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Article ; Online: Correlates of Toddlers' Physical Activity Levels and Sedentary Behavior During Unstructured Outdoor Play in Early Childhood Education and Daycare Settings.

Vega-Perona, Herminia / Estevan, Isaac / Bernabé-Villodre, María Del Mar / Segura-Martínez, Patricia / Martínez-Bello, Daniel Adyro / Martínez-Bello, Vladimir E

Perceptual and motor skills

2023 Volume 131, Issue 1, Page(s) 39–58

Abstract: Despite recent research showing that early childhood education and daycare settings (ECEC) have an important role in promoting toddlers' physical activity (PA), crucial information gaps remain regarding toddlers' PA and sedentary behavior (SB) in these ... ...

Abstract	Despite recent research showing that early childhood education and daycare settings (ECEC) have an important role in promoting toddlers' physical activity (PA), crucial information gaps remain regarding toddlers' PA and sedentary behavior (SB) in these outdoor settings. We aimed in this study to: (a) analyze PA patterns and SB during unstructured outdoor play time in preschool and daycare environments using accelerometry and systematic observation; (b) provide concurrent accelerometry and observational data to help validate the Observational System for Recording Physical Activity in Children-Preschool Version (OSRAC-P); and (c) examine individual, social and environmental correlates of PA and SB during toddlers' unstructured outdoor play time. We found that: (a) toddlers displayed high amounts of PA with no sex, BMI, and/or age differences in PA and SB levels,; (b) environmental variables (e.g., fixed equipment and playground density) were not associated with PA levels or SB intensity; (c) the OSRAC-P was a reliable and valid means of observing and analyzing toddlers' PA patterns during unstructured outdoor play time; and (e) different social patterns between boys and girls did not impact PA levels or patterns. Combining different measurement methods permitted an improved understanding of unstructured outdoor play in preschool and daycare settings.
MeSH term(s)	Male ; Female ; Humans ; Child, Preschool ; Sedentary Behavior ; Exercise ; Accelerometry/methods
Language	English
Publishing date	2023-12-05
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	204507-2
ISSN	1558-688X ; 0031-5125
ISSN (online)	1558-688X
ISSN	0031-5125
DOI	10.1177/00315125231218027
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Article ; Online: Sex Differences in Cardiovascular Disease Risk Factor Prevalence, Morbidity, and Mortality in Colombia: Findings from the Prospective Urban Rural Epidemiology (PURE) Study.

Lopez-Lopez, Jose Patricio / Toro, Martin Rebolledo-Del / Martinez-Bello, Daniel / Garcia-Peña, Ángel A / O'Donovan, Gary / Perez-Mayorga, Maritza / Otero, Johanna / Rangarajan, Sumathy / Yusuf, Salim / Lopez-Jaramillo, Patricio

Global heart

2024 Volume 19, Issue 1, Page(s) 10

Abstract: Background: Controversies exist on whether the presence of cardiovascular risk factors and their association with major cardiovascular events (MACE) is different between men and women. Most of the evidence comes from high-income countries, hindering ... ...

Abstract	Background: Controversies exist on whether the presence of cardiovascular risk factors and their association with major cardiovascular events (MACE) is different between men and women. Most of the evidence comes from high-income countries, hindering extrapolation of sociocultural and demographic factors of other regions. Objective: To evaluate sex differences in the prevalence of cardiovascular risk factors and the incidence of MACE and diabetes in Colombian adults. Methods: We performed a survival analysis from women and men aged 35-70 belonging to the Prospective Urban Rural Epidemiology-Colombia prospective study. Incidence rates for MACE composite (myocardial infarction, stroke, heart failure, death) and each outcome and diabetes were calculated. Kaplan-Meier curves and log-rank tests were performed. The association between demographic, behavioral, and metabolic variables with MACE and diabetes were evaluated with Cox proportional hazards models. Results: 7,552 participants (50±9.7 years) were included; 64% were women. Women had higher hypertension prevalence, body mass index, levels of total cholesterol, LDL-c, and HDL-c but lower triglycerides levels. Women were more sedentary but fewer smokers or active alcohol consumers and had higher educational levels. After 12-year mean follow-up (SD 2.3), the incidence rate of MACE composite was higher in men [4.2 (3.6-4.9) vs. 3.2 (2.8-3.7) cases per 1000 person-years]. Diabetes had the greatest association with MACE (HR = 2.63 95%CI:1.85;3.76), followed by hypertension (HR = 1.75 95%CI:1.30;2.35), low relative grip strength (HR = 1.53 95%CI:1.15;2.02), smoking (HR = 1.47 95%CI: 1.11;1.93), low physical activity (HR = 1.42 95%CI: 1.03;1.96). When evaluating risk factors by sex, only an increased waist-to-hip ratio was more strongly associated with MACE in men (p-interaction <0.05). Conclusions: The composite MACE outcome was higher in men despite having a lower overall burden of risk factors. The risk factors contribution was similar, leading us to reconsider the need to carrying out differentiated cardiovascular risk prevention and management campaigns, at least in our region.
MeSH term(s)	Adult ; Humans ; Female ; Male ; Prospective Studies ; Cardiovascular Diseases/epidemiology ; Colombia/epidemiology ; Prevalence ; Sex Characteristics ; Hypertension ; Risk Factors ; Heart Disease Risk Factors ; Diabetes Mellitus/epidemiology
Language	English
Publishing date	2024-01-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2629633-0
ISSN	2211-8179 ; 2211-8160
ISSN (online)	2211-8179
ISSN	2211-8160
DOI	10.5334/gh.1289
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Article: Role of Spanish Toddlers' Education and Care Institutions in Achieving Physical Activity Recommendations in the COVID-19 Era: A Cross-Sectional Study.

Vega-Perona, Herminia / Estevan, Isaac / García-Ochoa, Yolanda Cabrera / Martínez-Bello, Daniel A / Bernabé-Villodre, María Del Mar / Martínez-Bello, Vladimir E

Children (Basel, Switzerland)

2022 Volume 9, Issue 1

Abstract: To our knowledge, there are no published studies that describe the physical activity (PA) levels and objectively measure them through accelerometry in toddlers (2-3 years old) attending early childhood education and care (ECEC) institutions during the ... ...

Abstract	To our knowledge, there are no published studies that describe the physical activity (PA) levels and objectively measure them through accelerometry in toddlers (2-3 years old) attending early childhood education and care (ECEC) institutions during the COVID-19 pandemic. The aims of this study were two-fold: (a) to analyse toddlers' PA levels and sedentary behaviour (SB) during school hours in ECEC institutions, as well as the rate of adherence to specific recommendations on total PA (TPA) and moderate-vigorous PA (MVPA); and (b) to evaluate the characteristics correlates (age, gender, and body mass index -BMI) of young children and the school environment on toddlers' TPA, light PA (LPA), MVPA, and SB during school hours in ECEC institutions. PA was evaluated with ActiGraph accelerometers. The main findings were that: (a) toddlers engaged in very high amounts of TPA and MVPA during ECEC hours; (b) girls and boys displayed similar levels of LPA, TPA, and SB, while girls had lower levels of MVPA, compared to boys, and younger toddlers were less active than older ones; (c) BMI was not associated with PA of any intensity or SB; (d) playground and classroom density were not associated with higher levels of PA of any intensity, though classroom density was associated with SB. These ECEC institutions provide and challenge the new COVID-19 scenario, as well as supportive environments for toddlers' PA.
Language	English
Publishing date	2022-01-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children9010051
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Article ; Online: Joint Estimation of Relative Risk for Dengue and Zika Infections, Colombia, 2015-2016.

Martínez-Bello, Daniel Adyro / López-Quílez, Antonio / Prieto, Alexander Torres

Emerging infectious diseases

2019 Volume 25, Issue 6, Page(s) 1118–1126

Abstract: We jointly estimated relative risk for dengue and Zika virus disease (Zika) in Colombia, establishing the spatial association between them at the department and city levels for October 2015-December 2016. Cases of dengue and Zika were allocated to the 87 ...

Abstract	We jointly estimated relative risk for dengue and Zika virus disease (Zika) in Colombia, establishing the spatial association between them at the department and city levels for October 2015-December 2016. Cases of dengue and Zika were allocated to the 87 municipalities of 1 department and the 293 census sections of 1 city in Colombia. We fitted 8 hierarchical Bayesian Poisson joint models of relative risk for dengue and Zika, including area- and disease-specific random effects accounting for several spatial patterns of disease risk (clustered or uncorrelated heterogeneity) within and between both diseases. Most of the dengue and Zika high-risk municipalities varied in their risk distribution; those for Zika were in the northern part of the department and dengue in the southern to northeastern parts. At city level, spatially clustered patterns of dengue high-risk census sections indicated Zika high-risk areas. This information can be used to inform public health decision making.
MeSH term(s)	Adolescent ; Adult ; Age Distribution ; Bayes Theorem ; Child ; Child, Preschool ; Colombia/epidemiology ; Dengue/epidemiology ; Dengue/history ; Dengue/virology ; Dengue Virus ; Female ; Geography, Medical ; History, 21st Century ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Prevalence ; Risk Assessment ; Risk Factors ; Young Adult ; Zika Virus ; Zika Virus Infection/epidemiology ; Zika Virus Infection/history ; Zika Virus Infection/virology
Language	English
Publishing date	2019-05-20
Publishing country	United States
Document type	Historical Article ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2506.180392
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Article: Waist circumference cut-off points to identify major cardiovascular events and incident diabetes in Latin America: findings from the prospective Urban rural epidemiology study Colombia.

Lopez-Lopez, Jose P / Gonzalez, Ana María / Lanza, Paola / Martinez-Bello, Daniel / Gomez-Arbelaez, Diego / Otero, Johanna / Cohen, Daniel D / Perez-Mayorga, Maritza / Garcia-Peña, Angel A / Rangarajan, Sumathy / Yusuf, Salim / Lopez-Jaramillo, Patricio

Frontiers in cardiovascular medicine

2023 Volume 10, Page(s) 1204885

Abstract: Background: Abdominal obesity (AO) indirectly represents visceral adiposity and can be assessed by waist circumference (WC) measurement. In Latin America, cut-off points for the diagnosis of AO are based on Asian population data. We aim to establish the ...

Abstract	Background: Abdominal obesity (AO) indirectly represents visceral adiposity and can be assessed by waist circumference (WC) measurement. In Latin America, cut-off points for the diagnosis of AO are based on Asian population data. We aim to establish the WC cut-off points to predict major cardiovascular events (MACE) and incident diabetes. Methods: We analyzed data from the cohort PURE study in Colombia. WC cut-off points were defined according to the maximum Youden index. Multivariate logistic regression was used to obtain associations between WC and MACE, diabetes, and cumulative incidence of outcomes visualized using Kaplan-Meier curves. Results: After a mean follow-up of 12 years, 6,580 individuals with a mean age of 50.7 ± 9.7 years were included; 64.2% were women, and 53.5% were from rural areas. The mean WC was 85.2 ± 11.6 cm and 88.3 ± 11.1 cm in women and men, respectively. There were 635 cases of the MACE composite plus incident diabetes (5.25 events per 1,000 person-years). Using a cut-off value of 88.85 cm in men (sensitivity = 0.565) and 85.65 cm in women (sensitivity = 0.558) resulted in the highest value for the prediction of the main outcome. These values were associated with a 1.76 and 1.41-fold increased risk of presenting the composite outcome in men and women, respectively. Conclusions: We defined WC cut-off points of 89 cm in men and 86 cm in women to identify the elevated risk of MACE and incident diabetes. Therefore, we suggest using these values in cardiovascular risk assessment in Latin America.
Language	English
Publishing date	2023-10-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2023.1204885
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Article: Handgrip Strength Is Associated with Specific Aspects of Vascular Function in Individuals with Metabolic Syndrome.

Sánchez-Delgado, Juan Carlos / Cohen, Daniel D / Camacho-López, Paul A / Carreño-Robayo, Javier / Castañeda-Hernández, Alvaro / García-González, Daniel / Martínez-Bello, Daniel / Aroca-Martinez, Gustavo / Parati, Gianfranco / Lopez-Jaramillo, Patricio

Biomedicines

2023 Volume 11, Issue 9

Abstract: Background: Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic ... ...

Abstract	Background: Metabolic syndrome (MetS) is a disorder associated with an increased risk for the development of diabetes mellitus and its complications. Lower isometric handgrip strength (HGS) is associated with an increased risk of cardiometabolic diseases. However, the association between HGS and arterial stiffness parameters, which are considered the predictors of morbidity and mortality in individuals with MetS, is not well defined. Objective: To determine the association between HGS and HGS asymmetry on components of vascular function in adults with MetS. Methods: We measured handgrip strength normalized to bodyweight (HGS/kg), HGS asymmetry, body composition, blood glucose, lipid profile, blood pressure, pulse wave velocity (PWV), reflection coefficient (RC), augmentation index @75 bpm (AIx@75) and peripheral vascular resistance (PVR) in 55 adults with a diagnosis of MetS between 25 and 54 years old. Results: Mean age was 43.1 ± 7.0 years, 56.3% were females. HGS/kg was negatively correlated with AIx@75 (r = -0.440), Conclusions: Our findings suggest that in people with MetS, maintaining muscle strength may have an increasingly important role in older age in the attenuation of age-related increases in AIx@75-a marker of vascular stiffness-and that a higher HGS asymmetry could be associated with a greater vascular resistance.
Language	English
Publishing date	2023-08-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11092435
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Article ; Online: Reductions in systolic blood pressure achieved by hypertensives with three isometric training sessions per week are maintained with a single session per week.

Cohen, Daniel D / Aroca-Martinez, Gustavo / Carreño-Robayo, Javier / Castañeda-Hernández, Alvaro / Herazo-Beltran, Yaneth / Camacho, Paul A / Otero, Johanna / Martinez-Bello, Daniel / Lopez-Lopez, Jose P / Lopez-Jaramillo, Patricio

Journal of clinical hypertension (Greenwich, Conn.)

2023 Volume 25, Issue 4, Page(s) 380–387

Abstract: Isometric handgrip or (wall) squat exercise performed three times per week produces reductions in systolic blood pressure (SBP) in adults with hypertension. We aimed to compare these interventions and the potential to retain benefits with one exercise ... ...

Abstract	Isometric handgrip or (wall) squat exercise performed three times per week produces reductions in systolic blood pressure (SBP) in adults with hypertension. We aimed to compare these interventions and the potential to retain benefits with one exercise session per week. We compared blood pressure changes following handgrip and squat isometric training interventions with controls in a randomized controlled multicentre trial in 77 unmedicated hypertensive (SBP ≥ 130 mmHg) adults. Exercise sessions were performed in the workplace and consisted of four repetitions-three sessions per week for the first 12 weeks (phase 1), and one session per week for the subsequent 12 weeks (phase 2). Office blood pressure (BP) was measured at baseline, post-phase 1 and post-phase 2. Post-phase 1, mean reductions in SBP were significantly greater in handgrip (-11.2 mmHg, n = 28) and squat (-12.9 mmHg, n = 27) groups than in controls (-.4 mmHg; n = 22) but changes in DBP were not. There were no significant within-group changes during phase 2 but SBP was 3.8 mmHg lower in the wall squat than the handgrip group-a small magnitude but clinically important difference. While both interventions produced significant SBP reductions, the wall squat appears to be more effective in maintaining benefits with a minimal training dose. The low time investment to achieve and retain clinically significant SBP reductions-42 and 12 min, respectively-and minimal cost, particularly of the wall squat, make it a promising intervention for delivery in public health settings.
MeSH term(s)	Adult ; Humans ; Hypertension/drug therapy ; Blood Pressure ; Hand Strength/physiology ; Exercise/physiology ; Isometric Contraction/physiology
Language	English
Publishing date	2023-03-25
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2077222-1
ISSN	1751-7176 ; 1524-6175
ISSN (online)	1751-7176
ISSN	1524-6175
DOI	10.1111/jch.14621
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Zs.A 5723: Show issues

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Article ; Online: Spatio-Temporal Modeling of Zika and Dengue Infections within Colombia.

Martínez-Bello, Daniel Adyro / López-Quílez, Antonio / Torres Prieto, Alexander

International journal of environmental research and public health

2018 Volume 15, Issue 7

Abstract: The aim of this study is to estimate the parallel relative risk of Zika virus disease (ZVD) and dengue using spatio-temporal interaction effects models for one department and one city of Colombia during the 2015⁻2016 ZVD outbreak. We apply the integrated ...

Abstract	The aim of this study is to estimate the parallel relative risk of Zika virus disease (ZVD) and dengue using spatio-temporal interaction effects models for one department and one city of Colombia during the 2015⁻2016 ZVD outbreak. We apply the integrated nested Laplace approximation (INLA) for parameter estimation, using the epidemiological week (EW) as a time measure. At the departmental level, the best model showed that the dengue or ZVD risk in one municipality was highly associated with risk in the same municipality during the preceding EWs, while at the city level, the final model selected established that the high risk of dengue or ZVD in one census sector was highly associated not only with its neighboring census sectors in the same EW, but also with its neighboring sectors in the preceding EW. The spatio-temporal models provided smoothed risk estimates, credible risk intervals, and estimation of the probability of high risk of dengue and ZVD by area and time period. We explore the intricacies of the modeling process and interpretation of the results, advocating for the use of spatio-temporal models of the relative risk of dengue and ZVD in order to generate highly valuable epidemiological information for public health decision making.
MeSH term(s)	Cities ; Colombia/epidemiology ; Dengue/epidemiology ; Disease Outbreaks ; Epidemiological Monitoring ; Humans ; Models, Statistical ; Risk ; Spatio-Temporal Analysis ; Zika Virus Infection/epidemiology
Language	English
Publishing date	2018-06-30
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph15071376
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Article ; Online: Bayesian dynamic modeling of time series of dengue disease case counts.

Martínez-Bello, Daniel Adyro / López-Quílez, Antonio / Torres-Prieto, Alexander

PLoS neglected tropical diseases

2017 Volume 11, Issue 7, Page(s) e0005696

Abstract: The aim of this study is to model the association between weekly time series of dengue case counts and meteorological variables, in a high-incidence city of Colombia, applying Bayesian hierarchical dynamic generalized linear models over the period ... ...

Abstract	The aim of this study is to model the association between weekly time series of dengue case counts and meteorological variables, in a high-incidence city of Colombia, applying Bayesian hierarchical dynamic generalized linear models over the period January 2008 to August 2015. Additionally, we evaluate the model's short-term performance for predicting dengue cases. The methodology shows dynamic Poisson log link models including constant or time-varying coefficients for the meteorological variables. Calendar effects were modeled using constant or first- or second-order random walk time-varying coefficients. The meteorological variables were modeled using constant coefficients and first-order random walk time-varying coefficients. We applied Markov Chain Monte Carlo simulations for parameter estimation, and deviance information criterion statistic (DIC) for model selection. We assessed the short-term predictive performance of the selected final model, at several time points within the study period using the mean absolute percentage error. The results showed the best model including first-order random walk time-varying coefficients for calendar trend and first-order random walk time-varying coefficients for the meteorological variables. Besides the computational challenges, interpreting the results implies a complete analysis of the time series of dengue with respect to the parameter estimates of the meteorological effects. We found small values of the mean absolute percentage errors at one or two weeks out-of-sample predictions for most prediction points, associated with low volatility periods in the dengue counts. We discuss the advantages and limitations of the dynamic Poisson models for studying the association between time series of dengue disease and meteorological variables. The key conclusion of the study is that dynamic Poisson models account for the dynamic nature of the variables involved in the modeling of time series of dengue disease, producing useful models for decision-making in public health.
MeSH term(s)	Bayes Theorem ; Cities ; Colombia/epidemiology ; Dengue/epidemiology ; Humans ; Meteorological Concepts ; Urban Population
Language	English
Publishing date	2017-07-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2429704-5
ISSN	1935-2735 ; 1935-2735
ISSN (online)	1935-2735
ISSN	1935-2735
DOI	10.1371/journal.pntd.0005696
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Relative risk estimation of dengue disease at small spatial scale.

Martínez-Bello, Daniel Adyro / López-Quílez, Antonio / Torres Prieto, Alexander

International journal of health geographics

2017 Volume 16, Issue 1, Page(s) 31

Abstract: Background: Dengue is a high incidence arboviral disease in tropical countries around the world. Colombia is an endemic country due to the favourable environmental conditions for vector survival and spread. Dengue surveillance in Colombia is based in ... ...

Abstract	Background: Dengue is a high incidence arboviral disease in tropical countries around the world. Colombia is an endemic country due to the favourable environmental conditions for vector survival and spread. Dengue surveillance in Colombia is based in passive notification of cases, supporting monitoring, prediction, risk factor identification and intervention measures. Even though the surveillance network works adequately, disease mapping techniques currently developed and employed for many health problems are not widely applied. We select the Colombian city of Bucaramanga to apply Bayesian areal disease mapping models, testing the challenges and difficulties of the approach. Methods: We estimated the relative risk of dengue disease by census section (a geographical unit composed approximately by 1-20 city blocks) for the period January 2008 to December 2015. We included the covariates normalized difference vegetation index (NDVI) and land surface temperature (LST), obtained by satellite images. We fitted Bayesian areal models at the complete period and annual aggregation time scales for 2008-2015, with fixed and space-varying coefficients for the covariates, using Markov Chain Monte Carlo simulations. In addition, we used Cohen's Kappa agreement measures to compare the risk from year to year, and from every year to the complete period aggregation. Results: We found the NDVI providing more information than LST for estimating relative risk of dengue, although their effects were small. NDVI was directly associated to high relative risk of dengue. Risk maps of dengue were produced from the estimates obtained by the modeling process. The year to year risk agreement by census section was sligth to fair. Conclusion: The study provides an example of implementation of relative risk estimation using Bayesian models for disease mapping at small spatial scale with covariates. We relate satellite data to dengue disease, using an areal data approach, which is not commonly found in the literature. The main difficulty of the study was to find quality data for generating expected values as input for the models. We remark the importance of creating population registry at small spatial scale, which is not only relevant for the risk estimation of dengue but also important to the surveillance of all notifiable diseases.
Language	English
Publishing date	2017-08-15
Publishing country	England
Document type	Journal Article
ISSN	1476-072X
ISSN (online)	1476-072X
DOI	10.1186/s12942-017-0104-x
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