SummaryBackgroundThe Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.MethodsWe estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting.FindingsGlobally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 mil...

Objective: This study aimed to compare the effects of two intervention programs, (1) high-intensity interval training (HIIT) and (2) moderate-intensity training (MIT), on anxiety, depression, stress, and resilience during the confinement caused by the coronavirus disease 2019 (COVID-19) in healthy adults.Methods: A total of 67 adults who participated were randomly assigned to two groups: HIIT and MIT groups. The MIT group had to perform a home-based intervention based on aerobic exercises, whereas the HIIT group had to perform a home-based intervention based on HIIT exercises. The two groups (HIIT and MIT) had to complete the same physical exercise volume, 40 min per session (6 days per week) during the confinement period (6 weeks). Depression, anxiety, stress, and resilience were assessed before and after the intervention.Results: Results showed that HIIT and MIT significantly reduced the stress, anxiety, and depression as well as increase the resilience (p < 0.05). Moreover, the improvements obtained in the HIIT group seem to be greater than those of the MIT group in depression (p < 0.05).Conclusions: HIIT and MIT decreased anxiety, stress, and depression as well as increased resilience during the COVID-19 confinement. In addition, the HIIT intervention seemed to be more beneficial to reduce depression than the MIT intervention.

Objective To evaluate the effects of 24‐week exergame intervention in the physical fitness of women with fibromyalgia in both single‐ and dual‐task conditions. Design Single‐blinded, randomized controlled trial. Setting University facilities. Participants Fifty‐five women with fibromyalgia, recruited from the local fibromyalgia association, were randomly assigned to one of the two groups: exercise group and control group. Intervention The exercise group completed 24 weeks of supervised and group‐based exergame protocol, divided into two sessions of 60 minutes. The intervention was focused on mobility, postural control, upper and lower limbs coordination, aerobic fitness, and strength. Main outcome measures The strength of the upper limbs was measured using the arm curl test. The mobility skill was assessed through the timed‐up and go test, and the flexibility of both upper and lower limbs was measured using the back scratch and the sit and reach tests, respectively. Results Fifty participants completed the study. In the single‐task condition, exergame intervention led to significantly higher effects in the arm curl test (P = 0.008), sit and reach test (P = 0.033), and timed‐up and go test (P = 0.021). Moreover, under dual‐task condition, exergames led to significant effects in all the physical fitness tests (arm curl test, timed‐up and go test, back scratch test, and sit and reach test) compared to the control group. Conclusions Exergame is an effective tool to improve the physical fitness in women with fibromyalgia under single or dual‐task conditions.

Accessible Summary What is known on the subject? Attention‐deficit/hyperactivity disorder (ADHD) is characterized by problems of inattention and impulsive hyperactivity in children. Equine‐assisted activities and therapies (EAATs) have been used as alternative non‐pharmacological intervention option in patients with ADHD. What does this paper adds to existing knowledge? Nowadays, more studies of high methodological quality are needed to determine whether EAAT is an effective intervention for the treatment in children with ADHD. What are the implications for practice? Between 15 and 40 min of rising horses, 8–32 total sessions, for 4–32 weeks, seem to be beneficial to reduce the symptoms of ADHD. Abstract Introduction Attention‐deficit/hyperactivity disorder (ADHD) is a disorder characterized by problems of inattention and impulsive hyperactivity. Equine‐assisted activities and therapies (EAATs) have become an emerging non‐pharmacological intervention option in patients with ADHD. Aim To perform a systematic review of updated literature about EAAT in children with ADHD. Method A systematic review was performed until 28 November 2019, in four electronic databases: PubMed, Web of Science, Embase and Google Scholar. The inclusion criteria were as follows: (a) intervention programme, with pre‐ and post‐data, based on EAAT, (b) children with ADHD and (c) articles written in English. Results A total of 9 articles were found that meet the inclusion criteria. The evidence level was C for 7 studies and B for 2 studies. The level of conclusion was 3. Discussion There are few studies with high methodological quality, and there is a high heterogeneity in the variables included, what make that the level of evidence and conclusion are low. Conclusion There is no account with enough studies of high methodological quality to determine whether EAAT is an effective intervention for the treatment in children with ADHD.