Background: Accumulating sufficient moderate to vigorous physical activity is recognized as a key determinant of physical, physiological, developmental, mental, cognitive, and social health among children and youth (aged 5–17 y). The Global Matrix 3.0 of Report Card grades on physical activity was developed to achieve a better understanding of the global variation in child and youth physical activity and associated supports. Methods: Work groups from 49 countries followed harmonized procedures to develop their Report Cards by grading 10 common indicators using the best available data. The participating countries were divided into 3 categories using the United Nations’ human development index (HDI) classification (low or medium, high, and very high HDI). Results: A total of 490 grades, including 369 letter grades and 121 incomplete grades, were assigned by the 49 work groups. Overall, an average grade of “C-,” “D+,” and “C-” was obtained for the low and medium HDI countries, high HDI countries, and very high HDI countries, respectively. Conclusions: The present study provides rich new evidence showing that the situation regarding the physical activity of children and youth is a concern worldwide. Strategic public investments to implement effective interventions to increase physical activity opportunities are needed.

Use of corticosteroid injections to treat lateral epicondylalgia is increasingly discouraged,^1,2 partly because evidence of long-term efficacy has not been found,^3-5 and due to high recurrence rates.^3,6 In a randomized controlled trial with 1-year follow-up,³ recurrence was evident in 72% of patients receiving corticosteroid injection compared with 8% after physiotherapy.

Suicide is a major global health challenge and a leading cause of death among adolescents, but research related to suicide has concentrated on high-income countries. We aimed to estimate the prevalence of suicidal ideation, suicide planning, and suicide attempts in adolescents from 59 low-income and middle-income countries. In this population-based study, we used data from the Global School-based Student Health Survey of schoolchildren aged 13-17 years between 2003 and 2015, in 59 low-income and middle-income countries across six WHO regions. Using a meta-analysis with random effects, we computed the sex-based and age-based estimates of regional and overall prevalence of suicidal ideation, suicide planning, and suicide attempts. Our sample consisted of 229 129 adolescents (mean age 14·6 [SD 1·18] years; 111 082 [48%] boys and 118 047 [52%] girls). The overall prevalence of suicidal ideation was 16·9% (95% CI 15·0-18·8), suicide planning was 17·0% (14·8-19·2), and suicide attempts was 17·0% (14·7-19·3) in the 12 months preceding survey completion. The African region had the highest prevalence of suicidal ideation (20·4%, 17·3-23·6) and suicide planning (23·7%, 19·1-28·3), and the western Pacific region had the highest prevalence of suicide attempts (20·5%, 14·3-26·7). Southeast Asia had the lowest prevalence of ideation (8·0%, 4·5-11·5), planning (9·9%, 5·0-14·8), and attempts (9·2%, 5·1-13·3). Girls had higher prevalence than boys for suicidal ideation (18·5%, 16·4-20·6 vs 15·1%, 13·4-16·7), suicide planning (18·2%, 15·8-20·6 vs 15·6%, 13·7-17·6), and suicide attempts (17·4%, 15·0-19·8 vs 16·3%, 14·0-18·6). Adolescents aged 15-17 years had higher prevalence than those aged 13-14 years of suicidal ideation (17·8%, 15·8-19·8 vs 15·9%, 14·1-17·6), suicide planning (17·8%, 15·7-20·0 vs 16·3%, 14·7-17·9), and suicide attempts (17·6%, 15·2-20·0 vs 16·2%, 13·8-18·5). Suicidal thoughts and behaviours are prevalent among adolescents in low-income and middle-income countries, particularly in the African and the western Pacific regions, and particularly among girls and adolescents aged 15-17 years. Targeted suicide prevention initiatives are needed and should take into account the diverse range of cultural and socioeconomic backgrounds of the countries. None.

To examine associations between audiological and non-audiological factors and successful hearing aid use in older adults. In a retrospective study, audiological factors, attitudinal beliefs (as derived from the health belief model), client demographics, psychological factors, and age-related factors were evaluated. Participants included 160 individuals, 60 years or older, with unilateral or bilateral hearing impairment (HI), fitted with hearing aids for the first time in the previous two years. Participants were assigned to either an unsuccessful hearing aid owner group (n=75) or a successful hearing aid owner group (n=85) based on their self-reported hearing aid use and benefit. A multivariate, binomial logistic regression model indicated five factors associated with group membership: participants who had greater support from significant others; more difficulties with hearing and communication in everyday life before getting hearing aids; more positive attitudes to hearing aids; coupled with greater perceived self-efficacy for advanced handling of hearing aids; or who were receiving more gain from their devices; were more likely to be successful hearing aid owners. These findings highlight the importance of addressing non-audiological factors in order to assist older adults achieve success with hearing aids.

Although regular participation in physical activity (PA) has health benefits across the life span, the proportion of people doing sufficient activity for these benefits decreases with age. The aim of this study was to identify motivating factors and context preferences for PA in people in their sixties, and to examine gender differences in these factors. Data were used from people aged 60–67 years who responded to a mail survey in Brisbane, Australia, in 2009. Respondents indicated their agreement/disagreement with seven PA motivators and 14 PA context preferences. Data were analyzed using multi-level multinomial logistic regression, adjusted for sociodemographic and health variables, and PA level. Of the 1845 respondents, 59% was female. Based on self-reported PA, one in three respondents (35%) did not meet the PA guidelines of at least 150 min of moderate intensity PA per week. The three leading motivating factors for both women and men were to prevent health problems, to feel good and to lose weight. Women were more likely than men to be motivated by improving appearance (OR 2.93, 95%CI 2.07–4.15), spending time with others (1.76, 1.31–2.37), meeting friends (1.76, 1.31–2.36) or losing weight (1.74, 1.12–2.71). The three leading context preferences for both women and men were for activities close to home, at low cost and that could be done alone. Women were more likely than men to prefer activities that are with people of the same sex (OR 4.67, 95%CI 3.14–6.94), supervised (2.79, 1.94–4.02), with people the same age (2.00, 1.43–2.78) and at a fixed time (1.42, 1.06–1.91). Women were less likely than men to prefer activities that are competitive (OR 0.32, 95%CI 0.22–0.46), are vigorous (0.33, 0.24–0.47), require skill and practice (0.40, 0.29–0.55) and done outdoors (0.51, 0.30–0.86). Although there was overlap in motivating factors and context preferences for PA in women and men aged 60–67 years, there were also marked gender differences. These results suggest that PA options for people in their sixties should be tailored to meet gender specific interests in order to promote PA participation in this rapidly growing population group.