Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. MethodsWe used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age.Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including

BACKGROUND: Occupational burnout, which is more and more commonly encountered among medical professionals and investigated by researchers worldwide, may in particular affect health care workers during the COVID-19 pandemic. OBJECTIVES: The aim of the study was to assess the risk of occupational burnout among physiotherapists working actively in clinical hospitals in south-eastern Poland during the COVID-19 pandemic. METHODS: The level of burnout among the studied physiotherapists was assessed using the Polish version of the Maslach Burnout Inventory by Maslach (MBI). The study was conducted from 20 March to 3 May, 2020 among physiotherapists working professionally during the COVID-19 pandemic in the south east of Poland, during which time health services related to therapeutic rehabilitation were suspended. The study was conducted among 1,540 physiotherapists with a license to practice who worked in clinical departments. Considering the inclusion and exclusion criteria, 106 physiotherapists were qualified for the study. RESULTS: The current findings show that during the COVID-19 pandemic physiotherapists present high burnout rates in all three dimensions: EE (Mean 32.31; CI 29.47–35.15); DP (Mean 16.25; CI 14.48–18.03); PA (Mean 26.25; CI 24.41–28.10). As for gender-related effects, higher burnout rates were observed in the male workers, compared to the females, in all three domains: EE (Men: Mean 34.70; CI 29.90–39.50 –Women: Mean 31.03; CI 27.45–34.60); DP (Men: Mean 18.78; CI 15.98–21.59 –Women: Mean 14.90; CI 12.64–17.16) and PA (Men: Mean 24.54; CI 21.32–27.76 –Women: Mean 27.17; CI 24.90–29.44). The highest burnout rates, presented by the physiotherapists working in the profession for more than 20 years, were identified in the domain of EE (Mean: 35.30; CI 30.51–40.10) and in those with 10–15 years of experience, in the domains of DP (Mean: 18.31; CI 14.89–21.73) and PA (Mean: 23.97; CI 20.13–27.81). The highest rate of occupational burnout, reflected by the scores in all three domains (EE, DP, PA), was identified in Department I –Intensive Care and Anaesthesiology Department: EE - (Mean: 40.89, CI 35.27–46.52); DP - (Mean: 21.39, CI 17.90–24.88); and PA - (Mean: 23.07, CI 20.04–26.10), compared to the other departments. The subjects who rarely participated in courses or training programs showed the highest burnout rates (EE- Mean: 33.55, CI 29.33–37.77; DP- Mean: 16.71, CI 13.99–19.43; PA- Mean: 25.45, CI 22.47–28.43). CONCLUSIONS: Occupational burnout during the COVID-19 pandemic is noticeable among physiotherapists working in clinical departments. The current findings show high burnout rates in all three domains: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). A comparative analysis of these findings with reference to related studies published before the pandemic shows that the burnout rates among physiotherapists may have significantly increased during the COVID-19 pandemic. However, given the scarcity of scientific evidence related to this specific problem in Poland and worldwide, it is necessary to continue research in occupational burnout affecting physiotherapists, particularly during the second wave of the pandemic, in order to gain a better understanding of the possible effects of social isolation and greater personal work-related health risks on the mental health of these medical professionals.

The aim of this study was to assess the prevalence of overweight, obesity, abdominal obesity (AO), and obesity-related risk factors in children aged 5–6 years from Poland. The study was conducted at 22 randomly selected kindergartens representing each city district. A cross-sectional study of 1172 children aged 5–6 years was conducted using questionnaire forms and physical measurements. The physical measurements included body height, weight, waist circumference (WC), and body fat percentage (BFP). A univariate and multivariate logistic regressions were performed to evaluate the risk factors for excess weight, excess adiposity, and abdominal obesity (AO). The prevalence of excess weight (BMI ≥ 85th percentile) was 11.0%. The prevalence of excess adiposity (BFP ≥ 85th percentile) was 42.3%. Prevalence of AO (WC ≥ 90th percentile) was higher in girls compared to boys (14.9% vs. 10.7%, respectively). Multivariate logistic regression analysis indicated that children whose both parents were obese had significantly higher risk of excess weight, excess adiposity, and AO. Lower education level of fathers was associated with higher risk of excess weight and excess adiposity in children, while a lower level of maternal education was associated with higher risk of AO in children. Screen time over 120 min per day, participating less than once a week in at least 60 min of moderate-to-vigorous physical activity (MVPA) and birth weight over 4000 g were associated with excess weight, excess adiposity and AO. Moreover, cesarean delivery was associated with higher risk of excess weight and excess adiposity, and lower socio-economic status with higher risk of AO. This study revealed that excess adiposity and AO differed by gender. Parental obesity, screen time, MVPA, and birth weight could be significant determinants of excess weight, excess adiposity and AO in Polish preschool children.

ObjectiveThe lack of a widely accepted questionnaire used to assess the physical activity (PA) of adolescents in the Polish language creates a need to introduce such a valid, reliable, inexpensive and quick tool for assessment. This study was designed to culturally adapt and validate the Physical Activity Questionnaires for Adolescents (PAQ-A) in the Polish language.DesignCross-sectional study.Participants and outcome measuresCultural adaptation of the Polish version of the PAQ-A was performed following the standardised questionnaires cultural adaptation process. In a sample of 78 adolescents aged 14–19 years, the PAQ-A test–retest was administered within a 1-week interval. Reliability was analysed by the intraclass correlation coefficient (ICC) and internal consistency with Cronbach’s α. Participants completed the PAQ-A, and wore an accelerometer for 7 consecutive days. The PAQ-A was compared with PA parameters obtained using the accelerometer.ResultsTest–retest reliability showed ICC=0.97 for the total score of PAQ-A. Internal consistency was excellent (α=0.93). The PAQ-A was very strongly correlated with steps per day (r=0.94) and with moderate-to-vigorous PA (r=0.81) assessed by the accelerometer.ConclusionsThe Polish version of the PAQ-A is a valuable tool to estimate general levels of PA among adolescents from 14 to 19 years old.

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Detailed associations between physical activity (PA) and body composition in preschoolers remain unclear. The aim of this study was to assess body composition among preschool children differentiated according to their levels of PA and to assess whether meeting the current PA recommendations is associated with a lower risk of obesity, determined by body mass index (BMI) and body fat percentage (BFP). Free-living PA was measured using accelerometers for 7 days in children aged 5 to 6 years. Bioelectrical impedance analysis was used to estimate body composition. Significant differences in content of BFP, fat-free mass (FFM), and total body water (TBW) were found between boys meeting and not meeting moderate-to-vigorous PA (MVPA) recommendations. Meeting the MVPA recommendation was associated with a twofold lower risk of obesity determined by BFP in boys but not in girls. In contrast, the total number of recommended steps per day was not related to adiposity in boys or girls. No statistically significant differences were observed in body composition indices and quintiles of MVPA. Boys in the 3rd-5th quintiles of steps per day presented significantly lower BFP and higher muscle mass and TBW than their peers in quintile 1. However, different associations were observed between body composition indices and quintiles of PA.

ObjectiveAssociations between self-reported sleep duration and obesity indices in children are well recognised; however, there are no studies on associations between objectively measured other sleep parameters and physical activity with body composition in preschoolers. Therefore, the aim of this study was to determine the associations between sleep parameters and moderate-to-vigorous physical activity (MVPA) with body composition indices in preschoolers using objective measures.DesignA cross-sectional study.ParticipantsThe study group consisted of 676 children aged 5–6 years, who were enrolled in kindergartens in the 2017/2018 school year.Outcome measuresSleep parameters and MVPA were measured using accelerometers for 7 days. Bioelectrical impedance analysis was used to estimate body composition.ResultsSleep duration and sleep efficiency were inversely associated with body fat percentage (BFP) (β=−0.013 and β from –0.311 to −0.359, respectively) and body mass index (BMI) (β from −0.005 to −0.006 and from −0.105 to –0.121, respectively), and directly associated with fat-free mass (FFM) (β from 0.010 to 0.011 and from 0.245 to 0.271, respectively) and muscle mass (β from 0.012 to 0.012 and from 0.277 to 0.307, respectively) in unadjusted and adjusted models. BFP was inversely associated with MVPA and positively associated with number of awakenings and sleep periods. Number of sleep periods was inversely associated with FFM, and positively with BMI and muscle mass. Correlation matrix indicated significant correlation between BFP, FFM and muscle mass with sleep duration, sleep efficiency, number of sleep periods and MVPA.ConclusionsPeriodic assessment of sleep parameters and MVPA in relation to body composition in preschool children may be considered, especially in those who are at risk for obesity.

Little is known about physical activity (PA) of preschool-age children in Poland through the course of the day. PA monitoring using an accelerometer increases the reliability of measuring daily PA levels and offers a reasonable compromise between accuracy and feasibility of measurement. The aim of the study was to determine the level of physical activity of preschool children (aged 5–6) on the basis of moderate to vigorous physical activity (MVPA) index and the number of steps. The physical activity of preschool children was assessed using accelerometery (ActiGraph) in 371 children for up to seven days. The normality of distribution was assessed using the Shapiro–Wilk test. The Mann-Whitney U-test and Kruskal-Wallis test were used to assess the significance of differences. The study group children had an average age of 5.4 years (± 0.6). Boys and girls showed a different level of MVPA index. The results significantly improve the current knowledge of PA in Europe. Promoting active lifestyles in children should be one of the health priorities in developed countries.