determined based on exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was determined based on Cronbach's alpha and composite reliability (CR).

    RESULTS: During the development stage, eight items were generated for SS-Bloat scale and remained the same after content validity and pre-testing. A total of 152 participants with a mean age of 31.27 years old (68.3% female, 32.7% male) completed the questionnaire. Based on the EFA, three problematic items were removed. The total variance explained was 35.6% with acceptable reliability (α = 0.66). The model was then tested using CFA. The initial model did not fit the data well. After several model re-specifications, the final measurement model of SS-Bloat scale fit the data well with acceptable fit indices (comparative fit index [CFI] = 0.994 and Tucker-Lewis index [TLI] = 0.984). The CR was satisfactory with value of 0.84.

    CONCLUSION: SS-Bloat scale was deemed valid and reliable for assessing the level of social support among AB patients. The questionnaire can be useful for both research studies and clinical purposes, as it is easy to use.

  2. Wang X, Zhou Y, Li L, Kueh YC, Zeng L, Kuan G
    BMC Psychol, 2025 Mar 03;13(1):183.
    PMID: 40033429 DOI: 10.1186/s40359-025-02487-5
    BACKGROUND: Sport Mental Health Continuum - Short Form (Sport MHC-SF) is an adaptation of the Mental Health Continuum-Short Form for athletes. Although validated in Western contexts, its applicability to the Chinese population remains unexplored. This study aims to validate the Chinese adaptation of the Sport MHC-SF in Chinese university athletes, evaluate its reliability and validity, and confirm its factorial structure.

    METHODS: A total of 1,025 Chinese university athletes (65% male, mean age 20 ± 1.54 years) were included in this study. Confirmatory factor analysis (CFA) and multi-group CFA (MGCFA) were conducted using Mplus 8.0 to evaluate the factorial structure and assess measurement invariance across sports levels.

    RESULTS: Both the three-factor and second-order models demonstrated a good fit for the Chinese adaptation of the Sport MHC-SF. Chi-square values were 262.704 (74) and 262.705 (74), respectively, with a comparative fit index (CFI) of 0.968, a Tucker-Lewis index (TLI) of 0.961, a standardized root mean square residual (SRMR) of 0.027, and a root mean square error of approximation (RMSEA) of 0.050 (90% CI: 0.043-0.056). Measurement invariance across ranked and non-ranked athletes was confirmed, with minimal changes in fit indices (ΔCFI ≤ 0.01, ΔTLI ≤ 0.01, ΔRMSEA ≤ 0.015) from configural to strict invariance.

    CONCLUSION: The Chinese adaptation of the Sport MHC-SF scale has strong construct validity, reliability, and measurement invariance, making it a reliable tool for future research on the well-being of Chinese athletes. This study fills a critical gap in cross-cultural validation, offering a foundation for future research and practical applications in sports psychology among Chinese athletes.

  3. Sabo A, Kuan G, Abdullah S, Kuay HS, Goni MD, Kueh YC
    BMC Public Health, 2024 Sep 16;24(1):2507.
    PMID: 39285351 DOI: 10.1186/s12889-024-19990-w
    BACKGROUND: The influence of social determinants of health (SDH) on sustainable development goals (SDG) has gained attention in recent years. However, there is a scarcity in the availability of valid and reliable instruments to assess the multiple aspects of SDH. Hence, this study was conducted to develop a brief self-reported measure for assessing SDH.

    METHOD: A cross-sectional survey was conducted among university undergraduate students in Nigeria. The study consisted of 300 participants in the EFA (males 55.7%, females 44.3%) and 430 participants in the CFA (males 54.0%, females 46.0%). Participants were selected using a convenience sampling approach to assess their perceptions regarding SDH. Content Validity Index (CVI), Face Validity Index (FVI), Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), Composite Reliability (CR), Average Variance Extracted (AVE), Cronbach's alpha, and Intraclass Correlation Coefficient (ICC) were computed to determine the psychometric properties of the newly developed SDH scale.

    RESULTS: In the EFA, two factors were extracted (structural determinants of SDH and intermediary determinants of SDH), with all 20 items retained. The total variance explained by the EFA model was 61.8%, and the factor correlation was 0.178. The Cronbach's alpha values of the two factors were 0.917 and 0.939. In the CFA, the initial model did not fit the data well based on fit indices. After several re-specification of the model, the final re-specified measurement model demonstrated adequate fit factor structure of the SDH scale with two factors and 20 items (CFI = 0.943, TLI = 0.930, SRMR = 0.056, RMSEA = 0.053, RMSEA p-value = 0.220). The CR was 0.797 for structural determinants of SDH and 0.794 for intermediary determinants of SDH. The ICC was 0.938 for structural determinants of SDH and 0.941 for intermediary determinants of SDH.

    CONCLUSION: The findings indicate that the SDH scale has adequate psychometric properties and can be used to assess the perceived level of SDH. We recommended that this tool be tested in other populations with diverse age groups and other demographic characteristics.

  4. Wang X, Liu Z, Kueh YC, Zhang H, Zhou Y, Kuan G
    Malays J Med Sci, 2026 Aug;33(4):106-116.
    PMID: 42936828 DOI: 10.21315/mjms-03-2026-197
    BACKGROUND: University students frequently encounter academic, interpersonal and financial pressures, which may increase their vulnerability to psychological distress. Physical activity has been identified as a protective factor for mental health, potentially enhancing psychological resilience through improved self-control. This study aimed to examine the relationship between physical activity and psychological resilience among university students and to investigate the mediating role of self-control.

    METHODS: A cross-sectional survey was conducted with 726 university students (mean age = 19.2 years, SD = 0.92). The participants completed the Physical Activity Rating Scale-3, the Self-Control Scale, and the Connor-Davidson Resilience Scale. Descriptive statistics, correlation analyses, regression analyses, and mediation analysis were performed using SPSS 28.0 and PROCESS 4.0.

    RESULTS: Significant differences in self-control (F = 29.67, P < 0.001) and psychological resilience (F = 21.95, P < 0.001) were observed across physical activity levels. Physical activity positively predicted self-control (β = 0.269, P < 0.001) and psychological resilience (β = 0.251, P < 0.001). Self-control was a significant predictor of psychological resilience (β = 0.511, P < 0.001). Mediation analysis indicated that self-control partially mediated the relationship between physical activity and psychological resilience, accounting for 51.46% of the total effect.

    CONCLUSION: Physical activity enhances psychological resilience directly and indirectly through the improvement of self-control. These findings highlight the potential value of promoting regular physical activity as an effective strategy for strengthening psychological resilience and improving mental well-being among university students.

  5. Lu FJH, Gill DL, Yang CMC, Lee PF, Chiu YH, Hsu YW, et al.
    Front Psychol, 2018;9:2363.
    PMID: 30574106 DOI: 10.3389/fpsyg.2018.02363
    Although considerable research indicates that mental energy is an important factor in many domains, including athletic performance (Cook and Davis, 2006), athletic mental energy (AME) has never been conceptualized and measured. Therefore, the aim of this study was to conceptualize and develop a reliable and valid instrument to assess AME. In Study 1, a focus group interview established the initial framework of AME. Study 2 used a survey to collect athletes' experiences of AME and develop a scale draft titled "Athletic Mental Energy Scale (AMES)." In Study 3, we examined the psychometric properties and the underlying structure of AMES via item analysis, internal consistency, and exploratory factor analysis (EFA). In Study 4, we used confirmatory factor analysis (CFA) to examine AMES's factorial validity; and examined concurrent and discriminant validity by examining correlations with athletes' life stress, positive state of mind, and burnout. In study 5, we examined the measurement invariance of the 6-factor, 18-item AMES with Taiwanese and Malaysian samples. Study 6 examined the predictive validity by comparing AMES scores of successful and unsuccessful martial artists. Across these phases, results showed a 6-factor, 18-item AMES had adequate content validity, factorial structure, nomological validity, discriminant validity, predictive validity, measurement invariance, and reliability. We suggest future studies may use AMES to examine its relationships with athletes' cognition, affect, and performance. The application of AMES in sport psychology was also discussed.
  6. Chang YK, Chen FT, Kuan G, Wei GX, Chu CH, Yan J, et al.
    Front Aging Neurosci, 2019;11:227.
    PMID: 31551753 DOI: 10.3389/fnagi.2019.00227
    Objective: This study investigated whether acute exercise duration affects inhibition in late middle-aged adults. Methods: Over four separate days, 40 late middle-aged adults completed, in a counterbalanced order, three exercise sessions consisting of single bouts of moderate-to-vigorous intensity cycling, with the main acute exercise durations being 10, 20, and 45 min, and a control session consisting of 30 min of reading. Their inhibition performance was then evaluated by administration of the Stroop test following each session. Results: The participants had shorter mean response times for both the congruent and neutral conditions of the Stroop following the acute exercise lasting 20 min than they did after the control session. The acute exercise lasting 20 min also resulted in shorter response times for both conditions of the Stroop than the acute exercise lasting only 10 min. Meanwhile, the acute exercise lasting 45 min resulted in a shorter mean response time for the neutral Stroop condition than did the control session. Finally, the acute exercise lasting 20 min resulted in the shortest mean response time of all four sessions for the Stroop incongruent condition. Conclusion: The above findings suggest that the moderate-to-vigorous intensity acute exercise lasting 20 min facilitated multiple cognitive function domains in general, whereas the exercise sessions of shorter and longer duration had negligible effects on executive function in the late middle-aged adults. These results highlight the need to consider the duration of any moderate-to-vigorous intensity exercise when developing acute exercise programs to facilitate executive function in aged populations.
  7. Wu CH, Nien JT, Lin CY, Nien YH, Kuan G, Wu TY, et al.
    PMID: 34202770 DOI: 10.3390/ijerph18136802
    Numerous studies have shown that dispositional mindfulness is positively associated with many mental abilities related to sports performance, including psychological skills and mental toughness. The purpose of this study was to explore the relationship between dispositional mindfulness, psychological skills, and mental toughness among different types of athletes. For this cross-sectional study, 101 college athletes were recruited. Their dispositional mindfulness, psychological skills, and mental toughness were measured by the Mindfulness Attention Awareness Scale (MAAS), Athletic Psychological Skills Inventory (APSI), and Traits of Mental Toughness Inventory for Sports Scale (TMTIS). Pearson's correlation was used to calculate how dispositional mindfulness is associated with psychological skills and mental toughness. The results revealed that dispositional mindfulness is positively associated with comprehensive APSI (r = 0.21-0.36, p < 0.05), TMTIS overall (r = 0.27, p < 0.01), positive effort (r = 0.26, p = 0.01), and pressure (r = 0.30, p < 0.01). These findings suggest a positive linkage between mindfulness and the two examined psychological characteristics related to sports performance. Other approaches to increase mindfulness may be considered in the future.
  8. Zhou Y, He S, Zhou K, Kuan G, Chin MK, Kueh YC, et al.
    PMID: 34501842 DOI: 10.3390/ijerph18179253
    Background: This study examined the psychometric properties of the Chinese version of the Attitude toward Physical Activity Scale (APAS) using a cross-sectional design. Methods: The sample consisted of 692 primary students in China (boy 52.6%, girl 47.4%). The mean age of the participants was 9.4 years (SD = 0.92). Psychometric properties of the 57-item APAS was examined using confirmatory factor analysis (CFA). Results: The hypothesized seven factors model was supported by CFA (CFI = 0.912, TLI = 0.901, SRMR = 0.041, RMSEA = 0.029) after 22 items were removed and the inclusion of seven residual covariance for items loaded on the same factor. Cronbach's alphas of the scales ranged between 0.50 and 0.76. The composite reliability (CR) was between 0.50 and 0.75. All inter-factor correlation coefficient was less than 0.85. Conclusions: Findings provided empirical evidence that the Chinese version of the APAS has adequate psychometric properties for assessing attitudes of primary school children in China toward physical activity.
  9. Jong HY, Rauf RA, Abdullah JM, Reza F, Tye J, Karageorghis CI, et al.
    Malays J Med Sci, 2023 Aug;30(4):132-146.
    PMID: 37655149 DOI: 10.21315/mjms2023.30.4.12
    BACKGROUND: Adolescents with syntactic specific language impairment (S-SLI) fail to comprehend which object questions. We hypothesised that rhythmic music training is more effective in treating this condition than conventional methods because music is often perceived as having a clear, isochronous beat or pulse. Thus, this study aims to investigate the effects of rhythmic music training on the syntactic structure processing of Malay which questions among native adolescents.

    METHODS: In this research study, the participants were three groups of Malay adolescents aged 13 years old-15 years old: i) adolescents with S-SLI with music training, ii) adolescents with S-SLI without music training and iii) typically developing adolescents. Before and after music training, the participants were given a sentence-picture matching task. Accuracy measures and reaction times were captured using E-Prime 2.0.

    RESULTS: The results indicated that with music training, the accuracy and reaction time associated with which object questions among the two SLI groups were significantly higher and lower, respectively.

    CONCLUSION: The implications of using rhythmic music training in enhancing syntactic structure processing are also discussed.

  10. Ai JY, Kuan G, Juang LY, Lee CH, Kueh YC, Chu IH, et al.
    Int J Environ Res Public Health, 2022 Nov 22;19(23).
    PMID: 36497548 DOI: 10.3390/ijerph192315472
    Sleep is a crucial factor in healthy aging. However, most middle-aged adults experience high levels of sleep disorders. While previous findings have suggested exercise training could benefit the quality of sleep, the effects of multi-component exercise on sleep quality are less examined. Accordingly, the current study aimed to assess the effectiveness of a multi-component exercise program on the quality of sleep among middle-aged adults. Twenty-four middle-aged adults were randomly assigned either to a multi-component exercise (MCE) group or a control group. The participants in the MCE group attended a 90-min session per week for 12 weeks. The control group was instructed to maintain their daily routine for 12 weeks. The primary outcome was the sleep quality evaluated by the Pittsburgh Sleep Quality Index (PSQI). The secondary outcome was physical fitness, including muscular strength and endurance, balance, and flexibility. Regarding sleep quality, the global mean score (p = 028), sleep disturbances (p = 011), and sleep efficiency (p = 035) of the PSQI scores were significantly reduced in the MCE group after the 12-week intervention. Regarding physical fitness, the flexibility of the MCE group improved significantly after the intervention (p = 028), yet, no significant change was observed in the control group. Additionally, the muscular strength of the control group declined significantly after the 12-week period (p = 034). Our results revealed the effectiveness of the MCE intervention in improving sleep quality and physical fitness in middle-aged adults. Further studies using larger sample sizes, objective measures of sleep quality, different types of exercise training, as well as different populations, are warranted to extend our current findings.
  11. Abdullah N, Kueh YC, Kuan G, Wong MS, Tee V, Tengku Alang TAI, et al.
    PeerJ, 2024;12:e17265.
    PMID: 38708340 DOI: 10.7717/peerj.17265
    BACKGROUND: The objective of this study was to investigate the inter-relationship between psychosocial variables and their impact on symptom severity and quality of life (QoL) concerning abdominal bloating.

    METHODS: The study adopted a cross-sectional design with purposive sampling. Participants who consented and met the criteria for bloating based on the Rome IV classification completed designated questionnaires. Independent variables comprised health beliefs, intentions, health-promoting behaviors, social support, depression, and anxiety, while dependent variables included bloating severity (general and within 24 h) and QoL. Structural Equation Modeling (SEM) was conducted utilizing Mplus 8.0 to analyze the relationships between these factors.

    RESULTS: A total of 323 participants, with a mean age of 27.69 years (SD = 11.50), predominantly females (64.7%), volunteered to participate in the study. The final SEM model exhibited good fit based on various indices (CFI = 0.922, SRMR = 0.064, RMSEA (95% CI) = 0.048 (0.041-0.054), p-value = 0.714), with 15 significant path relationships identified. The model explained 12.0% of the variance in severity within 24 h, 6% in general severity, and 53.8% in QoL.

    CONCLUSION: The findings underscore the significant influence of health beliefs, intentions, behaviors, social support, depression, and anxiety on symptom severity and QoL in individuals experiencing abdominal bloating.

  12. Zhou K, He S, Zhou Y, Popeska B, Kuan G, Chen L, et al.
    PMID: 33401384 DOI: 10.3390/ijerph18010272
    This study aimed to examine the effects of three-months of classroom-based Brain Breaks Physical Activity Solution (Brain Breaks®) on attitudes toward physical activity levels of primary school children in Henan Province, China. The participants were 704 children enrolled in grades 3-5 who were randomly assigned to either an experimental or a control group. The experimental group participated in Brain Breaks® video intervention for 3-5 min daily, at low-to-moderate intensity for three consecutive months. The control group resumed their normal routine. The children's attitudes in both groups towards physical activity (PA) were evaluated using the self-reported Attitudes toward Physical Activity Scale (APAS), before and after the intervention. The effects of the intervention on APAS scores were analyzed using mixed model analysis of variance with Time as within-subject, and Group as between-subject factors. The analysis revealed evidence in support of the positive effect of classroom video interventions such as Brain Break on children's attitudes toward importance, fun, and trying to do their personal best in physical activity. Also revealed was the important role the teacher plays in this process.
  13. Mahd-Ab Lah N, Kueh YC, Kuan G, Yahaya FH, Wong MS, Abd Samat NA, et al.
    PMID: 33802426 DOI: 10.3390/ijerph18052487
    Abdominal bloating (AB) is a prevalent and bothersome symptom, but there are no specific measures for severity and quality of life (QoL) other than the Bloating Severity Questionnaire (BSQ) and Bloating Quality of Life (BLQoL). We aimed to translate the BSQ and BLQoL into the Malay language and to validate them using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) approaches. The 12-item BSQ has two components, seven-item severity in general (SevGen) and five-item severity in the past 24 h (Sev24), and BLQOL has five items. Translation to the Malay language (BSQ-M and BLQoL-M) was performed using standard forward and backward processes. EFA followed by CFA were performed in participants with AB due to functional bowel disorders, with the purpose of examining the validity and reliability of the questionnaires translated into Malay. After EFA with 152 participants, all the items of BSQ-M remained in the model. Total variance extracted was 53.26% for BSQ-M and 58.79% for BLQoL-M. The internal consistency based on Cronbach's alpha values was 0.52 for SevGen, 0.86 for Sev24, and 0.81 for BLQoL-M. After performing CFA with another 323 participants, the final measurement model for BSQ-M and BLQoL-M fit the data well in terms of several fit indices (BSQ-M: root mean square error of approximation (RMSEA) = 0.050, Comparative Fit Index (CFI) = 0.966, Tucker-Lewis Fit Index (TLI) = 0.956, and standardized root mean squared residual (SRMR) = 0.051; BLQoL-M: RMSEA = 0.071, CFI = 0.985, TLI = 0.962, SRMR = 0.021). The composite reliability for BSQ-M and BLQoL-M were satisfactory (SevGen = 0.83, Sev24 = 0.89, BLQoL = 0.80). The intraclass correlation (ICC) results showed excellent stability for BSQ-M and BLQoL-M, ranging from 0.74 to 0.93. The Malay language versions of BSQ-M and BLQoL-M are valid and reliable instruments for measuring the severity and QoL of AB for the Asian population with functional bowel disorders.
  14. Salleh RM, Kuan G, Aziz MNA, Rahim MRA, Rahayu T, Sulaiman S, et al.
    Nutrients, 2021 May 24;13(6).
    PMID: 34073684 DOI: 10.3390/nu13061783
    BACKGROUND: Reports of probiotic consumption on athletes' performance are debatable due to their equivocal results. There is a need for more evidence on the effects of probiotic intake on psychological state and fitness level. Thus, this study determined the effects of daily probiotic consumption on competitive anxiety, perceived stress and mood among university badminton players, besides their fitness like aerobic capacity, strength, speed, leg power and agility.

    METHODS: Thirty university badminton players aged from 19 to 22 years old were randomly divided equally into two groups, where the probiotic group (PG; n = 15) received a drink that contained Lactobacillus casei Shirota (3 × 1010 CFU) and placebo group (CG; n = 15) a placebo drink for six weeks. Anxiety, stress and mood levels were determined using the CSAI-2R, PSS and BRUMS questionnaires, respectively. Fitness levels were measured using by subjecting the players to 20-m shuttle runs (aerobic capacity), handgrips (muscular strength), vertical jumps (leg power), 40-m dash (speed) and T-test (agility). The Student's t-test (p < 0.05) was used to determine the differences between PG and CG players.

    RESULTS: After six weeks, the anxiety and stress levels of PG players significantly decreased by 16% (p < 0.001) and 20% (p < 0.001), respectively, but there were no significant changes detected in CG players. Supplementation of probiotics also improved aerobic capacity in PG players by 5.9% (p < 0.001) but did not influence the speed, strength, leg power and agility.

    CONCLUSIONS: Probiotics supplementation showed improved aerobic capacity and relieve anxiety and stress. However, further studies need to be carried out to determine the mechanisms through which probiotic intake produces these effects.

  15. Konukman F, Filiz B, Moghimehfar F, Maghanoy MA, Graber K, Richards KA, et al.
    Behav Sci (Basel), 2024 Apr 09;14(4).
    PMID: 38667101 DOI: 10.3390/bs14040305
    Guided by the theory of planned behavior, this study aimed to determine the influence of Physical Education (PE) teachers' attitudes, their perceived behavioral control, and the influence of subjective norms on their intention and constraints (intrapersonal, interpersonal, and structural) to offer a high-quality class based on best practices to deliver PE lessons online during the COVID-19 pandemic. This cross-sectional, multi-country survey study recruited PE teachers from five countries (China, Malaysia, the Philippines, Turkey, and the United States). A total of 928 online questionnaires were used in the analysis. In terms of the overall intention to teach online, our findings showed that American and Filipino teachers had higher levels of intention to continue teaching online. In contrast, Turkish, Malaysian, and Chinese teachers showed a lower interest. Moreover, Malaysian teachers had more intrapersonal constraints while the teachers in the other four countries were not as restrained intrapersonally. The results highlight the significant influence of perceived behavioral control and attitudes on PE teachers' intention to deliver online courses. Constraints to online teaching had a considerably large negative impact on attitudes, subjective norms, and perceived behavioral control. Based on the results, the proposed extension to the theory of planned behavior was an appropriate framework for understanding the behavioral intent of PE teachers.
  16. Wong KY, Tan H, Nyakuma BB, Kamar HM, Tey WY, Hashim H, et al.
    Environ Sci Pollut Res Int, 2022 Nov;29(54):82492-82511.
    PMID: 35751730 DOI: 10.1007/s11356-022-21579-y
    The present study examines the effect of medical staff's turning movements on particle concentration in the surgical zone and settlement on the patient under single large diffuser (SLD) ventilation. A computational domain representing the operating room (OR) was constructed using computer-aided design (CAD) software. The airflow and particle models were validated against the published data before conducting the case studies. The airflow in the OR was simulated using an RNG k-ε turbulence model, while the dispersion of the particles was simulated using a discrete phase model based on the Lagrangian approach. A user-defined function (UDF) code was written and compiled in the simulation software to describe the medical staff member's turning movements. In this study, three cases were examined: baseline, SLD 1, and SLD 2, with the air supply areas of 4.3 m2, 5.7 m2, and 15.9 m2, respectively. Results show that SLD ventilations in an OR can reduce the number of dispersed particles in the surgical zone. The particles that settled on the patient were reduced by 41% and 39% when using the SLD 1 and SLD 2 ventilations, respectively. The use of the larger air supply area of SLD 2 ventilation in the present study does not significantly reduce the particles that settle on a patient. Likewise, the use of SLD 2 ventilation may increase operating and maintenance costs.
  17. Ding K, Yang J, Chin MK, Sullivan L, Durstine JL, Violant-Holz V, et al.
    Int J Environ Res Public Health, 2021 Jul 01;18(13).
    PMID: 34280992 DOI: 10.3390/ijerph18137056
    During the novel coronavirus (COVID-19) pandemic, physical activity (PA) behaviors were altered worldwide due to public health measures such as "lockdown." This study described PA among adults residing in 11 countries during COVID-19 lockdown and examined factors associated with PA engagement. We conducted a cross-sectional anonymous survey among adults (≥18 years old) in 11 countries (Brazil, Bulgaria, China, India, Ireland, Malaysia, North Macedonia, Singapore, Spain, Turkey, United States). Of 11,775 participants, 63.7% were female and 52.8% were 18-34 years old. More than 40% of participants were insufficiently active (43.9%) and reported a decrease in their PA during lockdown (44.8%). Statistically significant differences were observed in (1) proportions of participants being insufficiently active, (2) level of PA, and (3) decrease in PA across the 11 countries. More stringent governmental policy responses were associated with greater likelihood of being insufficiently active during lockdown (adjusted odds ratio = 1.22, 95% confidence interval = 1.03, 1.45). Higher depression or anxiety scores were associated with greater likelihood of decreased level of PA during lockdown.We found substantial reductions in PA levels during COVID-19 lockdown across countries. Country-specific PA promotion interventions are needed during this and similar global emergencies.
  18. Ding K, Yang J, Chin MK, Sullivan L, Demirhan G, Violant-Holz V, et al.
    PMID: 33800008 DOI: 10.3390/ijerph18052686
    Despite the global impact of COVID-19, studies comparing the effects of COVID-19 on population mental health across countries are sparse. This study aimed to compare anxiety and depression symptoms during the COVID-19 lockdown among adults from 11 countries and to examine their associations with country-level COVID-19 factors and personal COVID-19 exposure. A cross-sectional survey was conducted among adults (≥18 years) in 11 countries (Brazil, Bulgaria, China, India, Ireland, North Macedonia, Malaysia, Singapore, Spain, Turkey, United States). Mental health (anxiety, depression, resilient coping, hope) and other study data were collected between June-August 2020. Of the 13,263 participants, 62.8% were female and 51.7% were 18-34 years old. Participants living in Brazil had the highest anxiety and depression symptoms while participants living in Singapore had the lowest. Greater personal COVID-19 exposure was associated with increased anxiety and depression symptoms, but country-level COVID-19 factors were not. Higher levels of hope were associated with reduced anxiety and depression; higher levels of resilient coping were associated with reduced anxiety but not depression. Substantial variations exist in anxiety and depression symptoms across countries during the COVID-19 lockdown, with personal COVID-19 exposure being a significant risk factor. Strategies that mitigate COVID-19 exposure and enhance hope and resilience may reduce anxiety and depression during global emergencies.
  19. Benzing V, Nosrat S, Aghababa A, Barkoukis V, Bondarev D, Chang YK, et al.
    PMID: 34831770 DOI: 10.3390/ijerph182212015
    The COVID-19 pandemic and the associated governmental restrictions suddenly changed everyday life and potentially affected exercise behavior. The aim of this study was to explore whether individuals changed their preference for certain types of physical exercise during the pandemic and to identify risk factors for inactivity. An international online survey with 13,881 adult participants from 18 countries/regions was conducted during the initial COVID-19 related lockdown (between April and May 2020). Data on types of exercise performed during and before the initial COVID-19 lockdown were collected, translated, and categorized (free-text input). Sankey charts were used to investigate these changes, and a mixed-effects logistic regression model was used to analyze risks for inactivity. Many participants managed to continue exercising but switched from playing games (e.g., football, tennis) to running, for example. In our sample, the most popular exercise types during the initial COVID-19 lockdown included endurance, muscular strength, and multimodal exercise. Regarding risk factors, higher education, living in rural areas, and physical activity before the COVID-19 lockdown reduced the risk for inactivity during the lockdown. In this relatively active multinational sample of adults, most participants were able to continue their preferred type of exercise despite restrictions, or changed to endurance type activities. Very few became physically inactive. It seems people can adapt quickly and that the constraints imposed by social distancing may even turn into an opportunity to start exercising for some. These findings may be helpful to identify individuals at risk and optimize interventions following a major context change that can disrupt the exercise routine.
  20. Swami V, Tran US, Barron D, Afhami R, Aimé A, Almenara CA, et al.
    Body Image, 2020 Mar;32:199-217.
    PMID: 32032822 DOI: 10.1016/j.bodyim.2020.01.006
    The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η2 = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.
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