Andrea Ramirez Varela

Bio: Andrea Ramirez Varela is an academic researcher from University of Los Andes. The author has contributed to research in topics: Medicine & Population. The author has an hindex of 10, co-authored 54 publications receiving 378 citations. Previous affiliations of Andrea Ramirez Varela include Universidade Federal de Pelotas & University of the Andes.

Towards better evidence-informed global action: lessons learnt from the Lancet series and recent developments in physical activity and public health.

Abstract: In the past few decades, the field of physical activity has grown and evolved in scope, depth, visibility and impact around the world. Global progress has been observed in research and practice in physical activity regarding surveillance, health outcomes, correlates/determinants, interventions, translation and policy. The 2012 and 2016 Lancet series on physical activity provide some of the most comprehensive global analysis on various topics within physical activity. Based on the Lancet series and other key developments in the field, literature searches, and expert group meetings and consultation, we provide a global summary on the progress of, gaps in and future directions for physical activity research in the following areas: (1) surveillance and trends, (2) correlates and determinants, (3) health outcomes and (4) interventions, programmes and policies. Besides lessons learnt within each specific area, several recommendations are shared across areas of research, including improvement in measurement, applying a global perspective with a growing emphasis on low-income and middle-income countries, improving inclusiveness and equity in research, making translation an integral part of research for real-world impact, taking an 'upstream' public health approach, and working across disciplines and sectors to co-design research and co-create solutions. We have summarised lessons learnt and recommendations for future research as 'roadmaps' in progress to encourage moving the field of physical activity towards achieving population-level impact globally.

Attacking the pandemic of physical inactivity: what is holding us back?

Abstract: Physical inactivity was characterised as a global pandemic in the 2012 Lancet series on physical activity and health.1 The extent of the pandemic, causes and potential solutions were further explored in other papers in the 2012 and 2016 series, and recommendations derived from these papers and an associated workshop are summarised by Ding et al. 2 This paper builds on these syntheses of global knowledge and assesses progress or the lack thereof in addressing the global pandemic of physical inactivity. Ding et al noted the substantial growth of research on physical activity and public health, progress in integrating physical activity into public health policy and practice and make recommendations for closing still important gaps in knowledge. However, population level advances in public health programmes and policies lag behind those seen in equivalently important areas of public health such as HIV prevention, maternal mortality and tobacco control. Clearly, one of the reasons for lack of progress is that physical inactivity, much like diet, obesity and diabetes, is a complex problem requiring solutions across many sectors and at many levels. There is no silver bullet for physical activity promotion. In the current editorial, we examine whether we are failing to implement proven strategies or do not yet truly understand what works to increase population levels of physical activity and close with recommendations for researchers and policymakers. Physical activity is now widely accepted as a global public health issue with many countries including it within national public health plans. Unfortunately, physical activity is often treated as a secondary factor hidden in broad non-communicable disease planning efforts. The 2018 WHO Global Action Plan for Physical Activity (GAPPA) may be the best manifestation of physical activity joining the mainstream of public health.3 It is well elucidated, evidence-based and engages multiple sectors, strategies and …

National physical activity and sedentary behaviour policies in 76 countries: availability, comprehensiveness, implementation, and effectiveness

Abstract: Evidence on current, national physical activity (PA) and sedentary behaviour (SB) policies is limited. We, therefore, analysed availability, comprehensiveness, implementation, and effectiveness of PA and SB policies internationally. In this cross-sectional study, Global Observatory for Physical Activity (GoPA!) Country Contacts from 173 countries were asked to provide data on their national PA and SB policies by completing GoPA! Policy Inventory. Data were collected for 76 countries (response rate = 44%). Formal written policies for PA and SB were found in 92% (95% confidence interval [CI]: 86, 98) and 62% (95% CI: 50, 75) of countries, respectively. Sixty-two percent (95% CI: 51, 73) of countries have national PA guidelines, while 40% (95% CI: 29, 52) have SB guidelines. Fifty-two (95% CI: 40, 64) and 11% (95% CI: 3, 19) of countries have quantifiable national targets for PA and SB, respectively. The most represented ministries/departments involved in the promotion of more PA and/or less SB were in the sport (reported by 99% countries; 95% CI: 96, 100), health (97%; 95% CI: 94, 100), education (94%; 95% CI: 88, 100), and recreation and leisure (85%; 95% CI: 71, 99) sectors. The median score (0–10) for the comprehensiveness of PA and SB policies was 4 (95% CI: 4, 5) and 2 (95% CI: 2, 3), respectively. For PA and SB policy implementation it was 6 (95% CI: 5, 6). For the effectiveness of PA and SB policies it was 4 (95% CI: 3, 5) and 3 (95% CI: 2, 4), respectively. PA and SB policies were generally best developed in high-income countries and countries of European and Western-Pacific regions. Most of the included countries have PA policies, but their comprehensiveness, implementation, and effectiveness are generally low-to-moderate. SB policies are less available, comprehensive, implemented, and effective than PA policies. PA and SB policies are better developed in high-income countries, compared with low- and lower-middle-income countries, and in countries of European and Western-Pacific regions, compared with other world regions. More investment is needed in development and implementation of comprehensive and effective PA and SB policies, particularly in low- and lower-middle-income countries.

Worldwide surveillance, policy, and research on physical activity and health: The global observatory for physical activity

Abstract: Background:The Global Observatory for Physical Activity (GoPA!) was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide.Methods:Information was collected for 217 countries. For 139 of these nations we identified a contact who confirmed information’s accuracy and completeness. Associations were calculated among surveillance, policy and research categories.Results:Of the 139 countries, 90.6% reported having completed 1 or more PA survey, but less than one-third had 3 or more. 106 included PA on a national plan, but only one-quarter of these were PA-specific. At least 1 peer reviewed publication was identified for 63.3% of the countries. Positive associations (P < .001) were found between research and policy (ρ = 0.35), research and surveillance (ρ = 0.41), and surveillance and policy (ρ = 0.31). Countries with a standalone plan were more likely to have surve...

World Health Organization 2020 guidelines on physical activity and sedentary behaviour

Abstract: Objectives To describe new WHO 2020 guidelines on physical activity and sedentary behaviour. Methods The guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations. Results The new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150-300 min of moderate-intensity, or 75-150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold. Conclusion These 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 and to strengthen surveillance systems that track progress towards national and global targets.

An Atlas of Anatomy.

Abstract: The pleasure of the undertaking lies not in reaching Xanadu-I am sure that no true scholar has yet found rest in that fabulous city-but rather in disclosing the road that leads ever onward to that goal. As the author states, such a venture into bibliography is to follow a path which enters \"a dark forest full of unsuspected brambles.\" It is obvious that the brambles but exerted a stimulus, for the search for Vesalian material continued over a period of 40 years. And it is evident that the journey was a pleasant one; deciphering the uncertain sign-posts by the way, making due count of those posts that mark the mfles; perchance retracing many steps to correct a waywardness induced by intriguing circumstances; attaining one objective only to find another ever more forcefully beckoning; these must have been the charms to compensate for so much labor. For the objective was \"to place the published writings of Vesalius in proper relation to those episodes of his life of which there is contemporary record,\" and this after a lapse of some 400 years. This has been admirably done; out of a wealth of scholarly study, and with more than a trace of sly humor, emerges Vesalius,-the man, his books, and the background of both. A name in the history of medicine becomes human, an everyday sort of person (in many respects) in an everyday world, if chance and mischance heaped the one upon the other can make an everyday world of the period that saw Galenism face a challenge. The title clearly indicates the double-barrelled nature of the book; it cannot fail to meet the approval of those who choose to focus on the \"Bio,\" while it will give equal satisfaction to those who would emphasize the \"Biblio.\" And for those who appreciate the artistry of fine book-making the volume affords great reward. -GEO. H. SMITH.